Experiences of an Endometrial Receptivity Array (ERA) biopsy

[PM985]

We are now considering an ERA biopsy before a 3rd FET attempt after 2 which failed due to suspected implantation failure.

Can anyone share their experiences of the ERA, such as...

1. How many biopsies / fake cycles are needed?
2. Were the results conclusive?
3. Did this result in implantation success?

I am in a similar situation. 8 failed iui cycles, 2 ivfs with failed implantation. Had 6 eggs collected today. Been suggested to do MRA but quite worried about how the experience will be. Any advise appreciated !

I had one fake cycle. Results showed I was pretty receptive and needed 48 hours more progesterone. Waiting to start my next cycle so can't comment on the success at this stage!

@Champakali

I am in a similar situation. 8 failed iui cycles, 2 ivfs with failed implantation. Had 6 eggs collected today. Been suggested to do MRA but quite worried about how the experience will be. Any advise appreciated !

Hi Champakali, sorry to hear about your failed cycles, implantation failure is really frustrating. I have not heard of an "MRA" - is this the same or different to an ERA? We have decided to go for an ERA and will have the biopsy later this month.

@okokok000

I had one fake cycle. Results showed I was pretty receptive and needed 48 hours more progesterone. Waiting to start my next cycle so can't comment on the success at this stage!

Hi okokok000, thank you for sharing your result and wishing you all the best for your next cycle with the modified progesterone. How did you find the ERA biopsy itself? Was it similar to an embryo transfer at all? How long did it take for your results to come back? Sorry for all the questions, we are currently on day 9 of our mock cycle so have a couple of weeks to go until the test itself. Would love to hear from you and whether this helped!

Hi OP,

The ERA itself was similar to egg collection, not transfer as I was put under deep sedation. This might be because my consultant recommended we do a hysteroscopy at the same time which saved the hassle of another cycle.

I was a little uncomfortable when I woke up but not too bad and I recovered pretty quickly.

My results took around 4 weeks to come back. I'd provisionally booked an appointment with my consultant so I didn't have to wait ages for my appointment. I'd ask the clinic when they typically get the results and get something booked in so you're not having to wait.

Thanks again @okokok000 - hope you are well and have had some luck after your FET?

I just thought I would come back and share my experience of the ERA itself - it was very similar to a embryo transfer in terms of the amount of time it takes to perform the procedure (15 min). Was recommended to take paracetamol before hand. There was some discomfort (lasted around 20 seconds) as a bigger catheter is needed to retrieve the biopsy (compared to a transfer). It took around 5 weeks for the results to come through which showed I was also pre-receptive and needed another 12 hours of progesterone.

Have just completed another FET cycle (this is our 3rd) and got our first ever BFP on Monday. Still very early days but I am so glad we opted to do the ERA after all!

That's amazing congrats @PM985

I had an ERA EMMA ALICE a few weeks ago, I was told I'm prereceptive and I need an extra day of progesterone. I was also told I had 0.00% lactobacillus (good bacteria), which may explain why I've never had a BFP and issues I've had with my lining. This has now been treated and I'm on day 6 of my FET at the moment, I'm hoping for a better outcome now I have this information, this is my 3rd transfer.

It's definitely worth pursuing an ERA if there have been unsuccessful attempts and if embryo numbers are limited and I'd advise anyone having the ERA to get the EMMA/ALICE too, the microflora is so important to achieve implantation and an ongoing pregnancy.

The wait is the hardest part! You’ve done all you can - fingers and toes crossed for you @Gardenlady543

After 3 failed We spoke about an era. Or may have been 4th I had it

Clinic. Advised

It did show I needed more /longer then day 19 for fet

So 5th we did take for longer, mainly as clinic in Madrid shut in aug and we were away in June so took while on holiday and then scanned once home and thickness was a perfect 1.1 and triple layer so we continued

That was our only successful bof and baby blondes was conceived

Who is now going to school blondes in sept and 4.5

Did the extra help. We will never know

It can’t hinder or hurt to try apart from cost

But a fake cycle is way cheaper then another failed one

PM985 how are you getting on? I have my ERA next week and only have one pgt normal embryo left so hoping it’s third time lucky for us…

Hi all
I have recently received ERA results. In terms of the procedure my experience was very similar to PM985’s. One thing to add is that it made my monthly cycle shorter as my period started a couple of days after coming off the meds, something I hadn’t considered as I’d assumed I’d be kept on them longer not sure why!

My cycle is always regular but my next cycle after the ERA sort cycle was also a bit shorter. Just something to consider if like me you are trying to plan dates in advance for your next Embryo transfer cycle.

My ERA results were normal so there was no change to my five days of progesterone, so it didn’t help me with answers to my RIf but I’m glad I had it done.

Fingers crossed for you @Unicorn9.

Things are going well it seems, currently 8+3, still a bag of nerves and just hoping for the best!

Interesting about your cycles being shorter @GreyGoose1980. We were advised to stay on the meds whilst we waited for the ERA results which ended up being a good idea as my new cycle started a couple of days after stopping medication and we were able to go straight into the next FET cycle without having to wait a month.

Totally agree @Blondeshavemorefun, we looked at it that way too. The ERA is cheaper than a FET cycle and also provides some reassurance. It is unfortunate it takes almost 2 months to go through it though. Glad it worked out for you!

