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 your FET will not fail over that! Eat whatever you feel your body needs, it's better you get calories in you. Also try to focus on how you're in the best position you've been in for a long time. I felt the same in my previous cycles always thinking he worst before I'd even had the transfer, it may be the hormones contributing, in 2 days time the transfer will be done

@seven201 I vote to take both the oral and vaginal as well.

So I've gone slightly mad, I have spent the evening obsessing over that FRER as I swear I can see the test line when I shine a light on it in a certain direction, it may just be that I'm seeing the reagent. Anyway it seems that it meant nothing as I've had some red stuff. It's all very strange though as I've never had dark brown stuff like this before. Anyway I'll see if my period is on full flow tomorrow and if so then I guess that will be day 1.

@Gardenlady543 can u post a pic? If not tmrw if ur af comes I suppose u will know....sorry for the rollercoaster! Was ur dh home wot did he sAy? Mine always saw my tests as bfp when I was sure they were bfn.

Thanks for the support. Im def in a better place that I was last 2 transfers, I knew my lining wasn’t right but everyone including mr lower told me it was fine! I then went back to him and then for some reason the scarring was apparent on the USS and saline scan which he missed 2 years prior. Care and Gorgy just kept telling it’s fine some women don’t have a triple lining. I kept screaming saying but I always did and I used to get preg so quickly even with my DH soerm count of below 100 thousand naturally. But no one would listen ! Anyways I finally got answers and era and Emma have added to that. I just don’t think it’s enough. My lining is still not fully triple and measures varying amounts in different areas. Plus pgs isn’t fool proof. Anyways it is what it is. And I’m transferring. And I know magic can happen and miracles occur so I’m clinging onto that! Though I feel like I’ve already lucked out and all my luck is done so I should be stopping!!! Anyways Sorry for the rambles!!!! Think i need to get to bed. Attempt no icecream tmrw (!) certainly no gins!

@Cream123 I think it is a full on period now. But you know what it seems quite a healthy colour and there is tissue in it, I'm not sure I've seen it like that for a long time, I'm hoping it keeps looking like this as it's how I remember it in the past. I'll have to see over the next few days, hopefully it's a good sign that the lining is fairing better with the good microflora.

Your case is clearly complicated, but everyone is happy for you to go ahead, so you can't do anything more now than give it a go. It sounds like you have a back up plan of having another look with a hysteroscopy if this is unsuccessful, so that could be your backup plan. That's what I focused on in my last FET, "if this doesn't work I'm going to get these tests".

Saying that, I think sometimes we need to accept that sometimes we may not be able to make things perfect, but people still get pregnant in the most unlikely situations, and science is on our side eliminating so many variables that nature would normally throw in.

Fingers crossed for all of us, it's interesting that we all ended up prereceptive and with microflora issues!

We all know the have been driven mad by ttc feeling. Sounds like you're both in that space right now, but for different reasons! I love getting pregnancy tests out of the bin to 'just check' I haven't missed something. Overthinking everything is part of this shitty train we're all on.

Thank you for the advice to keep taking the probiotics. I will!

@Gardenlady543 most of the threads re ERA everyone comes back perceptive bu 12 hours. I’ve hardly seen a normal or post receptive result. I was actually early receptive but I had my biopsy at 127 hours so it ended up being 139 once the 12 hours were added. Weirdly they say to add 12 to most prerecptive too so I hope my lining hasn’t already gone past it’s maturity......

Hope af is here in full swing and u can get going.
@seven201 not long till u can start?

@Cream123 oh I'm sure you won't go over it, I got 145 hours, so a full extra day. I'm worrying the opposite that it could take longer for my endometrium to get there, but I'm sure there's some leeway, the uterus is a nice environment that can sustain an embryo at least for some time until it implants. Hence why they often put the 3 day embryos in at that point rather than leave them in the incubator.

