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Help: reduce triplets to twins or to a singleton?

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  1. #1
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    Help: reduce triplets to twins or to a singleton?


    We are currently 9 weeks pregnant with triplets and will definetly be reducing. But we are debating on reducing to twins or singleton.

    Reducing to twins is simply for the reasons to keep the pregnancy and remove the risks that a triplet pregnancy brings. But we are still very afraid of the lifestyle afterward with twins. We already have a 2-year old son. Our concern is that if we have twins we will have NO time for him. And not to mention the mental stress that caring for twins would bring. Im not sure of my abilities to handle it. For these reasons I am considering a singleton. (Husband wants singleton for sure - he is not debating. but i feel his reasons are mostly financial thoughts.)

    However, I am concerned about my emotions after the procedure. I dont know if I would regret the decision to reduce to a singleton - or feel guilty about it since its more a social/personal reason rather than pregnancy risk.

    I was completely distraught when i first found out we are pregnant with triplets. and afterwards distraught about the thought of the reduction. now it has sunk in and I have not looked at an u/s or anything since. I am completely disconnected from this pregnancy right now actually. Im hoping that avoiding the u/s will help with dealing with the reduction.

    Im looking for advice from you guys. How did you deal with the decision to reduce to 2 or 1?

    And if anyone reduced to 1 with the option to reduce to 2, how did you feel about it afterwards?

    and anyone that has twins and other children, how do you think this impacted your life and the life of your other children?

    I have about 3 weeks to go before I can make this decision.

    Thanks so much in advance.
    I am so happy to find this forum to talk to others about this topic.


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  3. #2
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    Hi. Congrats on your pregnancy. I'm sorry that you have the face reduction when this should be a time of complete joy. Are you having a CVS done? I would feel the exact same way as you in regards to twin vs. singleton. I would probably go for a singleton because I doubt that I would be able to carry twins to term, as I dealt with cervix issues with my pregnancy. My husband would also feel the same as your husband. Good luck.
    Me:33 DH:34 TTC#1 Aug'08
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    Mar'10: Taking mental break, BFP
    Beautiful DD 11/24/10
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  4. #3
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    I'm so sorry you are facing this - no one plans to get pregnant with 3.

    Only you can answer the question of what to do. In our case, it was my 1st pregnancy. We knew all along that while twins would be OK, triplets would not (both for health reasons as well as our family dynamics). We never wanted more than 2 children total. So while it was heartwrenching, that was more due to the risk of losing the pregnancy vs. being a moral issue.

    What we did was see a psychologist affliated with the RE office, that really helped us (especially me) come to terms with what to do. I have to say I cried almost the entire 1st session.

    Just know whatever decision you make, make it and don't look back. There is no right or wrong re: twins vs. a singleton, it's what is best for you, your DH and your 2 year old.

    I have to say years later (10) I have very little regrets.

    We are here for you, HUGS.


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    UGH..where to begin? CONGRATS I too was pregnant with multiples. I went through infertility and IUI and ended up with triplets. I had my son at 32 weeks and he was a singleton. I have hypertension and knew I was setting myself up for failure with triplets with this pregnancy. I am not sure where you live but we used Marc Evans in NYC and had our reduction in November and I was just 13 weeks. He did not take insurance but I LOVED him as much as one could love a Dr. carrying out such a procedure. I thought it was painful. Everyone said it wasn't but I would be sugar coating it if I said that. It was fast...but very uncomfortable. The CVS testing was much more painful than the reduction. However after it was over I felt so relieved that I had gotten through this chapter of my life. (i cry writing this as it seems like such a distant nightmare to me) I am currently 23 weeks pregnant and not sure I will ever "enjoy" this pregnancy as it started out as a nigtmare. I would be more than willing to chat with you on the phone at some point if you would like. (message me) I would have never gotten through this w/o the advice from ladies who had been through this too. I did as everyone one else has told you I removed myself emotionally as much as possible. I didn't see u/s, didn't listen to h/bs and referred to everything in very clinical terms. It helped me through this time. Prior to my reduction, I felt sick every day both emotionally and physically. After my reduction all I felt was relief! I currently feel angry that I had to make such a difficult choice but try to only think about the future and the little girl that is growing inside of me. Surround yourslef with people who support you and your decision. Unfortunetly we didn;t not have the support of our family which made things even worse. I would lie if I said I never think about what was....but I quickly snap out of it and know it was not a choice but something we HAD to do to help ensure the health of me and a baby. Hang in there and know there are many women who have been though this. Please let me know how I can support you


