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

❤️

@Enfys23 so sorry to hear this. The delays are so frustrating I know. Xxx

I think you’re right @Gardenlady543 definitely hysteroscopy priority now. My clinic said they would do biopsy at over 4.5mm hopefully it’s not such hard work to get to that next time facepalm

@Janefx40 thank you I’m just getting so worried that if this all takes so long and our two frozen embryos don’t take, my ovarian reserve will be even worse 6 months plus from the last egg collection. Our funding package means we have to use all embryos before creating more though.

Sorry I’ve fallen off the thread ladies I stopped getting notifications in my inbox. I’ve tried to catch up the best I can!

Just a quick recap. I’ve got a 3 year old. Concieved again when he was 15 months old. Miscarriage at 18 weeks In Feb 2021.

Been TTC since with no luck. Starting July 2021 started getting a whole week of brown spotting before my period and a lighter period. Had hysterscopy and biopsy in May and nothing found - no scar tissue - no endometritis. I did loose our baby due to an infection so I’m worried My lining has been affected.

clomid alone didn’t stop the spotting but clomid along with cyclogest from 2 DPO is controlling the spotting.

Ive done 4 months of this now and no luck. I’ve booked in for IVF for January but I’m so worried about financial implications / it not working / this going on for a number of years etc. After 2 easy conceptions I just didn’t see myself here and I’m struggling what to do. What if my lining is horrendous and an embryo wouldn’t implant?

Im 36 and my AMH is low end at 8.4.

Im just so lost and on a work conference with so many pregnant women.

Is my issue low progesterone because the cyclogest is stopping that? Or is it an issue with corpus luteum and egg quality. I just can’t understand it.

@OrangeBengal good luck for tomorrow!

@Gardenlady543 hope the LIT goes well.

@Enfys23 so sorry you've been cancelled. It's happened to me a few times and it's absolutely gutting.

@Loz2467 sorry for your troubles. I'm sorry but I have no idea about that. Did you have the Alice and Emma?

@Loz2467 so sorry to hear this. It can be so painful being around others who have their happy news.

what did your biopsy check out - was it all three ERA/ALICE/EMMA? Hopefully that has ruled out infection?

are you using a funding package? Even though we’re ttc #1 and NHS eligible we’ve had to go private as consultant (who is nhs and private and I really trust and tries to save us money in every way possible) warned us with the added delay to start treatment of the NHS system (in the UK area I’m in even if you’ve been trying 2 years+ they make you wait additional time between them doing initial fertility investigations and starting IVF), my AMH might have fallen too low to then meet their criteria for NHS funding! Cruel irony. So we’ve decided to start immediately private.
so we’ve got a x3 ivf cycle refund package (if no baby home at the end of it we get our £11,500 back). They often include unlimited embryo transfers, various add ons etc and do make it a lot cheaper than paying as you go. You do have to pay for all your drugs though. It’s been reassurance for me actually having a refund package as I know the clinic really will want it to work just on a financial level as otherwise it’s a lot of money they are handing back and I’m sure it gets to a point where they’re only just breaking even if you’ve had loads of cycles and transfers.

Thanks @seven201. I’m feeling good actually. Throughout all my cycles (bar fresh) I’ve had to up my progesterone a couple of days prior to transfer and never known if I’ve achieved the 100+ mark on transfer day, and for the first time I can be assured of that. 111 on Monday - whoohoo!

@OrangeBengal good luck with your transfer 🤞🏼🤞🏼

@Gardenlady543 hope the LIT is ok. Great to get that done. Do you have to be re-tested after? How is your recovery now?

@Loz2467 sorry you find yourself here. I don't know anything about how clomid works but I'm not surprised the cyclogest sorted the spotting as it is usually associated with progesterone levels.

Periods being light doesn't necessarily mean much for the lining - it may just be because you were shedding a lot of it during the week of spotting and I think it depends how light it is too - I have been concerned about this in the past and had good linings but then they got super light this year and my lining was thinner. You will find out anyway in an IVF cycle as they will be checking your lining.

