Well, I guess the MFM that I saw last week was unclear about me not being on bedrest because I AM! I finished off work last week and then had my first visit on Saturday from the "Antepartum Care at Home" nurses (they will visit twice a week and call every day) and I am DEFINITELY on bedrest. I have to keep a record of baby movements, vaginal discharge and contractions and report it to them each day. At 28 weeks I will get once weekly non-stress tests at home too. CRAZY! Sheesh, I was really hoping to avoid being a high-risk pregnancy but I guess my body has other plans. I tend to get about 2-4 contractions an hour...which on their own, isn't the issue...it's the fact that I'm having cervical changes as well that's the issue. I have my next ultrasound and cervical measurement next Thursday (the 4th). I am SO hoping that it has stayed the same or even gotten better now that I am reclining or laying down all day! I am trying to keep myself occupied with books, movies and Netflix and so far it's working but I'm sure I will start to get bored soon...and this is only day 4 of bedrest! So...if anyone has suggestions of good movies, TV shows or books, let me know!
This brings me to the topic of single-embryo transfer, which had always been our plan until we only got 2 embryos and had to transfer on Day 2. I guess I am a PERFECT example of what they are trying to avoid by doing SET's. My clinic is pretty strict about transferring only one at a time for people who are "good prognosis" (young, no history of multiple failed cycles etc) unless they think there is a good chance you won't get pregnant at all if they transfer just one (like in our situation). I fully believe in doing SETs to decrease multiple-births related to fertility treatments (kind of hilarious, considering my current situation). When I worked on a pediatric ward I saw many many formerly premature babies in with pneumonia, influenza, feeding issues, cerebral palsy etc. And we know that twins are at much higher risk of being premature. I know this is controversial, and its not like I am regretting my twins (I am so incredibly in love with these babies, please don't get me wrong!) but a singleton pregnancy would have been much lower risk. Just food for thought. Its hard though, to make the decision to transfer only one when there is so much money involved. You want to give yourself the best chance when you are laying down that kind of cash! However, there are studies that give almost equal pregnancy rates with one good-looking blastocyst transferred as compared to 2 or 3 transferred but with a non-existent multiples rate. Still, it's a hard sell! I think the solution is better funding for IF treatments. In Canada, only one province (Quebec) funds IVF and they have decreased their multiple-birth rate dramatically (therefore saving the healthcare system millions of dollars in preemie-care). They will pay for 3 IVF cycles as long as only one embryo is transferred in people under 35 and only 2 in people over 35. Paying for these cycles, and therefore avoiding a bunch of premature multiples saves them TONS of money! I wish all the provinces here would get a clue and follow in Quebec's footsteps! I'm no economist but it just makes sense! Our healthcare system is very different from the States so I am speaking from a purely Canadian perspective. Anyone else have opinions about this?
I plan on transferring more than 1, however I do agree with you. If all provinces covered IVF, I would be fine with a SET. It's sad to know that money plays an important role in my decision, but it's true. It is all such a role of the dice. I transferred FOUR last IVF and got a BFN. Not one of them even started to implant. You transferred two and got two. Some people transfer one and get identical twins... you just never know.
ReplyDeleteSorry to hear about your bedrest. Have you watched the show Parenthood? I'm watching it now and I like it.
Thanks for your thoughts. And of course, the key to single embryo transfer is "one excellent-looking blastocyst" which you didn't have on your last cycle and I didn't either. So, of course, it all depends on the situation! Hoping Cancun is treating you well!
DeleteGood luck with the bed rest. I start mine at 28 weeks. I too am looking for movies and books. One book I downloaded to my iPad and plan on reading is called "the happiest baby on the block". It's all about soothing. I've heard good things about it. Also try making a journel to the little ones about your pregnancy and journey, and how you can't wait to meet them. It's so strange that our children are going to see what they looked like a few days before transfer!!!!