  6. #5
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    my opinion is to reduce to twins if you are healthy...but again you have to do what feels right to "you". Everybody here made a very personal choice. Some women choose to have quints, quads, triplets and not to reduce and they feel comfortable with that. My-self I reduced from quads to twins because I was told if you reduce more than what you are left with, it is more risky. Also, I feel comfortable with twins and already had experience bringing up my 3 year old so feel I could handle twins. Someone from this board wrote (forgot who??) that for one week you should pretend that you reduced to twins, then another week pretend you reduced to a singleton...see how you feel...give it some thought...ask your doctors...talk to people who know your situation and ask them their opinion and then think for yourself and have no regrets.

  7. #6
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    Congratulations on the pregnancy!

    I'd consider the following:
    1. Would you have trouble carrying twins?
    2. Did you have any other complications in your prior pregnancy?
    3. Are they identical or fraternal? do any share a placenta?
    4. Are you going to have CVS performed?
    5. Can you financially afford three?
    6. Would having twins negatively affect your relationship with you DH, especially since he only wants one more?

    All I'm trying to say is that you should (IMO) sort out all these details, then look at your options. You have some time; hang in there. It will get better.

    Best of luck, and keep us informed!
    TTC#1 Since 09/2010
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    Cycles 1 and 2: Combo with IUI: BFN
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    Beta 1: 640ish 12DPO
    US 1: 3 Sacs, US 2: 4 Sacs + 4 Sacs with Fetal Poles, US 3: 8 Babies

    January 14th: Reducing from Octuplets to Twins

  8. #7
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    Hi Sam,
    Well, I know *exactly* where you're coming from. I was pg with quads at the start of my current pregnancy, and I have a 3 yo daughter. I chose to reduce to a singleton, though there was no medical reason to assume I couldn't carry twins as safely as anyone else (in other words, more risk than a singleton, but a level that for whatever reason is generally considered acceptable).

    My reasons were similar to what you're considering. I felt like I would never be able to be a good mother to my 3 yo if I had two babies. I also felt like I would never have a one-on-one relationship with either of the babies. I also had some post-partum depression with my daughter, and am really hoping to be able to be in a better place for the newborn phase the second time around. I was pretty sure that the newborn phase with TWO newborns would generate at least as much PPD, probably more. Also, I was worried that I'd never see my husband again, and that the stress would be terribly destructive for our relationship. Finally, he was laid off when I was about 8 weeks pg with the quads, and I work outside the home full time, but I just couldn't imagine how we could afford it. The only people I know with twins and an older child who handled it relatively well could afford a LOT of help. They had a night nurse 2-4 nights a week for 8 weeks, then a nanny full time starting at 6 weeks. There is no way in the world we could afford any of that, and those things struck me as essential.

    Those things said, if left to his own devices, my husband would have chosen to have twins, not because he exactly wants twins, but he thinks he'd like three children altogether, and given that, we should just sort of cope with the first year of intense stress and then it would be okay. He was very supportive of my saying that I didn't think I could be a good mother to twins, and we agreed to reduce to a singleton together. It helped that my doctor also was very clear that the least risky pregnancy is a singleton pregnancy, though he was also completely open to the possibility of twins.

    I'm now about 30 weeks pregnant, and I'm not done coping with this decision. Every time I see twins, or hear about someone with an older child and twins, I think "they can do it, why couldn't I?" and begin to judge myself very harshly. Additionally when my husband and I agreed to reduce to a singleton, we also agreed that we would seriously consider having a third child in a year or two. I find myself obsessing about this possibility-- I know he still wants three children, but I am, unfortunately, increasingly certain that I don't. The thought of being pregnant again, of the newborn phase again, and really, of having more children than parents, continues to strike me as horribly difficult and unpleasant. When I let myself consider being "done" with this pregnancy, I feel an incredible sense of relief and joy. So that issue is deeply unresolved for me, but since you said your husband would prefer to reduce to one, your situation is a little different in that regard.

