CD 9 - Day 6 of Stims - Our Final Decision for an eSET

M and I have been talking about it forever, but we needed to make a final decision on whether or not to transfer only one embryo on transfer date. It's important we figure these things out now rather than on transfer date. We came to the decision and just gave our doctor the below letter. While nervous, I know this is the right decision for us and our family-to-be. While everything could change on transfer date if we don't have a good quality embryo, it is important that our needs and desires are known and agreed upon by all.

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Hello Dr. O,

After much consideration and research, M and I have finally come to a conclusion regarding our embryo transfer, and as promised I am writing to inform you that we would like to go ahead and plan for an elective single embryo transfer (eSET). It is not our desire to have twins.

We understand eSET’s are not practiced widely in the United States so with this, we hope we have the support of you and the rest of the doctors in this option. I would appreciate if you could please mark this down in my charts and ensure the team of doctors as well as the embryologists understand this decision.

In my research I have found that 5-day blasts are best for eSET procedures, so we will be hoping and aiming towards a 5- day transfer if we have the quality in our embryos we're looking for. We understand this may not be possible and will ultimately depend on the quality after fertilization, however we want to set expectations that a 5-day transfer of one embryo/blast will be our goal.

Our goal would also be to freeze any remaining good quality embryos that qualify for freezing. We also understand that this isn't always possible, but want to ensure you know that this is our goal as well.

In addition to this, I'd like to tell you what our plans are if this first cycle fails. We understand that eSETs have a lower rate of pregnancy rate than DET or otherwise. This is a risk we are willing to take to prevent a multiple pregnancy. If indeed this cycle fails, we have chosen to do another fresh cycle, as opposed to an FET. We would like to of course, start this process as quickly as possible and understand there is a small waiting period before trying again. If there was the opportunity to change protocols, such as bypassing the BCP phase, this would be optimal. We can discuss further options if we need to cross this bridge, but for now, the take away here is that we will want to immediately go into a FRESH cycle not an FET (although we still want any good candidates to be frozen from the first cycle for children in the future).

We appreciate everyone's support in the next coming weeks, and hope we can make all of this happen successfully. I'm attaching an incredible study done in the UK on eSET just for your own reading pleasure. :) Attachment Here.

To summarize our wishes and decisions:

1. We want an eSET for this IVF cycle and we want to aim for a 5-day transfer.
2. We want to freeze any likely candidates for children in the future.
3. If the first IVF cycle fails, we want to do another Fresh Cycle and as quickly as possible.

Thanks so much and please let us know if you have any questions,
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