However if there is a simple hormonal cause of your lining being thinner then medications used in IVF can sort it out. As you'll see in this thread it can be more complex but I think you have to try the obvious things (like estrogen and progesterone supplements) first.

Best of luck xxx

@Enfys23 I haven’t had the ERA / EMMA and ALICE. It was basically the hysterscopy and a biopsy to check for inflammation / endometriris that came back clear. Plus a gentle D&C to help rejuvenate the lining and stop the spotting - but that didn’t work. The only thing that stopped the spotting was the cyclogest. All this spotting started the month of my covid vaccine too which I’m worried about. I’ve looked at the IVF packages actually at my clinic - CARE fertility and they do seem good. That’s if my AMH has stayed over 5.4 wirh it being low in January I don’t know how quickly it drops. I guess like you say it’s reassurance going into it.

@Janefx40 Thank you! I guess I worry because I’ve only had my lining done once after ovulation and it was 7.2mm and “not very clear”. It did look very strange on the screen and not like the linings I see on ultrasound images on google! I know the progesterone changes the look of the lining but she didn’t convince me that it was okay. Obviously my partner would say don’t worry about lining because I’ve had the hysterscopy but that’s a camera and doesn’t see any thickness and I do worry incase the infection has damaged the lining and the texture of my periods have changed since my miscarriage. Sorry for TMI but they are like gloopy?! It just doesn’t make sense to me 😞 xxx

My AMH is 6.1 and the consultant said that it takes around 12 months to fall significantly enough to need to recheck it so you should be fine and with 8.4 you’ve got a bit of wiggle room @Loz2467

Thinking of you today @OrangeBengal and @Gardenlady543 x

@Enfys23 I hope it’s stayed up! If not I’ll do the multi cycle package no refund. Have you had egg collection yet? I’m wondering I won’t get many eggs with that AMH. My follicle count was 21.

@OrangeBengal good luck and everything crossed.

You ladies are all so knowledgable. Also he said my protocol will start on cycle day 1 but I know some people start on day 21.

@Loz2467 personally I think that follicle count is more indicative of egg numbers than AMH. I used to think AMH was the key number but over time I've started to question that. But quality is also important and at 36 you should hopefully still have a good proportion of healthy eggs.

Hi everyone. I'm sorry I've not been around for a while, I've been really struggling, life is very overwhelming and I feel like I'm hanging on by a thread.

I've not managed to keep up with the thread but I hope that everyone is doing well ❤️

I am in the middle of my FET. The plan was a low dose stimulation to use my natural estrogen to boost my lining. That was the plan but its got a bit batshit and a head🤯 on Monday I had 1 dominant follicle, lining was progressing OK. I started fyremadel to stop me ovulating on my own. Yesterday, my lining had grown by 1mm and I now have 3 follicles. My doctor said, why don't we convert this to an egg collection cycle, I don't want to waste these follicles. Tomorrow is another scan (my 4th this cycle!), if those follicles are still doing well, trigger is Saturday and egg collection on Monday. If not, it'll just be the FET as originally planned. I don't even know what to make of it. I've responded almost exactly the same as my fresh ivf cycle but on a much lower dose of meds (225 vs 75). He bumped me up to 150 to try and boost my follicles. I didn't even know this was a thing. The nurses I'd seen had already commented my protocol was not standard.

So that's where I'm at, genuinely don't know if I'm coming or going.

Lots of love to everyone 💕 xx

Thanks @Janefx40, @Loz2467 and @Enfys23, transfer went well, I’m just relaxing today. Embryologist was very happy with my embryo (it was one that had been biopsied twice due to an unknown PGS result the first time round) and lining and uterus in general fab apparently. Aspirin started and will add Clexane to the mix later. Prednisone started a few days ago. I’m going to start testing from Sunday in case I’ve been having chemicals all this time and just haven’t realised because I tested too late to know.