    I'm not sure if any of what I have said is helpful-- I fear I may have provided weight to BOTH sides of the decision you're considering. Nonetheless, I did want you know that other people have considered and made decisions on all sides of this issue. Good luck, and I'm happy to try to discuss more if it's helpful.

  9. #8
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    I faced a similar decision last spring when I got pregnant with quads and had a 2 year old already. Our decision was to reduce to one (though I wound up losing the pregnancy a few days after the reduction anyway), and we would make the same decision today. We only ever wanted 2 kids, but if we wound up with twins the second time, we would have kept them and been fine with it. However, once we decided to reduce anyway after facing high-order multiples, the question became what would be best for us and our family, including the welfare of our son? Our preference was one, we felt reducing to one would give that one the best chances, and I had gestational diabetes with my earlier pregnancy and I'm "old" (36), so one would be a more sound medical choice given those possible complications. Additionally, I worried about the impacts to my son if we had twins (would mean taking him out of daycare where he is thriving, and getting a nanny for 3 at home), plus generally less attention.
    It's a personal decision that only you can make, but I encourage you to discuss it fullly with your husband and maybe a therapist that specializes in this issue.....then you can feel confident you've really considered it and made the best decison for you.....and that's the best any of us can do in life!
    Good luck! Christineam
    PS- For the procedures, I'd encourage you to continue to detach from the process until your follow-up visit post-SR (several postings about this). It was VERY hard to lose my pregnancy late 1st trimester post-SR, but at least I don't have visuals in my head since I quit looking at the U/S after the initial quad diagnosis. Also, don't let my loss freak you out too much- during my year on this board, I've seen way more happy endings than sad ones.

  10. #9
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    I cant thank all of you enough for your responses. This is a long message - Im so excited to find a group that really understands it all that I have so much to talk about with you!

    We are going to be using Dr Silver in Chicago, and he doesn't recommend the cvs, although hes not against it. He prefers to use the 1st trimester scan (BUN?) because it gives you lots of info to make a decision on which to reduce, and its non-invasive. I havent had this yet - its done in the 11th week.

    And all 3 of ours are fraternal. There is some SLIGHT concern over 1 of them as it is almost a week behind the others in size. at 6 weeks it was only a day or 2 behind, but each u/s after (7+ and 8+ weeks) it was further and further behind. but the doctor says the heartbeat is good, and that multiples can have a synergistic effect on each other and keep each other going.

    I was borderline gestational diabetes with my first pregnancy. So that concerns me with the idea of twins because i am pretty sure that i would end up with it as twins increase the risk of it. however, I have been told NOT to use that as a factor because it is something that can be controlled and treated. Otherwise my pregnancy was healthy - my son came at 38 weeks - we had induced because i was retaining fluid like crazy and could barely walk (feet severely swollen).

    I am also 36 and overweight. So this concerns me too. But again Dr Silver said most twin pregnancies are to older moms and most pregnancies women are overweight. None of these concerns are concerns to him. So although I havent written any of my concerns off completely, I have lowered their importance in my decision making.

    Both Dr Silver (reduction doc) and my IVF doctor recommend reducing to twins although the decision is completely mine/husbands. They say its the least risky. However in doing my research I called NYC Mark Evans and got to speak with him. He said the least risk is to reduce to a singleton. the procedure to reduce 2 is slightly higher than reducing 1, but that a singleton pregnancies reduces the overall pregnancy risk and that outweighs the procedure risk. Dr silver only does a few reductions a month, Dr Evans does a few a day. So I take Evans opinion very seriously.

    Unfortunately as many of you know - Evans doesnt take insurance. We have thought about paying for it, but its hard to do when he is further from us and we have an option that takes insurance.

    Financially we are OK. Twins does scare me financially. I would be jumping from 1 daycare fee to 3 daycare fees. and the cost of diapers is the biggest other cost. So - i think we could make it but we would have to cut out a lot of crap from the budget. We would struggle a bit financially i think.

