To Twin or Not Two Twin

Well my friends, we got more good news from the lab today. Of the 11 embryos that fertilized initially, 9 of them are still growing normally!! The embryologist described them as "growing beautifully". We are simply thrilled. The transfer will happen on Saturday morning, followed by 48 hours of bedrest for me. Honestly, I'm sort of looking forward to that :)

OK, so here's the tough question between now and then. The doctor will ask us when we arrive on saturday whether we want to transfer one embryo or two. Here's the difference by the numbers: if you transfer one embryo, the chance of making it to delivery is about 60%. Of the people who do make it to delivery in that case, 2% will have twins, which represents the case where one embryo splits into two before implantation. These would of course be identical twins. If instead you transfer 2 embryos at once, the chance of making it to delivery is about 80%. Of those people who make it to delivery 40% will have twins (fraternal twins) and there is a theoretical 2% risk of triplets if one of the embryos were to split and all three implanted.

The difference between 60% and 80% success to delivery certainly feels like a lot. But of course, with 9 embryos growing we could try out hand at the 'one-at-a-time' several times in a row. The 60% chance each time would be in our favor. But this approach would require more patience. Also it would require money since each "frozen-transfer" is about $2,000. Now, compare that to the realistic risks of twins: higher preterm birth rate, more low-birth-weight babies, both of which require more time in the Neonatal ICU. These babies are at higher risk for scary things like neonatal stroke and birth defects. BUT, the absolute incidence of all these problems is actually really LOW. Most twins do just fine. And there's some new data out there showing you can improve outcomes with twin pregnancies if you ensure proper weight gain and nutrition early on for the mother.

So I really thought I had my decision figured out. Dane and I had agreed to have only one embryo transferred. That's what we said all along. But I keep coming back to the twins. I don't know why. My heart just keeps drifting back to it. This may sound crazy, but when I was growing up I thought I would have twins some day. My Nana gave birth to 3 sets of twins, and I was sure that I had inherited this "ability". Alas, I was quite wrong about that. And Nana's twins were actually subject to some harsh realities: only one set of three made it to adulthood. Of the other sets of twins, one set had one early death, the last set sadly both babies died. I think this fact alone commands a healthy dose of respect for the risks that come with 2 babies in one womb.

I'm sure that anyone would tell me "there's no right answer". I believe that. If there was a right answer, my doctors would strongly campaign for it. They have not been shy about telling me what to do up to this point. So it comes down to me and Dane. We have to figure out how much risk in terms of implantation failures we are willing to accept compared to the risk of all that comes along with twins.

Which, by the way, I didn't even discuss all the EXTRA WORK it must be to have two babies instead of one. Two crying babies, two dirty diapers, two times the laundry, two times the baby supplies, two teenagers the same age, two kids going to college at the same time!! AAAAHHHH!! Of course, for every scary thing, I'm sure there are rewards. Two smiling faces, two happy warm babies to hold and love, two beautiful people who always have a twin to be their best friend. I'm told it's a special bond.

Dear reader, If you feel you have any wisdom in this department, please feel free to comment below. I'll take whatever I can get. Thanks for listening, and wish me luck. I'll update again this weekend from my bed rest.