IVF Twins: 2 girls, or 1 boy + 1 girl, what would you pick?

[chuckm]

EDIT: Not sure why folks are choosing to downvote, but please read the post + comments before you do so. Actively looking for advice from this sub on whether or not to transfer 2 embryos after loss.

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Hey everyone, I'm new to this sub and posting here to get a better understanding of what it's like to have multiples so my husband and I can make an informed decision on if this path is right for us. My intention here isn't to play God, we've had a long and difficult fertility journey so far: 3+ years TTC, 18 months of IVF (2 egg retrievals, 2 failed embryo transfers, and 1 embryo transfer resulting in an early miscarriage). Our goal is to optimize for a healthy live birth, not necessarily twins, we will be thrilled with any outcome.

I'm gearing up for my 4th embryo transfer scheduled for mid April, and our fertility doctor has encouraged us to think about implanting 2 embryos this time to increase our chance of success (he is very pro implanting 2). I know this obviously comes with additional personal risk but I'm healthy (31, 5'8", 135lbs, in shape) and seriously considering it. Also, I'm aware that parenting is going to be difficult regardless of singleton vs multiples, but I have full confidence that our marriage can handle it (IVF has brought us closer than ever).

I'm here to ask you all a couple of things:

1. Knowing what you know now, would you recommend having twins? If given the choice to go back in time would you do it again?
2. If you had the ability to choose whether or not to have twins and what their genders are, what would you pick and why? (See poll below)

For those of you who are curious, we currently have 6 euploid embryos (5F + 1M). Thanks so much in advance for your thoughts

View Poll

 

[johnvladimir]

@chuckm I don’t have experience with IVF, my twins were spontaneous.

That said, if I were to try to imagine myself in your shoes I would want to do whatever my doctor recommends as my best shot to have a viable and healthy pregnancy.

If that’s transferring two, that’s what I’d go for. But if your doctor doesn’t think it’s necessary or makes a difference in your chances of being a baby home, I wouldn’t do it. Twins are wonderful and turned out the right thing for our specific family circumstance, but raising them is hard and a twin pregnancy is much more risky than a singleton. So, I wouldn’t invite all that complication in unless it’s what your doctor is advising as your best shot.

As for the two sexes, I mean again I’d go with whatever the doctor feels is the best candidate(s). Every kid is different with their own personality, regardless of whether they are male or female.

 

[chuckm]

@johnvladimir Hey thanks for your insight. As mentioned in my OP, our REI is strongly encouraging us to implant 2 given our lack of success with our 3 previous transfers. After my second egg retrieval, we were so thrilled to find out that we have 6 genetically normal embryos, all with similar grading (likelihood of success) so the choice of which one(s) to transfer isn't obvious.

I actually wish I didn't know the genders of our embryos (it is apart of the PGT report), but now that I know, I can't help but imagine my life with a variety of different outcomes: singleton vs. twin girls / twin boy + girl. The reason I ask about gender specifically is because I can imagine same sex twins feeling the need to compete for the same group of friends, activity achievements, etc. whereas having two singleton twins of different genders might provide more space for each child to lean in to their individuality.

At this point we're just looking for guidance from this community (since y'all are multiples experts) to help us make the best decision for us. Thanks!

 

[xuxu]

@chuckm We transferred two euploid embryos on our third try with IVF, after two failed transfers and a couple years of trying before that. At that point we were desperate and hoping anything would stick. Our doctor suggested it but didn’t push it. I was about to turn 37, so we were sort of open to twins because we wanted two kids anyway, but we had NO idea what we would be getting ourselves into. They both stuck, and after a very stressful and medically complex pregnancy we now have b-g twins.

I am so grateful for both of my kiddos, and because of my age I’m not sure we’d have tried for a second one had we only had one. And I can’t imagine not having met either one. But the pregnancy was HARD and terrifying. And these first two years have been profoundly hard. I have not really gotten to show up as the parent I wanted to be. You just can’t. You have to divide your attention 100% of the time. You never feel like you’re giving enough to each one. The guilt is immense.

Transfer one at a time. You have plenty of time.

 

[xuxu]

Also - I was in great shape, too, zero risk factors for anything other than being 36-37. And I acquired a large number of scary complications. There are complications that they don’t tell you about that you’re at much higher risk for because of IVF, too - both my placentas had velamentous cord insertion, which makes vaginal birth extremely unsafe for the baby/ies, and which involved a lot of monitoring. My MFM said the best guess as to why this is associated with IVF is because with PGT testing they take cells from what will become the placenta.

 

[chuckm]

@xuxu Thanks so much for sharing your experience. It’s incredibly helpful to have a better understanding of what pregnancy might look like with twins, and to be more aware of possible complications. As I mentioned earlier, we’re not exactly optimizing for twins but a healthy live birth, and our REI is the one strongly encouraging us to transfer 2 after the last 3 unsuccessful cycles. If we were to end up with twins, I want to make sure that I’ve done my research in advance so I feel prepared with what to expect.