Pm985 that’s great news and gives me some hope. This is a silly question but are you allowed protected sex during the era cycle? I will also stay on meds so that I can go straight only FET. Partly because the ERA is a bit like a scratch…

@Unicorn9

Pm985 that’s great news and gives me some hope. This is a silly question but are you allowed protected sex during the era cycle? I will also stay on meds so that I can go straight only FET. Partly because the ERA is a bit like a scratch…

@Unicorn9, I don’t recall being advised either way, can’t see why it would be an issue after the ERA procedure but probably best to check with your clinic. I also read some articles that made reference to increased chances of implantation following an ERA as it’s similar to the endometrial scratch. I can see the logic there. Hope all goes well for you next week!

PM985 Me too! It’s our last euploid embryo so I’m hoping it comes back pre-receptive and it works this time:-) BIG GOOD LUCK to u….

@PM985

Totally agree *@Blondeshavemorefun*, we looked at it that way too. The ERA is cheaper than a FET cycle and also provides some reassurance. It is unfortunate it takes almost 2 months to go through it though. Glad it worked out for you!

Thank you

Fingers crossed for you

Hiya
I had my ERA last thursday, so 24th June. I stayed on progesterone until Tuesday (29 june) to delay my period but I started spotting on the Sunday (27 june). My consultant said it is from the ERA and to tell him when I get a proper full flow bleed at which point I should start oestrogen for my FET in July.

I know some clinics advocate waiting a cycle as the bleed after the ERA isn’t a true period but due to consultants holiday, effects of ERA being a scratch etc we have opted for fet straight after ERA.

@PM985 did you spot bleed after the ERA but it wasn’t the actual full flow until days later? My full bleed only came on the thursday evening so i started oestrogen on the friday morning first thing. But today is sunday and it is so light now for a “period” and it has only been three days since the full bleed when my normal period is 5-7days.

I gUess Im worried that I should have started oestrogen on the sunday and not the friday, five days later and now everything will be messed up but my literal thinking brain is saying, stop its ok, it doesn’t matter how long you take oestrogen for it is how long you take progesterone that makes the difference for endo receptivity… any thoughts? Sorry for the ramble…

@Unicorn9

Hiya I had my ERA last thursday, so 24th June. I stayed on progesterone until Tuesday (29 june) to delay my period but I started spotting on the Sunday (27 june). My consultant said it is from the ERA and to tell him when I get a proper full flow bleed at which point I should start oestrogen for my FET in July.

I know some clinics advocate waiting a cycle as the bleed after the ERA isn’t a true period but due to consultants holiday, effects of ERA being a scratch etc we have opted for fet straight after ERA.

@PM985 did you spot bleed after the ERA but it wasn’t the actual full flow until days later? My full bleed only came on the thursday evening so i started oestrogen on the friday morning first thing. But today is sunday and it is so light now for a “period” and it has only been three days since the full bleed when my normal period is 5-7days.

I gUess Im worried that I should have started oestrogen on the sunday and not the friday, five days later and now everything will be messed up but my literal thinking brain is saying, stop its ok, it doesn’t matter how long you take oestrogen for it is how long you take progesterone that makes the difference for endo receptivity… any thoughts? Sorry for the ramble…

@Unicorn9 - I don’t recall having any spotting after the ERA procedure but everyone is different and I may have forgotten as it was a few months ago now!

Our consultant advised to stay on progesterone to delay the period until we received the test results and that took 4 weeks. My period came 2-3 days after stopping progesterone and it was a full bleed for 1 day but notably much lighter afterwards. I started oestrogen on day 2 as advised by the clinic.

I wouldn’t worry too much and trust the advice of your consultant. Oestrogen is needed for the first step of the process and you are right in that the ERA results will indeed tell you how long you need to take progesterone for.

All the best!

@PM985 oh that is reassuring. I stopped all meds and stopped the injectable progesterone but was told to just continue with the suppositories for five days. Then I had two days of spotting and on the third a proper bleed started. It’s like non existent on day 3 though. I started full bleed Thursday evening but only started oestrogen the next day. Thank u for the reassurance!

ERA came back receptive:-(

@Unicorn9

ERA came back receptive:-(

@Unicorn9 sorry it was not the result you were hoping for, I can only imagine how frustrating that must feel. Fingers and toes crossed for your next cycle, the procedure itself may help you nonetheless!

Hi there hope you don’t mind me jumping into this conversation.
First of all congratulations on your results and hope you are doing well 💕
Can I just ask about the ERA I just had it and done and waiting for results. Did you get progesterone tested prior to starting it and also were you on the same progesterone protocol for the actual FET?
Also was there a diff in your endometrial thickness for the era and actual cycle.
Thank you xx

@Babydustt12 I think we're a year late on this thread but I just had a biopsy for ALICE/EMMA/ERA about 2 weeks ago. Just waiting for the results. I was on oestrogen for about 2 weeks, then the scan showed my lining hadn't thickens so another week at a higher dose. Then after the scan showed it was okay I added in progesterone and had the biopsy on the 5th or 6th day of that. When are you expecting your results?
We have an appointment on 29th April to discuss them.
I think this is also quite a good dummy run for FET...they will know I definitely need more oestrogen and will probably need more progesterone too!

@Coops0406 very similar to you. As my lining was only 7.2 mm after almost 15 days of estrogen and also the triple line had gone decided to get the biopsy done rather than cancel this cycle.
I got in done last week and they said results take 2 weeks (got it done in Spain)

Did you test your progesterone level before you started progesterone?
I will be changing to estrogen patches this time as don’t seem to respond to oral (unless I have chronic endometritis which is causing the thin lining?)
Good luck with you results xx