My period is fully here and the flow is better than I remember which is good. It's all quite strange, Mr Trew had highlighted how I was getting up to a good thickness so it didn't seem to be a thin lining issue. But then everything seemed to have looked abnormal from the time I started progesterone, patchy and thin followed by a light period. I'll have to see what happens in this cycle. I'm on estradiol 2mg - three times a day orally + three times a day vaginally and aspirin. First scan is the bank holiday morning which is day 11.

Oh yes @seven201 now you're results are back you should be able to start soon, when's your expected start date?

@Gardenlady543 sorry your period arrived. At least you can move on with everything now.

@Cream123 can't believe your transfer is tomorrow now. That's so soon!!

I expect my period around the 12th June but Sod's law it will arrive early or late! I only just qualify by one day to do it that cycle as they say I have to have taken 6 canesflor plus 4x 1 a week before my first post stim scan. Part of me thinks I should do norethisterone this cycle so I don't have to stress about it, but the other part wants to try naturally, especially as the biopsy is sort of like a scratch!

I have a tmi question. I've been using canesflor and my new ovusense monitor. Quite often the ovusense monitor has stuff stuck to it in the morning. I have assumed it's just the canesflor casing but maybe I should be worried that it's been affecting absorption and should take extra? I haven't been super careful at pushing them right up, I just did it standing up quickly. Am I overthinking this?

@seven201 It's hard to know, it's not ideal that the ovusense is in there with the vaginal probiotic. I had trouble pushing it up as well, while other people seem to be able to feel their cervix I'm nowhere near able to do that! I ended up using the applicators that come with utrogestan,

it is not ideal as the probiotic is much smaller so I kind of have to balance it on before inserting, but I know it's getting higher up than my finger would get it.

I'm not sure of the solution, can you adjust the timing so the probiotic has a couple of hours to absorb before the ovusense goes in? it's only a temporary issue. The ovusense is good for tracking but the probiotics are so important, you don't want to be second guessing.

That's annoying that the clinic are insisting on completing treatment, but like you say having a chance to give it a go naturally is good too.

@Cream123 oh yes it's tomorrow, how exciting! What time are you going in?

Ohhh @seven201 didn’t know u we’re doing a fresh. Wonder why u need to have finished the course? Worries over infection?

I found the canesflor hard to put in I just used my finger and hoped it got to where it needed to. Am now worrying I didn’t go high enough!!!! Agh!

I’ve no exp of ovusense sorry. Only advantage of husband having zero sperm is no contraception or bother with ovulation monitors for me!

Yes tmrw at 2. The house is a tip so I’ve spent all afternoon sorting it ow tmrw I won’t sit still and dh is being kind and knows I’m a bit mad when things r messy so he’s being helpful :)

Will keep u posted. I’ll be testing 7dp (hope my blast makes it tmrw!)

@Gardenlady543 whoooo for starting. And great ur period feels more like a bleed.

@seven201 I missed it was a fresh too, I think it's sensible to complete the course before a fresh cycle. I'm sure you could start the suppression meds before the course ended if you really wanted to. But it probably won't make that much difference with the timings, so I think do whatever you think is right.

@Cream123 ahhh good luck, 7dp5dt sounds very sensible, I think I would crack before that!

Agh sorry, I have no idea why I called it a post stim scan! It's not a fresh cycle. I confuse even myself a lot of the time!

I've done 6 now so I'm going to do 7 instead and try and get this extra one in the right place and do it in the morning. Yesterday I left it 3 hrs before putting the ovusense in but still had the same issue.

@Cream123 well done for getting tidy today. Best of luck for tomorrow! Let us know how it goes.

I've just searched my emails and can see that I bought some optibac probiotics the month before I conceived my daughter! I can't remember exactly when I started taking them but it was possibly then. I have no clue when I stopped taking them. I probably got them for my constant thrush. I am probably over analysing this but I wonder if that's why I fell pregnant (took 9 months to conceive her) then!

My ivf doctor said after the biopsy "I'm starting to think we should put all out women on probiotics". I wish I'd known it was a fertility thing!

