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!

Thanks :) I mean it was a long shot, but it would have been amazing to fall naturally and not need to go into this FET, which I'm sure I'll be worried throughout after all the tests I've had and lining worries.

@Cream123 Mr Trew said sometimes it's hard to tell what works and while people may get a BFP when on steroids, it could have just been luck. I hope this cycle works for you it sounds like you've ticked lots of boxes to get yourself in the best position.

Ohhh that's exciting @seven201 I wonder if they're calling to say you're either pre or post receptive, Mr Trew seemed quite happy that I came out as prereceptive, it's just another piece of the jigsaw found. I bet you're the most interested in the microflora after seeing what's happened to me and @cream123!

I know @Gardenlady543 seems like those people with a bfp just before they cycle never actually happens (to us . ) but u have some missing pieces for sure hopefully it’s all of them!

Yeah that’s the problem - no rct and prob won’t be. Quenby does a lot of great work on it but even she says one cycle u could have high nk cells and the Next low . Others test levels in blood. It’s a Bloddy mindfield!

So lower does do biopsies a lot on thin lining patients and he thinks microflora can affect lining quality - but think I said not really thickness.....either way sorting urs out is only a great thing . Can’t bel ur vegan and been on a course about it all and it’s zero! Maybe ur gut health is amazing though!!

@Gardenlady543 do u have a progesterone level on day or before transfer? If not do I found out one of cycles taking 1 lubion and 2 cyclogest was 24 day of transfer - even with my ashermans that alone would have reduced chance of implantation . In the past I’ve always use POI and levels r always fine though but I hate the stuff!

@Cream123 I had a progesterone level taken in my last FET the day before the transfer, it came back as 48.5, no one agrees on what the level should be, some people go for over 20, others over 30, my specialist wanted to go for over 50. At that point I was on 1 x lubion and 1 x cyclogest, so she increased it up by 1 x cyclogest. I have them taken the 1 x lubion and 2 x cyclogest I'm my mock transfer and will be on it in the next FET too.

For the ERA result to be applicable, it needs to be the same progesterone regime, so I won't have another level taken as it will just make me worried if we then have to change the dose.

What's POI?

Mr Trew said he finds a combination of lubion and cyclogest works best when he spoke to me yesterday, which is good.

It’s progesterone in oil. It’s much better at giving stable levels but it’s really painful after a few weeks it can cause some fat necrosis. I’ve never had a problem with PIO and levels but I have had issues with lubion. But I’m still on lubion as I just can’t handle the PIO if I ever get pregnant and need it to 10-12 weeks again like I did with my son.
Yes no one agrees as per usual!!!
mr Gorgy likes over 80.
Argc who I have cycled with before 100
And my care over 50

There’s an rct atm about optimal levels that care are doing ATM but certainly 24 isn’t great!

Yes that’s true about ur era it’s prob fine if u have had it measured before. I do 2 lubion and 3 cyclogest ow my levels r low...

@Cream123 ah yeah the dreaded progesterone in oil, I've heard this is good stuff, but you ideally need someone to inject it because it's IM. My DH isn't around most of the time now as his buisness has reopened and I think it would be very difficult to self administer IM injections, not that my husband would be any better!

That is a bit on the low side, what was your ERA result again? I got pre-receptive with no need to repeat as most people in my position are receptive with an extra day.

So on 2 lubion and 3 cyclogest my levels were 100 I got it tested on me era cycle so doing the same for FeT. It was my
Previous fet to this where I found it at 24 so I’ve upped my doses for era and this cycle.

@Cream123 Oh I see, that's reassuring then! 100 is a great level.

I had some brown discharge and it has now turned pink and I have cramps so I think my period is coming on 2 days early at 12dpo which is really annoying as I've only had 3 x vaginal probiotics and wanted to have a few more before the start of my FET cycle, nevermind. Did you use them during your period @Cream123 ?

@Gardenlady543 my Period came 3 days early too. Literally never happened maybe another effect of the era?!

No I didn’t use them during period as I bleed pretty heavy but I did use them for a few days after period (when more or less stopped and just spotting) whilst doing my oestrogen I’d say day 4-10 or so so I did about 12 days of the probiotics before stopping. Hoping it was enough!

I ended up starting my Oestrogen on cd3 as it came early and it didn’t fit in with work!

@Cream123 ah that's interesting, I was wondering if the HSG could have affected it too. I've had so much bloody done it's not surprising my cycle is confused. I mean it's good to get started I suppose. I have to wait until full flow before I tell the clinic though. My specialist has me start estradiol on day 1 so I'll prob have to wait a bit before officially declaring the start of my FET.

Yes hsg may have too. Yes me too
I’ve been on high dose oestrogen most of this year. No wonder I feel so gross!!!

@seven201 any results!

I can't keep up with everything . I'm on PIO - lentogest injections 3 times a week when I do a cycle. The injections are not fun! One time I was limping for a few days after! I've not heard of lubion. I have cyclogest. After my first transfer my period arrived after 6 days so they think my progesterone levels dropped, hence the injections. I've never been re-tested as they say the POI doesn't show up in blood tests - not sure how!

I've been feeling a bit dizzy lately. I thought it was from when I was on all the drugs for the era but it's still going on. Although I have realised now I'm not having breakfast that's probably not good with my normal meds (labetalol for slightly high bp and metformin) so going to try eating breakfast again and see if that fixes it. Just can't deal with another medical thing to have to get sorted! Maybe I should get my eyes tested.

