ERA / EMMA / ALICE testing thread 5(!)

[VenusStarr]

Just setting up a new thread as we're coming to the end of thread 4.

@Janefx40 @birdbybird @seven201 @Gardenlady543 @patientpatient @MyEasterEggs @thislittlebird @Yuliaaa @Violette22

❤️

@Gardenlady543 rolling over was the last thing to get better after my section but I don't think it was more than 7-10 days. Hopefully you are nearly there x

@Janefx40 ah that sounds so tough for you! I can barely handle a TWW after a normal cycle let alone IVF. Sending big hugs and crossing everything for you! When’s your official test day?

Im just upset and confused right now after 2 natural pregnancies - well we lost our second didn’t we but I can’t comprehend now having so many fertility issues. I know my spotting is an issue but the progesterone is controlling that. I’ve asked my DR if I should change any of my meds for the next 2 months.

im half tempted to start it before next year but I’m not sure I’m in the best place mentally. It gets harder not easier doesn’t it. I will likely go for the 3 cycle with 50% refund it my AMH stays high enough.

Does anyone know how much AMH can change within 12 months?

@Loz2467 they say that it works 95% of the time with 3 x single euploid embryo transfers, it comes from this study doi.org/10.1016/j.fertnstert.2020.07.002 the authors said when they looked at more data (not on this study) for a 4th transfer, there was a 50% chance of it working on that attempt even though those people already failed the first 3 tries. Were you using tested or untested, untested could take more transfers to work. I've done 2 untested and 2 euploid and never implanted, next will be my 5th go and will be another euploid.

@Janefx40 I know you have had symptoms before when it has been a positive but from what I can see it is so variable and there are so many people that absolutely swear it hasn't worked and spend the last few days crying in bed only to then get a positive and an uneventful successful pregnancy. Try and see if you can get back to the joy of being PUPO that you had the other day.

I decided to remove the dressing, feels weird without that slight padding, I don't want to touch the steristrips though.

@Janefx40 symptoms can change each pregnancy, so there really is no point in worrying about that. Obviously I worry about it every time! Is there anything you could do to distract yourself? See if a friend is free to go to the cinema together or something?

@Gardenlady543 well done on taking the dressing off. I don't think I had steri strips, I think I had a big sticky all over bandage thing that the midwife took off for me. Don't feel afraid to call the ward or doctor for advice, you've paid them enough I'm sure. I can't remember when I slept on my front, but I would do it as soon as you felt comfortable to do so. It's miserable feeling so sore! You don't strike me as the type of person who likes sitting/relaxing! Could you take up knitting or something, for when you're comfortable sitting? I think it took me about a week to be able to slowly potter about the house.

@Dochas12111 did you already tell us? I don't want to not congratulate you, so... congratulations!! It is lovely to hear that other people have made it after all the time and fighting.

@Loz2467 sorry you're planning your next go. It's just so unfair!

No news from me really. Still waiting for my period then after that I'll have a scan to check my retained products have gone (bloody hope so!) so I can get on with a letrazole cycle.

This time last year I had the surgery with mr lower to remove my big adhesion, cyst and tidy my c-section niche. Since then we've tried to get pregnant 3 cycles and had two natural pregnancies and one ivf pregnancy, all very brief (though this one is dragging out). It's just annoying that we've only been 'allowed' to try 3 times in a whole year. Xmas will be 5 years of trying, which fees significant. I feel like time is flying by far too fast. I'm sure my recent 40 years old status is magnifying those feelings. Just a little def indulgent rant.

@Gardenlady543 if you are ignoring the ERA then consider adding PIO after transfer if you are worried. Yes it’s painful but it’s the best at getting progesterone up and staying up.

I think it was week and half before anything got easier. I sleep on my side and I used a pillow to support me. I will say it feels like you will never get better then suddenly you just are. I am so sorry you are going through this it’s so unfair. Do you read much? Could be worth picking a series and getting stuck in. Ken Follet has two amazing trilogies that are really gripping. If you’re too tired to read maybe the audiobook?

im sorry you are having a bad day @Janefx40 irs not over yet. Keeping fingers crossed for you.