@seven201 I can't stop telling the world to take these specific probiotics! It's such an easy fix, there is evidence that this helps and it's so easy. My period is reminding me of what it used to be like before I ever had the coil, and given it's been so light for 18 months, it's must have been the microflora that caused it to be light and was therefore affecting the lining.

The weird thing about my case is the amount of probiotics in my diet that did nothing. So I think some women will need a week of antibiotics and they aren't going to prescribe them unless there is evidence of the dysbiotic bacteria and the only way to get it is a fairly invasive biopsy. I think all we can do is tell everyone that has an ERA to get the EMMA and ALICE done at the same time and take probiotics regardless.

This may not be be my only issue, I hope it is though and either way it wouldn't have helped having so much dysbiotic bacteria, without pushing for this test that my specific clinic had never done before, how many unsuccessful cycles would I have gone through?

@Gardenlady543 oh wow, imagine if it is that affecting lining thickness!!!

I wonder why I don't need antibiotics seeing as I have dysbiotic bacteria too, although not as serious a case as yours.

I'm definitely going to start telling ttc women to get some probiotics. I only did what the "it starts with the egg book" told me to do!

@seven201 I think it must be because the non-lactobacillus in your sample aren't considered as bad as others. My friend had a similar percentage of lactobacillus to you but had gardnerella and was put on antibiotics. Probably because of its links with bacterial vaginosis we know it's pretty bad.

@seven201 yes I had provetella 10 percent hence the antibiotics but 70 percent lactobacillus. So I needed the antibiotics to clear the provetella I think ur bugs are not considered too bad / not at high levels. I really Hope the antibiotics didn’t totally kill
Off my good levels of lactobillius. I forgot to count the days during af I didn’t do the probiotics vaginally - so I think I did about 9 days and I know it’s meant to be 10 as I stopped it once I started vaginal oestrogen. If this cycle fails wondering if I repeat Emma/alice to check all ok? Or maybe I just repeat the tx course and take a long course of vaginal probiotics? Plus obv the hysteroscopy

Think the whole microbiome thing is fairly new and “trendy” certainly when I was going through fertility tx a few years back wasn’t a thing at all. The fertility nutrionist didn’t used to recommend it either but they have over the last year or so prob as the new data has emerged......

Glad your af is lovely @Gardenlady543 !! Be interesting to see how ur lining is this time....

It’s in
Let the madness commense!

@Cream123 congrats on being PUPO!

Thanks @Gardenlady543
Agh! So hard to keep calm during this phase

Thanks both for the good/bacteria info.

@Cream123 congratulations!! Well done for getting to this point, that in itself is a great achievement. I hope you've got some good tv or books planned for the rest of the weekend.

Yep got a few lined up! I’m off work on Monday too which is great. Then I’m back to it.
I must stay sane till Next sat am! I’m not feeling a thing atm but I know it’s early but still!

Hi all, I’m proceeding with ERA/EMMA/ALICE next week. Re probiotics I have been taking a new supplement that includes probiotics for this last few months. Apparently the makers of it are trying to address the impact of gut health for IvF.

I’ve been doing some research on lining. Mine was 6mm on baseline scan and is now 10.8 with 11 days of taking FEMTAB. I think that sounds ok but read somewhere that it should be Max 5mm on baseline scan to proceed with FET. Anyone read anything about ideal linings? This will be my protocol for FET so I’m trying to spot anything I can now before putting back a hard come by embryo!

@Cream123 good luck on your TWW

Hi @ForeverAintEnough12 you know I'm not sure of the baseline thickness. My clinic doesn't do a baseline scan at all, so they clearly aren't that bothered by the thickness before medications are started. It sounds like you have a good thickness going now which is great :)

It will be useful to see if the probiotics you've taken have led to a good microflora. What brand are you taking?

Thanks @Gardenlady543 just read the report and apparently altjougjcthick I don’t have the triple stripe - which I always had on fresh cycles. It’s never straightforward is it! Think you’ve a problem solved and another pops up.

Here are the supplements: www.nuafertility.com/nuabiome-women/