When is an ERA test necessary?

[SamTTC]

So my clinic does not offer ERA testing, and I am debaring how necessary it is for me, after a failed IVF cycle (and several failed IUIs).

I have a period cycle that is borderline irregular - these past 6 months it has actually been regular at 25-27 days, but go back further than that and it has ranged from 22-31. (I even had one 18 day cycle but I was on IUI meds and got a cyst that month, and I think that messed me up.)

I have regular ovulation, so the issue would only be the timing of my embryo transfer. Even with a fairly regular cycle and ovulation induction+progesterone support, could they be timing me wrong? And if the cycle isn't 100% regular, is it even worth it doing an ERA test, as the next month the optimal time could be different?

Is the ERA even worth doing? There are a lot of mixed opinions out there!

I hope my questions make sense! This is such a jungle.

I did an ERA (plus the Emma and Alice tests) after my fresh ivf cycle ended in heavy bleeding and a late positive test but ended in a chemical pregnancy.

It's only helpful if you are doing ivf and medicated transfers. So I had to mimic my frozen embryo transfer cycle and instead of transferring an embryo, I had the biopsy. It was helpful for me to get the window of implantation and my next pregnancy was tuned accurately and it was successful (miscarried later for different reasons, I have recurrent losses) but it did give me confidence going into the next transfer cycle knowing the information.

Do you have embryos left from your ivf cycle?

@VenusStarr (promise I’m not stalking you but…) I’m having these same tests in a couple of cycles before FET. When you say “mimic”, can you share what you had to do? Is there any prep or drugs or is it just a matter of going into the clinic around the “ideal” time of transfer for the biopsy? Thanks 💛

Haha @TheHopefulEgg :)
So for my FET, I took progynova (estrogen) from cd2, scan on cd6, I started clexane on cd8, on cd10 I had a scan and my lining was 8mm, my ovaries were quiet but they did a blood test for my progesterone levels to check I hadn't ovulated and I had intralipids. Started progesterone and prednisolone at 8am the next day and had the biopsy on at 8am (120 hours) on cd16. I stopped all the meds after that and my period started a few days later. My results were back within 8 days. X

@VenusStarr

I did an ERA (plus the Emma and Alice tests) after my fresh ivf cycle ended in heavy bleeding and a late positive test but ended in a chemical pregnancy.

It's only helpful if you are doing ivf and medicated transfers. So I had to mimic my frozen embryo transfer cycle and instead of transferring an embryo, I had the biopsy. It was helpful for me to get the window of implantation and my next pregnancy was tuned accurately and it was successful (miscarried later for different reasons, I have recurrent losses) but it did give me confidence going into the next transfer cycle knowing the information.

Do you have embryos left from your ivf cycle?

Thanks for the response. I'm so sorry it didn't stick, but great that it could potentially help you in future!

Because the ERA happens in a different cycle than the transfer cycle, I'm still questioning whether it will help someone whose cycle length shifts from month to month.
Unfortunately I didn't have any to freeze and with only 5 eggs retrieved I am unlikely to have any in future cycles. :(

@SAMTTC cycle length doesn't really matter so much, it's the exposure to progesterone, once your lining reaches an optimum level (over 7mm is the baseline). The typical window is 120 hours, but some people need more or less for the ideal implantation window.
If you're not planning a frozen embryo transfer, I wouldn't think you would need one.

I'm sorry you didn't get anything to freeze ❤️ I have low amh so we weren't expecting any to freeze either (they weren't even sure I'd make a transfer). But I did mild ivf and I think that helped. We only got 3 out of 7 eggs fertilised but they all made it. I did get pregnant after my era with a frozen embryo but I miscarried and that baby was chromosomally normal. So a low number of eggs / embryos isn't necessarily a bad thing. But I appreciate when you have to start again, it's hard. I'm taking a break before we transfer our final embryo xx

@VenusStarr that’s interesting so I might need to be near clinic for several days during mock cycle then FET. That’s so helpful. Thank you ☺️

A little random update, apparently my clinic’s messaging system has been buggy, so I wasn’t informed that I got two embryos frozen! Out of five eggs retrieved, three good quality blastocysts is a heartening result (even if they aren’t PGT tested) and lessens the sting of the failed fresh transfer

Sounds like a good idea to take a month break now - I can only imagine your body and mind will be more fortified when you are ready to transfer again

That's really good news @SAMTTC 🙂