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Dr. Wisot,

I have four blastocyst frozen. I do not have the specific grades, but two are high quality and two are low quality.

Our Doctor is not giving us a recommendation, rather assumed scenarios.

Option 1: implant two high grades will yield the best chances
Option 2: implant one high and one low. This will give us a second FET in case the first doesn't work.

This entire journey is out of pocket so we will not be able to afford another full IVF round. We could potentially afford the second FET but of course money is getting tight.

Do you have any suggestions or different views on this choice? My husband thinks option 2 is safer, while I feel we should do whatever we can to increase our chances the first time (option 1).

Your age is a very important component to this decision. The younger you are Option 2 would be preferred to avoid twins (assuming that a single embryo transfer is not an option). If you are 38 or above then Option1 would make more sense.

But I think this is something that your doctor should be advising you on. Not me.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California

Dr. Wisot,

I just did a FET using one of the high grade blastocysts. Our doctor and embryologist felt that it was a high enough grade to try as a single embryo transfer.

Unfortunately I ended up with a negative result. Our protocol consisted of bcp, estrace, ganerelix, PIO and crinone.

For our second FET (still deciding how many to implant) our new protocol will be bcp, LUPRON, estrace, PIO and crinone.

Do you see any advantages of using Lupron? I would prefer not to use it, especially if it will yield the same results as my first protocol, however, my doctor says it is "gold standard" to use Lupron for a frozen transfer.

I am 36 yrs old, husband 34 years old. Good lining during transfer. Healthy and easy transfer.

Thank you

The Lupron is usually used to prevent one from ovulating before you are ready to start progesterone. In most cases it is not necessary because the estrogen is usually enough to prevent the development of an ovulating follicle.

It may be your doctor's "gold standard" but it's not ours.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California