@Gardenlady543 I don’t think there is any rush with the steri strips. At my follow up it said the scar has healed perfectly. I left the strips till week 4 like I said. I showered everyday and just let water run down past the scar - I didn’t touch it or wash it directly I just patted it dry and wore thin high waisted underwear

@Gardenlady543 I had a c section belt after mine. You can put a pad in to protect the scar and it also comes with a cool pack and heat pack to put in (although I didn't use either).

The padding was good tho and reassuring too. I've just spent 20 minutes scouring the internet and they don't seem to sell them any more! There might be something else you could find. It was basically like a bum bag which you insert a pad/heat as needed .

Here it is

www.theraline.co.uk/caesareanbelt.htm

Hi all, hope you are all ok. I have had a little skim through but a lot has been going on since I last posted.

I just wanted to let you know I had the results of my repeat EMMA today. The gardnerella has gone and the lactobacillus has gone from 0% to 87.5%! Apparently they like it over 90% but not far off and I can’t believe the difference! I just want to thank @Gardenlady543 for all the advice. Really helped me understand it all and stock up on all the probiotics! Im definitely not going to stop them any time soon.

So I’m all good to try another transfer on my next cycle. Typically I’m CD2 today so couldn’t be further away but we are off to France on Sunday so hopefully can enjoy a nice holiday before we get back in to it. I know I’m still a long way from the outcome we want but feels very strange to actually have some good news!!

Thanks @Dochas12111 I really hope I can start sleeping more comfortably soon.

@Janefx40 oh wow I didn't realise they made anything like that belt. How are you feeling today?

@seven201 I hate thinking back about time :( by the time I can do another transfer it would have been a year since my last one. I'm worried about speaking to my specialist since I had the open surgery I'm worried she will say I need to wait longer than 3 months.

@Molls87 wow amazing news!! The evidence often looks at >80% lactobacillus so the number you got is great and with a few more vaginal probiotics it will likely be even better. You could try a daily vaginal probiotic during your transfer cycle.

@seven201 I missed the 40 year old status comment. Happy belated birthday! And don't worry - 40 isn't that old (says the 45 year old).

@Molls87 great news about the lactobacillus. Really reassuring to know the treatment works.

@Gardenlady543 I've been very low. As time goes on I feel more and more certain this is a failed cycle BUT I've decided to pretend the opposite and enjoy being PUPO. I've got 4 more days to enjoy the possibility so if anyone asks, I am pregnant! I'll see how long I can keep it up

X

@Janefx40 oh yay I'm hoping you have a really lovely 4 days! Are you testing on Sunday?

@Gardenlady543 I'm not quite sure when I'll test. DP is away Saturday to Sunday night. I've planned to do evening tests so that we have time to process without DD. Sunday is 10dp5dt which would be test day at my old clinic who I always use as a benchmark. My OTD is Thursday 15th but I have to test before then as if positive I need to do intralipids asap.

I think I'd be tempted by Saturday if DP was here. We shall see...

That study is really helpful! Thank you @Gardenlady543 I wasn’t thinking about the testing but maybe I am now.

@Janefx40 thinking of you! It must be hard with the symptom spotting but as you said try and enjoy being PUPO although I’m not sure I’ll cope when it’s our time!

I know this might sound crazy but I’m going to put it out there. I had a MMC at 17 weeks on the 1st Feb 21. I had normal ish period April, May and June. From July I got prolonged brown spotting for at least 7 days before my period started. Assuming it was low progesterone because I don’t spot now I’m on cyclogest. I was worried it was caused by the covid vaccine because I had that in July but another worry is I over exercised last Feb and more March in particular as my coping mechanism after the loss and was raising money for Sands charity. I’ve seen that over exercising wrecks your hormones and depresses estrogen and progesterone which is the problem I have. But surely 18 months later it wouldn’t still be having an affect? I’m trying to find the reason for the brown spotting. Xx

@Molls87 that is so great that you've had such a good turn around. Weight off your shoulders before your holiday.

@Gardenlady543 I hope your day hasn't been too uncomfortable and sore. Gosh, a year delay, that is a killer. I hope your specialist doesn't make you wait long.

@Janefx40 four days! Agh! Try and enjoy the pupo. Thank you for the birthday love.

@Loz2467 I'm sorry, I don't know. I can't see how it would have a lasting effect though.