ReplyDeleteWe'll be bed rest buddies! Thanks for your ideas...one thing I definitely plan on doing is making one of those digital photobooks of our journey. We took lots of pictures over the whole process (me waiting to have my septum surgery, me getting an injection, in the ultrasound room just after finding out it was twins etc) so I can't wait to put those all together. The last photo in the book will be of the babies! Oh, and I bought that Happiest Baby book used a few months ago. Thanks for reminding me, I'll have to start reading it!
DeleteLike you, I am acutely aware of the risks of a multiple pregnancy but even I succumbed to the fear of not getting pregnant at all on our first IVF transfer. We only had 2 embryos and only a 30 % chance of a singleton pregnancy. I was too afraid to not transfer both and when I looked at their picture I was in love and I wanted both. Totally not a rational decision. Obviously it didn't work and after that transfer I vowed never to transfer 2 again. Since we have the luxury of many frosties from our last cycle I feel much more able to choose SET and even though my RE is pressuring me to transfer 2 next time I won't do it. I don't know how I would handle the stress of a high risk pregnancy. I am sending good vibes your way and hoping you stabilize for the rest of the pregnancy.
ReplyDeleteThanks! And thanks for sharing your thoughts on SET as well! Hoping one of those frosties is your nice healthy singleton waiting to happen!
DeleteI'm sorry you are already on bed rest. Hopefully you find some things that entertain you.
ReplyDeleteThanks for your thoughts on the SET. My clinic is also pretty strict about transfering no more than one for people with good prognosis and I'm fully on board with it. As of now. But we'll see how I feel when we get closer to transfer. If we only have two to begin with and the chances to freeze one of them is slim - I'm not sure... Hopefully this isn't a decision we have to make.
I know, and like I said to "Gypsy Mama" above...it all depends on the situation. You'll just have to wait and see what happens. I never imagined that from 19 eggs we'd only have 2 embryos and I don't regret transferring two at all, it was the best choice at that moment. Can't wait to hear about your retrieval!
DeleteI'm so glad they have a good eye on you and your babes!
ReplyDeleteI agree with you on the funded IVF. Heck, even a little bit of coverage would be better than the absolute nothing that we got... oh pardon me, our insurance covered $9.38. Right now, we are in the debate of 1 or 2 in our FET... we really want to get our docs opinion, but I've always had this feeling that if we were placed in a position to make a choice, I would put 2 back.... definitely thinking more of all the risks now that we are so close to actually making the decision for real. What a huge responsibility!
You just rest up then and keep those babies tucked up warm.
ReplyDeleteI completely agree that Quebec has set a great precedent and all provinces should follow suit. I know that there's a push for it in AB. I thought I heard that Ontario has something in place now too?
ReplyDeleteI hope you don't go stir crazy on bedrest and your babies stay put for awhile longer!
As a person in the states with no IF insurance coverage at all, I can say it would be nice if it were mandated all over. It sounds like Quebec is setting a good example for what works. I have always wanted twins, but the high risk concerns that come with multiples is a little scary. Please take care of yourself and those babies! I agree with Gypsy Mama, Parenthood is a great show. I also really enjoyed the Hunger Game book series, if you haven't already read them. Other than that, I read a lot of blogs :)
ReplyDeleteI'm an advocate for SET's, after I finally fell pregnant on transfer 8 (a DET), with twins. I never thought it would happen. 7 previous BFNs (3 DET's & 4 SET's), why would 8 be any different.
ReplyDeleteI had a big bleed from one placenta at 21wks & continued to have recurrent bleeding up until their premature birth at 30+4.
I thank my lucky stars everyday, that they are here, safe & with no lasting medical issues so far.
I know a lot of clinics say that DET's increase the pregnancy rate, but that's incorrect. It only increases the chance of multiples.
I know I was doing DET's to end a nightmare. I never actually thought any would stick. I've since seen others who have had previous IVF success demand a DET, one who fell pregnant with triplets.
Anyway off my soapbox.
Enjoy your bedrest (as much as you can) & keep those two safe inside, for as long as you can.
Hope the cervix is behaving!
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