ERA testing after multiple implantation failures. Anyone had it done?

[seven201]

I've had four transfers so far (first 3 from 1 batch, fourth from a second egg collection) and 4 BFNs. I have a naturally conceived 4 1/2 year old and had a natural pregnancy with early miscarriage a bit over 3 years ago. My lining struggles to get to thickness, I have polycystic ovaries (on sukkarto), a fibroid, slightly high thyroid thingy (on levothyroxine), high bp (on meds) and a midline septum (ridge/divide in the uterus). I had surgery to unblock a tube 2 years ago. I'm in the healthy weight range.

My clinic have suggested PGS testing (we have 5 embryos in the freezer) but I'm really not keen on it as I've read about actually fine embryos being shown as poor and therefore being disposed of.

They also suggested ERA (endometrial receptor assessment). Has anyone had that done and found it useful? I just hate anything that delays the next FET but I think maybe it will be worth it?

Any other suggestions? Last FET I was on lots of estrogen, extra progesterone injections, clexane, neupogen infusion, aspirin and probably a whole load of other stuff I've forgotten.

I am so fed up with it all!

@Cream123 I don't think the estradiol will change the receptivity, it's the progesterone timing that's going to be the most important, 10mm sounds great! I'm sorry it's looking a bit weird but could that be normal with everything your uterus has been through?

@Gardenlady543 yeah mr lower said he couldn’t do much more for it and prob some areas are deeply damaged from
My placenta praevia as some areas we’re probably accreta like. It did have a faint triple stripe which it’s never had since my son or in any cycles post op so I’m glad about that. But it was wavy not smooth?! I’m sure that’s a sign of scarring but lowers scanner is amazing on Friday so will get a really good look at it and hopefully he will say it’s looking as good as it can and to go ahead. I’m a bit of a perfectionist so unless it’s totally perfect I’m never going to think this will work!

Agree about the oestrogen but still worry! In the same way u found microbiome May effect it I suppose I’m worried things they don’t realise have an impact
Prob overthinking it!

@Cream123 it's also worth noting that these scans aren't perfect, I saw someone questioning an expert on why their lining had shrunk while they were on estradiol
and the specialist replied that it wouldn't have and it would have been that the scan measurement was not accurate in one of the scans.

Really good you have this scan on Friday.

I think at this point we will question everything!

@Gardenlady543 yes with my sons cycle my lining was 6mm at gorgy office and then at care 2 days later 5mm. I was utterly freaking out but must have been interibserver variation!
Yes Friday will be an important scan.
My
Letter from lower a few months ago comments that microbiome may be affecting my endometrial pattern and recommends Emma which is why I did it
I’m wondering if that’s why for first time in 2.5 years I had a triple stripe - ok it wasn’t a great one but u could convince urself there was one there ....

@Cream123 that's great news then! Oh it's interesting that Mr Lower appreciates the impact of the microbe!

Mr lower loves the Emma Alice and ERA. Every time I met him post op
Have u done it
Have u done it
Have u done it !!!!

@Cream123 oh wow that's interesting, because I want to know whether my abnormal flora could have caused my thin lining or whether I'm stuck with the thin lining issue once my flora is normal.

I’m not sure about the thin side of things..but he seemed to suggest it may be affecting my
Pattern

I had a thin lining with my son. I managed to get pregnant with lining of 6-7mm every time. Things I did to raise it where

Neupogen wash
Asprin and clexane
Oral viagra twice a day
Vit e 10000u
L argine (I think 6g!)
Beetroot shots - hideous!

Have u tried any or some of these? The most important is that it’s triple and that suggests it’s receptive. I saw mr lower prior to my son and he was way more bothered it was triple and didntt really care it was hovering around 6mm

Will be interesting to see if you have any changes one ur biome is flourishing again!

Either way it’s a good thing u have found an issue to fix which is easy to fix....
This getting pregnant is like a jigsaw and u just have to find all the pieces the problem is some of the pieces r hiding and u don’t even know where to look once the big things r ruled out!

@Cream123

I've tried all the diet stuff including beetroot juice, but it made no difference.

I was on aspirin in the mock FET, I'll be on aspirin up until and then heparin after transfers in the transfer cycles.

I'm on the vit E and l-arginine already.

