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 @seven201 that's a busy day for Tuesday then! That's interesting that you've gone with Mr Trew, he will want to get you booked in for a HSG in the first half of your cycle I'd imagine.

Yes to getting things off your chest! I feel like my conversation with my manger yesterday was a very long rant! Workplaces do not understand infertility, my manager is a doctor and clearly doesn't understand it, even though I've told him on multiple occasions what I find upsetting, I don't think he's doing it on purpose or anything, but it's so frustrating.

I get really annoyed with the clinic delays as well, I'm always chasing as well! I don't know what's happening with my treatment as I was going to do the mock FET but it looks like that's going to be put off for a month while I have this hysteroscopy.

@Gardenlady543 I didn't mean Mr Trew. I meant Mr Lower , it was just because I'd just read Trew in your post!

I find the chasing absolutely infuriating. And when I do get through to a nurse I am sure they will just tell me I have to wait and see what the doctor says. I really don't see why they can't just add me to the end of august list! I would much rather get started in august before school is back and I have to be close to all the unvaccinated kids!

The other day a male colleague I rarely talk to was chatting to me about the end of term. He got out his phone and I was expecting some kind of crap end of term meme, but no, I had to look at many photos of his baby. About 2 years ago I hinted heavily at this man that I was struggling with infertility. Twat. Sorry, told you everything is annoying me at the moment!

@seven201 oh I'm in the worst mood at the moment! So don't worry we can be moody together! I snap at people when they do things like this colleague of yours. I think men might think women love to see pictures of babies, I've had a few men do this to me in the past.

Lol I wondered why you were suddenly under Mr Trew!

Have you got your fertility specialist secretary's email. I go directly to them and she passes messages on to the specialist.

@Gardenlady543 I'm glad I have a moody buddy! I really wish I'd said to him "I've just had my fifth failed ivf round. I don't want to see other people's babies right now" but instead I pretended to like the photos. So now I am annoyed at myself .

No, I haven't got a secretary's email. I don't think she has one, I think everything is done via one main general email address that all nurses use. I think I'll just have to be less polite about it all to actually get a response. I find it very awkward though kicking up a fuss!

@seven201 honestly I would have said that, I don't think it wins me any friends, but I would rather be honest and not have to deal with them doing it again in the future.

Your specialist should have a secretary, you're with care aren't you? I'm with them and my specialist definitely has a secretary. If you call up the reception and ask who your specialist's secretary is and their email they will hopefully tell you. Honestly mine gets so many emails from me, but I'm considered a complicated case so I feel like they expect it.

Hi everyone, sorry I dropped off the thread for a while. I've been struggling with waiting and feeling low, but finally had my appointment yesterday and given the all clear to start with my next period which is imminent as I am spotting today. So hopefully cd1 tomorrow or Monday, so will start the progynova. I'm booked for a scan on Friday and then one on day 10 and hopefully my lining plays ball and I can start my progesterone and book the biopsy. It majes such a difference to my mood to be able to do something . Did any of you need a repeat biopsy after taking the antibiotics / probiotics? He said that around 10% of people need a repeat but it would just be between cd15-25, so not a full mock cycle again. I hope I don't need one, I want to do this then plan my FET.

I am definitely a pain with my clinic - I emailed immediately after my appointment to book my scan and when I didn't get a reply 3 hours later I called them. Kind of feel like a pest but then I think, no one else is going to be bothered if I miss out this cycle. Don't feel bad @seven201! :) I'm sorry about your insensitive colleague, knob.

Have you got your hysteroscopy booked @Gardenlady543? My consultant yesterday says he could do a hysteroscopy at the same time as my biopsy, but my recurrent mc specialist doesn't think I need another one, so want to save unnecessary expenditure, the era, emma and alice are already expensive enough!

How are you @Cream123?

@VenusStarr I was advised by the lab to do a repeat but my specialist and Mr Trew said there wasn't a need and I could do a transfer, so I did but it didn't work, which is why I'm planning on doing a repeat. My friend is under a specialist who repeats on everyone that needs treatment and it's pretty variable who need two courses of treatment. The two patients he had with 0.00% lactobacillus only needed one course of treatment, so the percentage of good bacteria doesn't seem to affect who needs more than one course.

Oh I am constantly emailing my clinic so I wouldn't worry. I would hope that the clinics expect people to want to make sure everything is right.

I'm having the hysteroscopy a week on Tuesday.

It sounds like you're al set for the mock cycle :)

@VenusStarr glad your all set! I didn’t repeat mine. I needed antibiotics and then replaced my lactobillus which was at 66 percent so not too bad. I took a month off and went at into my fet. I’m ok thanks. I’m finding this pregnancy hard to believe it’s happening tbh. I’m still quite anxious and had another bleed last week which has freaked me. Find myself up at night worrying - I’m sure u know all these emotions. Just waiting for my Nhs dating scan next week . I’m sure time has stopped still.

@Gardenlady543 good luck re hysteroscope keep us posted.

