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Hello and I would be happy to help. Here is what I think that your doctor is worried about:1. In women who have had a prior myomectomy (that involves cutting into the muscle wall of the uterus)2. The muscle wall is 'compromised'. In most cases, these patients are not allowed to labor - they are scheduled for C-sections3. A certain, and not insignificant, number of women will have 'rupture' of the uterus before the onset of labor. This risk is increased in the setting of prior C-sections, and certainly with prior myomectomies4. Putting back two embryos that might result in twins (or even triplets) would increase these risks dramaticallySo, I agree with your doctor. Weighing the risk of twins and uterine rupture with potential loss of life of the twins (and you) against what would already be a higher risk pregnancy as a singleton is heavily in favor of the single embryo transfer.Does this makes sense?Dr. Tim
The only thing that would INCREASE the risk is having a shorter interval from the myomectomy to eventual C-section (less that 18 months between surgery and delivery). After that point, there is nothing that would further reduce the risk.
Based on the limited amount of information that I have available, I would agree with your doctor. In someone like you, I would STRONGLY suggest a second opinion. This does not have to be a fertility specialist. If you have a regular OB/GYN that still does Obstetrics, schedule a visit with them and see what they think.Dr. Tim
You are very welcome. Please take a moment to rate my answer (5 stars). This is greatly appreciated.Dr. Tim