I think I'll see how I get on in the next mock FET, I'm quite keen to push for pentoxifylline and viagra if the lining is still thin during the mock cycle. Then I may look into the other things like filgrastin in the future.

I agree it's a nightmare figuring out what needs to happen to improve things, I'm trying not to get too hopeful as I'm so used to thinking I've solved something only for something else to crop up.

@Cream123

When you see Mr Lower could you possibility ask him if he thinks a really bad case of dysbiotic bacteria, as in only dysbiotic bacteria in the uterus could cause thin lining? I'm not due to see Mr Trew until 25th, so I have quite a wait until I can run it by him.

@Gardenlady543 I will try - I find him quite difficult to talk to tbh! I always leave him confused and with my answers not answered. But I’ve always let it slide as he’s a good surgeon and really my anxiety and questions are not as important!

But I’ve written it down on my list I luckily don’t have many for him this time so I’m sure I’ll manage one st answer from him!

Yes pentoxy and vit e combo has great results. The filgastrin didn’t actually do much for my thickness. But it’s meant to help implantation so I did it and am doing it again on Friday.

@Cream123 perfect thanks, I've heard that about Mr Lower actually, a few people have said he didn't tell them the results of surgery and all they were given was the notes from the procedure and told to wait for a follow up.

To be honest a lot of surgeons are like this, and it's more important that they have the technical skills.

@Gardenlady543 exactly. I’ve freaked out a lot after My Appts and then I just tell myself it doesn’t matter he can’t chat to me as long as he can operate !!! I’ve heard mr trew is more forthcoming and also a great surgeon so hopefully he will be great!

You're both so good at research and knowing what to take etc!

I've just booked my vaccine for tomorrow. It's at guys and at thomas'. I'm 38 and got a text invite. I'm really hoping it's not AZ as I think that's not advised for pregnant women, so I assume that includes those ttc so I think I'd have to decline. I'm so excited about potentially being vaccinated! Especially as I'm in a room of 30 teenagers most days.

@seven201 I just had my second dose last Saturday :) the guidance is that if a person is

Good luck @seven201! Be great u will be vaccinated before u embark on ur next fet. I’ve had both of mine !

I’m a bit obsessive @seven201!!!

@Gardenlady543 thank you very much for that. I definitely want to be vaccinated. I'd feel much more comfortable at work and would love to get it done before my next FET.

@Cream123 thank you!

How are you both doing?

@Gardenlady543 you feeling ready for your appt tomorrow?

@seven201 yeah definitely, when I had my first dose I thought I'd be in the middle of a cycle when I had my second dose! My company want me in face to face clinics more these days and feel so much better knowing I've had the vaccine.

Ah yes I've written down the stuff I want to cover:

• I need her to agree to let me go straight into the biopsy cycle when I start my period in a week.
• I need her to agree to repeat the ERA, because I'm worried the completely new flora may change it.
• I want to ask her if the receptiva test is possible, I think she might have a heart attack though, last week she said she has had to read so much about the EMMA/ALICE.

In other news our one attempt at DTD on the day of the HSG has made me think there may be a slight chance we could have conceived naturally this month, now I have the antibiotics and probiotics.

Oh yes @Gardenlady543 good luck tmrw! Let us know the update....

I’m ok @seven201 how r u? I’m feeling sick (!) no change there but hoping I’ll be transferring in the next 10ish days sometime. Have u had ur withdrawal bleed from era yet? Good luck trying this month!

@Cream123 aw I hope the nausea eases a bit, exciting that you'll be having a transfer soon!!

@Gardenlady543 you do sound ready for the appt! I hope it all goes to plan. You never know, the sex this time with the antibiotics and probiotics could be enough.

@Cream123 sorry you're still feeling sick. It's so rubbish! Wow, 10 ish days until potential transfer is good!!

I'm ok. Been worrying about my sister but I'm going to see her this weekend. Really pleased not to be on the drugs as they really affected me. I went a bit crazy on them. My period arrived yesterday. It's really light but I think that's because I was on lentogest as my period is always light and really long after that. My ovusense monitor arrived so that's exciting! My fem dophilus arrived but I think they sent me the lowest strength one accidentally so I'm trying to get it replaced. Sorry, that was very dull news!