@seven201 let us know wot lower says likely will bring u in for a scan to see how big ur niche is. Hope he helps!

So af arrived this morning :) although it's quite a painful one, I'm pleased I can start progynova tomorrow. Hoping it all goes smoothly from here. That's interesting about the repeats @Gardenlady543 I will just have to wait for my results. Not too long to wait for your hysteroscopy.

I'm sorry you had another bleed @Cream123 and that you're so anxious. I hope your nhs scan brings reassurance. It has definitely felt like time has stopped!

Hope you're OK @seven201

@VenusStarr I'm glad you are getting started. It feels good to just be doing something doesn't it. I didn't need mine repeating (I had low good bacteria and era showed starting progesterone a day earlier).

@Cream123 sorry you've had yet another bleed. It's just so cruel. I hope the scan next week goes well.

@Gardenlady543 how are you doing?

I haven't been able to get hold of anyone at cafe all last week or this week and all my files have disappeared off my portal. Their IT and phone lines are down. Annoying as I wanted to send some bits to mr lower and I wanted to try and get a message to my doctor instead of having to wait for a full consultation. I'm hoping mr lower is helpful tomorrow. I've made a timeline of my treatments etc and have sent him a 4 page word doc summary - poor man! I get flustered when asked for dates and info so I feel glad I have that to refer to.

@seven201 good luck! Don’t worry if u don’t warm to him Tmrw. He’s pretty direct and non emotional but he really knows wot to do and that’s all that matters! Come and report back

@VenusStarr hope ur ok on progonva it always made Me feel Sick! It’s quite short the era cycle so will be over soon

@Gardenlady543 good luck for ur hysteroscopy again not long to go and really
Hope some answers for u st after it . Least for once u don’t need to wait ages and we will tell u the summary post op.

I hope your appointment goes well today @seven201 that's really frustrating about not being able to access your notes or contact your clinic. Hopefully your notes will help you and you come away with a plan 🤞

@Gardenlady543 I meant to ask, did you manage to get hold of the implantation clinic?

Thank you @Cream123 cross posted! I'm trying to work out when my biopsy will be so I can see if dh can come with me. I know I'll be fine on my own but the clinic is a fair drive away and it'd be nice to have a chauffeur!

Hope you're doing OK

@Cream123 I had my appointment with Mr Lower, I liked how he just wanted the info and made a plan. I'm going for a saline sonogram at the end of august to look at my section niche and midline septum with a possible hysceroscopy early sept, if the scan shows it's needed. It means delaying my next FET (not that I know when my next FET is, so maybe not!) and losing a Month of natural trying which frustrates me, but worth doing.

He was saying maybe I should pgta test my 4 frozen embryos or if not do a new round with him and have the fresh ones tested. Agh, just don't know! So it's more risky testing frozen ones right (due to having to thaw and re-freeze)? How long does pgta testing take out of interest and am I right in thinking it's about £600 per embryo?

I also had my counselling appt. I think it was useful but I feel a bit emotionally drained at the moment.

@VenusStarr thank you. The biopsy isn't as bad as it sounds. For me it was just painful period pains for a couple of minutes then it was over. I took paracetamol I think half an hour before my appt. it would be nice if dh is free to chauffeur you though! You'll deserve cake after, definitely.

Thank you @seven201 I had a biopsy a couple of months ago and I was wriggling around all over the place! My doctor did apologise in advance if it's painful definitely cake will be required after :)

I'm pleased you have a plan and like his approach. I find it hard missing cycle to ttc naturally but having a plan in place does help me deal with it.
I don't know much about pgta testing but I agree, doing the frozen ones and thrn refreezing may be risky. I know someone who's recently done the tests and it was about £3500 for 8 embryos.

I know what you mean about counselling being emotionally draining. I've debated going back to my counsellor but I don't feel I have the energy at the moment.

@seven201 I defrosted and tested my 3 embryos I did on my first ivf cycle as pgs was kinda new when I did my first ivf cycle 8 years ago so I didn’t do pgs ans then 2 years later did it on the frozen ones. Care assured me that the normal ones survive and they had good data. So all 4 were tested al survived the defrost and frosting - all were complex abnorma!!!

I know there are problems with pgs but I’m very keen on it. The only 2 pregnancies I’ve had make it past 12 weeks were pgs normal. I’ve miscarried al my non tested or natural pregnancies despite being 28-34 during them all. I def would have mc those 3 embryos so I’m glad I did it. I’m actually really cross I didn’t do pgs before….

U could see how u feel post surgery as if there’s a def reason for ur bfn he’s now fixed maybe not testing them is an idea? It’s hard I know

I think it’s about 800 for up to x no of embryos I can’t rem now.

Oh wow it's all systems go on here for everyone at the moment!