    I have the support of 1 friend and my mom (other than hubby). Although my mom doesnt know we are considering reducing to 1. My friend greatly supports reducing to 1. Her sister is a OB and she spoke to her sister about this (without telling her it was about me). Her sister recommended reducing to 1 because its the easiest/least risky pregnancy. And this friend also knows a couple that has twins - and thier pregnancy and life is stressful. And the couple is 2 women - both of which are maternal. My mom --- well if i reduce to 1 i think i will just have to tell her the concerns of my age and gest diabetes. For her its really about medical needs - but she is completely supportive of the reduction from triplets as she knows i would have the odds against me of having healthy pregnancy and babies.

    I think the things that concern me the most are:

    1. what kind of mom would i be to 2 babies?
    see someone that would have twins as thier first pregnancy, they dont know what they are getting into. However I have a son, I know very well what im getting into. Im not sure I can do it. Did everyone else have this concern? How did you get past it?

    2. what kind of mom would i be to my first son?
    I really dont think its fair to him to be completely ignored. and right now i feel guilt about time spent with him. I wish i could have less housework time and more time with him. So i already have guilt over the time he gets. Poor kid, he things its fun to use wipes on the cabinets and the broom to clean the floor.

    3. what affect will this have on my marriage?
    i worry greatly that having twins will strain our marriage. we are not on the rocks at all, but i think the strain of twins could stress any any marriage. and i think it would be a long time before the stress of twins would be manageable.

    4. i worry about regrets if i reduce to a singleton.
    its easy to agree to reduce to twins as it is extremely logical when you look at the numbers/risks. however, i feel somewhat guilty about the thought of reducing to a singleton for personal reasons only (non-medical). I feel like i WANT a singleton instead of twins. But will i hate myself for it later? Its so hard to know how i will feel after it all.

    5. will i ever want to be pregnant again?
    my husband and i have always considered the possibility of have up to 4 kids. we just always felt it was based on our circumstances if we would keep having more. so - if we reduce to 1, we just assumed that we would be adding 1 at a time! im concerned about my emotions about getting pregnant again. but we also discussed adoption (hes originally from india and we discussed adopting from india). but if i reduce to twins instead of 1, then maybe we would feel complete?

    thanks for the idea of pretending a week of twins and a week of one. i think this is a great idea.

    Thank you! your situation is nearly identical to mine. I will be messaging you if you dont mind.

    Your situation is so much like mine. I was borderline gest diabetes and I am 36 too. And your concerns about family are the ones I have. I will be messaging you if you dont mind.

  11. #10
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    Samantha- Although I have never been in your situation, I do have Twins and now i have a singleton. I don't know if I will be of any help, but I hope you get something out of it.

    Your question-
    1. what kind of mom would i be to 2 babies?
    see someone that would have twins as thier first pregnancy, they dont know what they are getting into. However I have a son, I know very well what im getting into. Im not sure I can do it. Did everyone else have this concern? How did you get past it?

    Having 3 kids is amazing. My twins who are 2.5yr old adore their little sister ( 4mon old). It took a few weeks to adjust to a schedule, but they have all adapted very well.

    I lost twins at 21wks. I delivered both of them. Taryn livedm,,, , for 5hrs and Anthonie-James lived for 1.5hrs. Precious time. They were a result of 2 blasts from IVF cycle #3. ... 6mon later I put 2 blast back again ( ivf #4).. knowing i had the possibility of having twins again. Yes it happened again :-). My twins made it to 34wks and are now a healthy 2.5yrs old.

    I know its overwhelming, but Twins are simply amazing!!! When we decided to TTC again, we were going to put back 2 frozen embryos, but only 1 survived and we ended up putting 1 (6d) blast back which is the result of our now 4mon old.
    *~* Proud Mommy of *~*
    Twin Angels~ Taryn & Anthonie-James (b/d March 2007)
    Living Miracle Twins~ Austin & Trinity (May 2008)
    Our Newest member~ Abigail (Sept 2010)

    Baby #4 on HIS way!!

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