Also, given that we are in a unique situation where we can choose how many embryos and gender, part of my question above is trying to better understand the different dynamics between b-g twins vs g-g twins, and (sorry if this sounds messed up, not my intention at all) if one pair is hypothetically more ideal than the other, for whatever reasons.

Thanks again!

 

[xuxu]

@chuckm We had four euploid embryos and they all had the same grade. We picked one of each so that if one stuck we wouldn’t know which and we could still be surprised by the sex.

And honesty, I didn’t think anything would work at that point. I was so sick of infertility and IVF by then. I’m so sorry you’re in the middle of it. I didn’t want to just transfer one at a time and have four more failed transfers. I didn’t want to spend another year of my life like that! Transferring two made a lot of sense in that context, but it was so abstract. My partner spent the entire first year of our twins lives feeling so angry with himself that he advocated for transferring two - it was just so, so hard.

As for dynamics, ours fight a lot but I think it has nothing to do with sex or gender - it’s developmentally normal at 2 years old and it’s a significant daily challenge (I’m a SAHP right now). Older twin parents have told me theirs fight a lot too, but are great friends now at 10 or at 18 or whatever.

 

[bryantkm]

@chuckm We struggled as well.

So many transfers and disappointments. Then our singleton came along with a double embryo transfer. He cried incessantly as a baby, testing our sanity on multiple occasions. That said, we still wanted a second, and, maybe in the distant future a third. (Well, I did at least, her not so much.)

We started trying about 1.5 years later, transferring one embryo of "high" rating twice with both failures. Then we decided the heartache wasn't worth two more transfers of the "low" rating. So, we doubled down on that last transfer and ended up with beautiful fraternal girls.

I can certainly say twins are parenting hard mode as babies, toddlers, and pre-schoolers. It's a completely different set of circumstances than a singleton until elementary school, where I've found it has gotten immensely easier to manage. If I had a mulligan, I would go back and transfer one at a time. I love my girls, but managing twins has changed a lot in our life (emotional well-being, physical health, financial situation, and so on). I'm not entirely sure you can imagine how difficult it really is, and this was after we already had a grasp of what raising a baby was like. There's a reason that there are so many posts about a multiples parent blood-boiling when they're told, "My Irish twins are just like yours."

I love my family, but I would rather have had two or three singletons.

 

[chuckm]

@bryantkm Thanks so much for sharing your perspective. I'm so sorry that you also had to go through IVF, but it sounds like you have a beautiful family, and that gives me hope for my own. You're absolutely right that I don't know what it's like to be a parent, but we're ready to accept whatever outcome gets thrown our way (twins or singleton).

If you don't mind me asking, how are your twin girls doing now? Are they close? Do you feel like they are more competitive than singleton born sisters? Do you think they like having the other so embedded in their life?

 

[bryantkm]

@chuckm My girls, 6yo now, are just awesome. They were very close up until 1st grade where they have branched out to their own social paths despite being in the same class. One is a little social butterfly with friends across her grade-level and multiple schedules of play time to observe during recess. The other is more introverted and tends to stick to herself but does have strong relationships with a few children. Plus, she is much more academically inclined.

They (and us to some extent) compare them against each other naturally. It's hard not to compare considering they're the same age, exposed to the same environment, and around each other a significant portion of their lives. I doubt it makes them more competitive than a singleton. Both of us parents have a competitive streak, so they have that, too. They definitely play well together at home without too much drama, so I don't think it affects their relationship.

I don't know much about twins resenting one another. They definitely do not want to be referred to as "the twins." We've done a pretty good job at calling them by their names and developing their own identities so that they don't get labeled as their birth situation. We encourage them to have their own interests as well. I've heard that helps immensely in their self-image growing up.

Follow-up to my comment regarding twin parenting... I asked my wife about this response, and she said you shouldn't be afraid of twins - just be realistic about how much community/family help it takes to raise them. When it's just one kiddo, two able-bodied adults can usually handle the situation with little to no help. With twins, and possibly recovery from a C-section, it becomes hard to manage life while also taking care of them early on. This was of course compounded for us by having a 3-year-old around at the time, though. I did everything I could to help, up to changing every diaper until my wife was on her own following my return to work. Unfortunately, I was pretty burned out by that time. I wish I had asked for more help from my family and friends.

 

[nirajrana]

@chuckm Look I did this……I was at the end of my rope and transferred two embryos and both stuck.

While I don’t regret it, but it turned out reasonably well in my case in terms of long term health complications for me and for the babies.

A twin pregnancy is a LOT more risky!!!!! It’s far more common to get complications than to NOT have complications in a twin pregnancy. Some of those complications are “minor” like gestational diabetes (which every twin mom I know IRL got during pregnancy) or being forced into a c section bc Baby B is breech and no one at the hospital is comfortable delivering the second twin breech. Others have much more longer term effects……..very preterm birth is much more common in twin pregnancies than singletons and that can result in NICU stays for weeks or months.