My period arrived. It's another weird one, but more than just spotting. I start the Letorozole tomorrow. I'm having a worry as he's put me on 7.5mg (usual dose is 2.5 I think) but I've always responded strongly to clomid and tamoxifen and even had to not try some months on them. But when I tried to say that to Mr S he pointed out that was years ago now and was a bit dismissive and changed the subject. The thought of a twin pregnancy really scares me. I'm thinking of just taking 5mg. Can always up the dose for the next cycle. Bad idea?

Hi @seven201 my understanding is multiples are much less common with letrazole than clomid. I wonder if the dose is age related, as mine was 7.5mg. I wouldn't change the dose personally but then I had a really slow response both times on it and ended up triggering later than my usual ovulation.

I'm sorry you have the spotting issue @Loz2467 I would suspect some sort of hormonal reason, particularly as it doesn't happen on cyclogest.

@Janefx40 the anxiety is unreal, I've been thinking of you ❤️

How are you getting on @Gardenlady543

Lots of love all x

I'm popping back in, I've been ignoring testing side of things lately but started going for tests this week.

@seven201 I was on 5mg, I started on that and stayed on that because I responded well/quickly. Will they scan you and adjust it?

@VenusStarr belated happy birthday!

@Gardenlady543 I hope you're feeling a bit better after your op, I didn't expect it to be so intense.

@Janefx40 fingers crossed for you, hope you're ok x

@Molls87 I'm still learning about all this flora and fauna stuff. How did you get your lactobacillus numbers that high?

I got my Fertylisis results. Who else here did that, just @Gardenlady543? Not sure where to go now. Did youget the antibiotics from the Greek doctor (assuming I can do it virtually)? I haven't had time to research everything in the report yet.

I have low lactobacilli, but what was interesting to me was the strep and staph. Did others have that? I have had an ongoing skin issue since 2019. I have always had eczema, but it suddenly went crazy around the time we started ttc. I spent some time with a dermatologist getting on top of it, taking antibiotics, steroids etc. But the problem has never entirely gone away, it hasn't gone back to how it was pre-october 2019, even if it's under control now. It's like there's always an underlying infection. I can't help think I have this issue systemically, I guess. No idea how relevant it all is but made me wonder.

The antifungal cream is Canesten, I assume.

Also had some vitamin deficiency tests this week and I’m going for some swabs with my GP surgery today just to check there’s nothing else happening. I suspected I had thrush but maybe I don’t, the report from the Greek doctor didn’t detect Candida.

@Loz2467 it's so hard to tell with our bodies, I think a lot of things can affect the hormones but if you're having treatment that should be able to be overcome.

@seven201 will this be a trying naturally with letrozole cycle?

@VenusStarr I'm doing ok, just the usual really, I've read some accounts of others who had the same op and everything I've read said it's a tough recovery. So I think I just need to get through the next few weeks of it.

Hi @thislittlebird
So streptococcus and staphylococcus are associated with endometritis. Co-amoxiclav is the medication the report is referring to to get rid of them. You'll want to take 625mg three times a day for at least 7 days. Staphylococcus is associated with skin infections.

The anaerobic bacteria will need a similar plan to the one I have spoken about before, the report recommends you complete the first antibiotic, before starting the second, you'll want to take metronidazole 400mg three times a day, you'll want to do this for at least 7 days as well. I added in vaginal clindamycin to my course.

You could up the length of the courses to 10-14 days.

Probiotic wise they usually suggest taking a vaginal probiotic every other day while on the antibiotics and on the other day a antifungal treatment, they usually recommend clotrimazole 100mg pessaries or a cream if you have trouble getting that, I got the pessaries from an online pharmacy.

They are also suggesting taking a course of vaginal probiotics it reads as if they want a course of them between the two different antibiotics, but my friend got a treatment plan with several antibiotics from them and I'm pretty sure she just did the alternating treatment throughout. Whatever happens you will want to take 10 days of vaginal probiotics after finishing the second antibiotic. I would recommend that you also use a vaginal acid product after the metronidazole.

I think you can pay about €100 and the doctor will write out a plan and I think they can provide a international prescription. I personally would just take the report to my gp and ask for them to prescribe the antibiotics if I were you. It's the co-amoxiclav that you'll have the main issue getting as you can get metronidazole and clindamycin as well as the clotrimazole pessaries from online pharmacies.