@seven201 well done for writing everything down I did the same with Mr Trew and he said it made everything easier as he only had a couple of questions to ask. Try not to worry about the delays, it looks like I'm going to be doing tests for the next few months too. I Pgt-A tested my embryos after the 2nd transfer didn't work. I had 7, 1 didn't survive the thaw (the best one! But maybe it was abnormal) and only one was aneuploid... the next best one. So at the very least I saved myself 2 unsuccessful cycles. The high rates of euploid embryos- 83% helped establish that my issue is clearly implantation failure. And it means with transfers the chance of success goes from around 30% up to 50-70%. The costs should be on your clinic's website, I think I paid an initial payment of over £1000 and then it's about £300 per embryo. They need to book it in so if you want it done I'd get on and get it booked in.

My update is the hysteroscopy is coming up soon, I have to do a PCR test at the end of the week and am shielding to avoid contact. The implantation failure clinic just got in touch I'm having a remote consultation a week on Friday, which is great timing as I'll know the results of the hysteroscopy and hopefully I can have the first biopsy in the same cycle, so at least something else is done while delaying the ERA and EMMA cycle.

I'm feeling a bit down, I kind of hoped that things would've worked naturally this month. Because it's still a case of perhaps I've been reset and I'm actually fertile now the microflora has been treated and maybe my chances are better without all the medications, this is our first time trying properly in the fertile window since everything was treated. But as normal I'm looking at one line on the tests. It's been important for me to test early because obviously if it is positive then the hysteroscopy will need to be cancelled.

@seven201 to add we have v severe male factor so that May been contributing to our bad embies

Thank you everyone for the info/thoughts on embryo testing. I'm leaning towards it but my dh isn't so keen. He has said it's me organising everything so if I want it done he won't say no.

@VenusStarr sorry that your previous biopsy wasn't nice. I hope the upcoming one is better.

@Gardenlady543 I'm glad your hysceroscopy isn't long now. I know what you mean about trying naturally with hope since a problem has been solved. I was so disappointed a couple of months ago, especially when my ovusense didn't think I'd ovulated. It felt like a step backwards again.

Mr Lower said I should do a week on, a week off and repeat for the canesflor so I'm going to do that. I should have asked if I was ok to go swimming!

Morning, just an update to say my first scan went well and this mock cycle is on. I'm cd6 and my lining is already 6mm and my ovaries are quiet. I'm back next Tuesday for another scan - as I'm on an immune protocol I'll need intralipids next week and will start clexane injections with progesterone on the Wednesday and the biopsy is pencilled in the following week 🤞

Was your scan this week @Cream123 or is it next week? Hope you're well

How are you feeling about Tuesday @Gardenlady543 are you being sedated or just local anesthetic? Not long now.

@seven201 I think if you're leaving toward the embryo testing, it's best to look into it further otherwise you'll probably have regrets and wonder if that's what you should have tried? I'm glad your dh is supportive too. Did you find out about the swimming? I'm wondering whilst you're on treatment is it best to not go? I have no idea though!

That's great news @VenusStarr do you need to be on the steroids and intralipids in the mock cycle out of interest, because I don't know if this will be recommended for me in the future and I won't know until after I've done a mock cycle.

I actually don't know what kind of an aesthetic I'm getting, nobody has told me anything @Cream123 did you get sedation or a general for your hysteroscopies?

I have got an email to say they gave me the wrong date for the implantation failure clinic and it's actually today. I said that's fine and I'll update if the hysteroscopy finds anything. I'll let you guys know how the appointment goes.

My friend is having an IVF cycle right now after needing two courses of antibiotics and probiotics. Her specialist has told her to take a vaginal probiotic daily from day 1 until the day of transfer. I think I might replicate this in the future. Clearly with this specialist's opinion and Lower telling @seven201 to take more vaginal probiotics, it seems better to take them more regularly.

@VenusStarr if you don't mind me asking why do you have intralipids and clexane? I have clexane but don't start until the evening of transfer. I'm glad you're off to a good start with the cycle. 6mm already is great.

I didn't ask about the swimming. I'm on holiday so kind of begrudge not being to have fun. I have been in the pool once but could have gone 4 times (dh has taken our dd) and have been in the sea too. I wouldn't swim on an ivf cycle, it's just a normal month trying for me and when I had my first covid vaccine I didn't ovulate and I had my second dose a couple of weeks ago so suspect I might not ovulate this time either so am being less strict with everything. I hate all these little decisions that feel like such big decisions!

Mr lower said to do the week on and week off thing but to try and do the week off around when I'm ovulating, since we're trying the natural way. So I agree @Gardenlady543, it seems like there's no harm in taking lots!

How nice to have your implantation failure appt brought forward. Nice doesn't seem like the word, but you know what I mean! I hope it's helpful. I think hysceroscopy is usually general but not always. Personally I'd prefer sedation I think.

@Gardenlady543 will be a GA.

@VenusStarr that’s great all Going on plan and u can get your biopsy done!

@seven201 you deserve your break so swim and relax!

I’m fine thanks. Scan was today and was fine

@Cream123 congratulations! Such lovely news.