I had an “uncomplicated” twin pregnancy according to my doctor. I got gestational diabetes, severe edema starting at 16 weeks (had to eat low sodium to help reduce this, and gave birth at 36 weeks. I had to have a c section and my Baby B was born with fluid in her lungs. Her lung collapsed and she had to have a procedure within 24 hrs and was in the NICU for 3 weeks on oxygen. My baby A was relatively ok and had no NICU time. This is a pretty good outcome for twins.

My milk never came in and I was in severe pain at 6 weeks PP…….turns out I had a retained placenta and had to have a D&C at 7 weeks PP. Still had bad pelvic pain and had to go to 6-7 months of physical therapy to o stop being in pain 24/7. At 17 months PP, I still have to be careful not to do too much or the pain returns. Really a twin pregnancy can do a number on your body.

I wouldn’t trade my babies for anything, but I would never ever recommend transferring two embryos.

ETA: my embryos were untested……I don’t think my RE would have let me transfer two if they were tested. If the embryos are tested, it’s more about the uterine environment.

 

[chuckm]

@nirajrana Wow I’m so sorry you went through all that but I’m so happy you and your babies are ok! Thanks so much for sharing your story, again very helpful to get a realistic picture into what a twin pregnancy might look like, and the different complications that can occur.

 

[chestertonleddihn]

@chuckm I'm still confused because implanting two was the norm when I tried 20 years ago but apparently when I mentioned that I got downvoted to hell lol (did two then three, both from frozen, neither worked).

Obviously, I'd go for the healthiest ones. But all things being the same, I'd go for boy and girl just because growing up with a twin of the same gender can be just exhausting (although in my case I had boy and girl and the girl turned out to be transgender anyway).

And yes I'd do two, but again, insurance didn't cover it for us at the time, so it would depend on that a lot too. If they are already frozen and it's not a huge financial problem, I'd go for 1...

 

[chuckm]

@chestertonleddihn I heard that as well (historically multiple transfers), but given more recent advancements with genetic testing (PGT and mitoscores), most REIs will typically advise one "normal" or euploid embryo at a time.

My doc feels strongly that we should try two with this upcoming round to best optimize our chances of success (all 6 embryos are all well graded). At the same time he's not carrying the pregnancy, and "success" doesn't just mean achieving pregnancy but a live birth of a happy / healthy baby(ies).

This is a big decision and we want to make sure we're aware of the pros and cons of each path forward. I feel so fortunate to be able to reach out to communities like this to ask for advice from people that have lived our possible reality, so thanks again for taking the time to share.

 

[hurahitag]

@chuckm I had a daughter with IVF in 2020. It took three full cycles before we had success. We wanted to try for a sibling, and went through three additional full rounds of IVF. Due to my age and embryo quality issues, we transferred two embryos on our third and fourth transfers.

The fourth transfer resulted in a twin pregnancy, which was not our goal. We didn't know the sex of the embryos, but ended up with one boy and one girl. I would've been happy with any combination.

Twins are HARD. I love and adore them and wouldn't change anything, but it is incredibly hard. The pregnancy, the delivery, the newborn, and now toddler stage were magnitudes harder than my singleton.

 

[chuckm]

@hurahitag Thanks so much for sharing. I’m sorry that your journey to build your family was so difficult but I’m glad to hear that IVF can work out

 

[stevek]

@chuckm After having spontaneous identical twins my first pregnancy because it was physically brutal on me my husband and i are planning on doing IVF so we can have a son and thus one of each. Two girls and a boy. Twin pregnancy has way more risks compared to a singleton even if they are di/di. With that being said if your doctor is all for two i would listen to your doctor.

 

[chuckm]

@stevek Thanks for your input!

 

[mezzome]

@chuckm Twin pregnancy is no joke. By 6 months, I was standing to pee because my knees hurt when I sat, waking up at 3am everyday because my arms were numb, and couldn’t really walk much, cook, do dishes. I probably would have had gestational diabetes (which raises later risk for Diabetes) but I had a placental abruption and gave birth at 28 weeks after a week in labor trying to not be in labor anymore. Three months in the nicu, commuting an hour each way to be with them each day. Thankfully they haven’t shown major complications yet at 3 years old. I was older and not fit; some people do just fine and go full term. Some people have extreme prematurity with lifelong disabilities.

That said! I love having fraternal twins. I’m a child psychologist. It’s interesting and fun. We both work from home and have a nanny, for context. It’s very joyful and they love each other. They don’t really compete (two girls). Not sure if they will in the future. They’re already just very different (one is much taller and heavier and better at gross motor, the other is smaller and loves to tell jokes and be a rascal). I think if I were you and going to transfer two, I’d ask for it to be random

 

[mezzome]

Oh - besides the financial and wfh situation, another reason twins have been great for me is because my partner does at least half of the childcare and domestic labor, without me ever having to ask or direct. Important context. We split shifts at night. He did way more parenting when I was pumping.