It’s all a lot to take in. I’m not even sure I have it in me to bother with all this, or the money. I’ve never had any indication of having endo before, I’m assuming the presence of strep and stap don’t = endo automatically, it’s just one potential outcome? I’m familiar with staph because of my many skin infections over the years.

I take it what you mention above is what you had to do? I’ll think about whether to do the consult or not, my GP might help and then they might not. Hard to say. Hopefully they will.

I thought you said endometriosis but you said endometritis, so now I’m even more confused because I’ve never heard of that before lol. @Gardenlady543

I dunno, this whole Level Up of infertility is making me question everything I guess. I’ll see if I can book in with my GP which may take a few weeks and go from there.

@thislittlebird my gp practice has a thing where you can just leave them a copy of the report and they'll write a prescription, so maybe ask reception if they can do that? I think it's best to start treatment asap so if you can't get your gp to help, do you have a fertility clinic? My friend said the fetilysis doctor wrote a prescription but they were not able to collect it from a Uk pharmacy so their gp wrote the treatment up in the end. Also I take it you're not allergic to any medication as cost amoxiclav has medication from the penicillin group in it.

Endometritis is inflammation of the endometrium, there are certain bacteria that can cause it. It can cause adhesions and scarring in the uterus. So once you've completed treatment you may want to do a saline scan or hsg to check.

@Gardenlady543 Yeah they’re fine, I’m not allergic. good to know there may be no point getting prescriptions from Greece. Did you pay for the full plan or just submit the initial report to your GP? I’m switching clinics soon, I’ll be moving to a private clinic from my nhs one after my last transfer. My GP are ok sometimes but other times more annoying. My own GP is really good and supportive but getting an appointment with him is hard work sometimes.

I can’t start this right away unfortunately, I’m on antibiotics right now for my skin which has flared up again recently. So I’m assuming I’ll need a break and then can start all this another time. But I’m going to aim to take probiotics after this course of antibiotics ends in a few days. Is there any other brand of vaginal probiotic beyond canesten that you’ve used or know?

@thislittlebird what antibiotic are you taking at the moment?

My story is complicated:

I did EMMA ALICE and had 0% lactobacillus and a mix of dysbiotic bacteria and was told to take co amoxiclav.

I repeated EMMA ALICE, still had 0% lactobacillus, the mix of dysbiotic bacteria I had last time was gone but I had a large amount of garnderalla. I took metronidazole and clindamycin for 12 days, alternated between the vaginal probiotic and antifungal then took a course of vaginal probiotics after.

I decided to do fertilysis microbiome testing after rather than another biopsy and that showed everything was normal and I didn't need anymore treatment.

My friend did 2 x EMMA ALICE and had some gardnerella on both, she then did fetilysis and it picked up ureaplasma, she had the consultation with the doctor at fetilysis and got her gp to prescribe what they recommended. She then repeated fetilysis and still had ureaplasma so went to see a private STI doctor in London who took over the treatment, they wanted a swab to show evidence of the infection though before treating.

@thislittlebird these are my favourite probiotics:

Vaginal:

Florafemme, this is the ultimate vagina probiotic, it has 72 billion bacteria in it and lots of different strains. It is expensive and you only get 6 in a packet so I would recommend doing it straight after the final course of antibiotics and then do one packet before a transfer.
https://florafemme.com

Physioflor
This has Lactobacillus Crispatus in it which is felt to be a very good strain of lactobacillus
https://www.sanareva.co.uk/physioflor-vaginal-flora-natural-probiotic-7-capsules.html?queryID=7ba247daa28306736d35e5cc6b5bb8fb&objectID=22151&indexName=productionenngbproducts

Vagibiom
This also has l crispus as well as some other strains
https://www.ebay.co.uk/itm/Vaginal-Probiotic-Suppository-30-Natural-Vaginal-pH-Odor-Control-No-Parabens-/283702366882?mkcid=16&mkevt=1&_trksid=p2349624.m46890.l49286&mkrid=711-127632-2357-0

Gynolact, this one is good as it has 3 different strains in it
https://www.pharmasana.co.uk/gynolact-vaginaltabletten-8-st-03034436

Oral:
Bio.me.femme
www.supplementhub.co.uk/products/bio-me-femme-v-60-capsules

Optibac for women, you can get this from a lot of places, I've even seen it at tesco.

Femdophilus - there are 2 strengths I get the strongest. You can get from Amazon.