I can't get hold of a nurse at the clinic to get my results. It's really annoying. I bet they call back when I'm teaching.

I'm in a bit of a grump today!

@Gardenlady543 don't worry too much about not getting all the probiotics in. Doing some after your period sounds a good idea.

@Cream123 oh dear sorry to hear you're not feeling well, could you make a smoothie in the morning for breakfast? I always have a breakfast drink and it's a great way to get nutrients in especially when you're feeling off food. It doesn't have to be a green one, just throw some frozen fruit and juice in a blender. You can get extra stuff to add in from the supermarket these days if you wanted, I add a tablespoon of some superfruit berries and flaxseed in.

How annoying about the clinic, I hope you can get through soon!

omg my body is playing tricks on me, so I had period style cramps, brown discharge, turned a bit pink, stopped, back to a tiny bit of brown discharge and now it's stopped again and no more cramps. So despite it being 12dpo I am now thinking my body wants me to think this is implantation. I've decided to go and spend hundreds of pounds on my FET meds in the hope that the universe will turn it into implantation.

Oh wow garden ! I’m Hoping the same. Any chance ur ovulation date is wrong? Did u temp or do sticks?

@Cream123 all I did was the clear blue monitor, I was my first day of peak fertility the day of the HSG, we DTD that evening (only time this cycle). I haven't done any temperatures until the last few days when my temperature had dropped. I don't really know when I ovulated for sure all I have is the first day of the LH surge and the fact we only had sex once.

I did a FRER on 9dpo, 10dpo and 11dpo all were BFN so I then gave up. I know I must be a late implanter because of the ERA result, but 12dpo is pretty late and apparently has quite bad outcomes.
It may just be my body playing tricks on me, it's just weird normally it's bright red from the start. And I would have thought it would have built up to bright red by now. I'm going to get my FET meds now and just focus on that and see what happens in the next few days.

@Gardenlady543 definitely spend the hundreds on the drugs. You never know!

I have my results!!

I need to start progesterone a day sooner than before. She needs to work out the exact hours.

I have a mild dyspiosis profile - low levels of good bacteria. So I need to do 6 days of canesflor then 1 a week for 4 weeks. Then take oral optibac tablets. So thank you both for your canesflor advice as I've already taken 5 which means I just about squeeze into being allowed to do my FET when my next period arrives in a few weeks.

I do not have any bacterial pathogens.

I've asked to see my results, so hopefully I can look at the specifics as I'd like to see my good bacteria %.

@Cream123 how are you feeling about Saturday?

[quote seven201]@Gardenlady543 definitely spend the hundreds on the drugs. You never know! [/quote]
As in you never know, it might work this time and you won't care about the wasted money.

Have the full results now

@seven201 ohhh that was quick for it all to be back! Those are good results to know! You'll need more progesterone before the transfer like me. Interesting that they're overall happy that you don't need the antibiotics, you just need to get the vaginally probiotics

@seven201 yeah that was my thought, get the meds so I act annoyed if I don't need them, infertility makes people superstitious. So after my walk around Asda I have come home and dammed and it is very dark brown discharge, I've never had anything like it. Have done a FRER which remains a BFN.

@seven201 how many hours are you meant to transfer at? Mine is 139 (sorry it was cut off ur result). And great about ur Emma/alice easiest issue to sort the probiotics will def raise it as levels are not too low. Fingers crossed these help-so when do u start fet.

@Gardenlady543 yes it is late but strange things happen. My son I didn’t get a postive on a frer till the equiv of 13dpo. He had a hcg of 13 that day. I stopped my meds was sure was a chemical (al the literature bascually said I had 98 percent chance of this ending. 8 months later he came! Maybe test again tmrw!

I’m Feeling a bit funny anout sat. Though I’m
Glad I have some reasons the last 2 failed I just don’t believe my lining is good enough yet to be receptive - I think I need another op but lower said it was “good enough and we didn’t need perfect”. I’ve also the era Emma results which hopefully help. But I’ve also got the niche and there is fluid in it which is also not ideal. So bascually I’m not feeling hopeful! I’ve also eaten a scoop of icecream every day this week and had a gin and tonic on Monday (and now convinced my fet will fail for these 2 reasons). I usually stop everything a month before but I just given up a bit I think.

@Cream123 137 hours mine is. I'm not sure if I should carry on taking the oral probiotics (femdophilus) or stop as she said to start oral
Probiotics after I finish my 6 days plus 4 weeks of vaginal ones.

I was surprised all the results were in. I was expecting it to just be the ERA part.

I was absolutely convinced I wasn't pregnant when I was. My dd was naturally conceived and I had what I thought was pre-period cramping that was just lasting ages. I didn't test until I was 6 days late and was completely shocked when it was positive. It was a very feint positive so we refused to believe it until the next day i'd bought another test. I had a couple of red bleeds in the first trimester, but she was fine. She's a pretty stubborn little girl now - we always say how she insisted on implanting and was set on staying where she was and being breech.

@Cream123 I've been there with the ice cream and alcohol! Don't be hard on yourself. I was meant to be healthy this cycle but I haven't been. The doctor wouldn't say it was good enough if he didn't think that was really true. I don't think I've gone into any of my cycles feeling positive. It just feels like you'll have further to fall if it doesn't work again.

Ah interesting ours is very similar then!

No harm in taking both she prob said that as there’s no need to do both if your doing it
Locally and the oral will just keep it topped up. But I would just do them both def no harm done will just top u up even more!