So glad to hear from you @VenusStarr I've been wondering how you are but didn't want to @ you as I know you mentioned taking a step away a little time ago. Wow at going from FET to collection cycle, that's a big change! Will you do a fresh transfer? I'm still recovering from my surgery, I can't have a transfer until the 3rd bleed, so the cycle will likely start in late November. I have a immune protocol and have all the meds, had enough of it really, it just seems like so many medications to take and I don't know, I'll give it a go, but not sure how many immune protocol FETS I'd be up for especially after all the LIT and surgery. Think I will feel like, erg I went through all that for nothing if I have another failure after all this.

Congrats on being PUPO @OrangeBengal glad the transfer went well.

I know @Gardenlady543 totally crazy. He said if I get some blasts, if they're A/Bs we can do a fresh transfer with one of them. If not, we'll put my frozen one back (if it thaws). My head is thinking of all the worst possible scenarios. Even though he said this is all very promising and he seemed genuinely excited, I'm petrified. But I could also go tomorrow and thefollicles aren't there / not growing well so we just revert back to the plan. But I feel a bit of excitement that it is a possibility. But mainly feel anxious.

It's so hard. I'm losing track of all my meds. I'm currently having intralipids, it's a lot isn't it. All the prep, all the meds. It's exhausting and terrifying. I hope you're feeling well after your surgery.

I had a scan at the hospital in September to double check for scarring. I'd put in a complaint as the consent doesn't mention it as a possibility. Small win in that they've updated the Surgical Management of Miscarriage consent forms to include that now.

Congratulations on being pupo @OrangeBengal 🥰

@OrangeBengal Congrats on being PUPO. Glad it went so well. Enjoy these first few days if you can before the craziness sets in!

@VenusStarr lovely to hear from you but yes what a headf$*+! I guess the good bit is that you are responding. Let us know how things go (if you want to) x

@VenusStarr cautious excitement, I know that feeling, so much has gone wrong for me that there are no wins, because as soon as something seems to be going good I'm so used to it then going wrong! It sounds like you have a solid plan though with options for various scenarios.

I feel like I know quite a bit about adhesions and scaring now and it's surprising how it never gets mentioned when people are having gynaecological surgery. It's my biggest fear from the op I've just had.

@OrangeBengal how great that all went smoothly. Good idea to test earlier so you know about chemicals.

@VenusStarr lovely to read your update! We've all been wondering about you but wanted to respect your privacy. Well done on getting the team to give warnings on scaring. It's probably where mine latest one came from (surgery to clear last adhesion) unless my July medicated miscarriage set it off somehow! I hope you have three plump follicles tomorrow at your scan!

I hear you all with the meds. It's pissing me off at the moment, although I know you have it worse @Gardenlady543 with the LIT. You will at the least know you threw everything at your December round. My hair is still falling out from the hydroxy and my messed up dreams are meaning I'm not getting good quality sleep, just started my steroids today and that usually means I can't get to sleep. I have a whole kitchen drawer of my meds and supplements, plus overflow in a cupboard. One day that drawer will be gone, one way or another! Let's not even mention the cost (intralipids being a biggie). Sorry, having a moan!

I've now finished the fertilie window of my letrazole cycle. My dd has caught a sickness bug so the timing was bad, but hopefully the sperm has made it to the right place at the right time!

I’m sorry things are so rough right now @seven201 it’s so hard to find positives at times like these. We can only keep focusing on the end goal.

@OrangeBengal so glad things went smoothly and thinking of you during this wait.

@VenusStarr wow what a turn of events! I hope you are doing ok with the emotional rollercoaster. Hope all goes well with those follicles now! 🤞🏼

@Loz2467 I think you’ve got good chance of decent number of eggs with those stats. I know with my AMH they expected more and were surprised my results so poor. Thanks endo!
It is most common now to have short protocol which usually starts day 1. It’s better usually to do short protocol if your AMH lower side.
You quickly get knowledgable in this “game” @Loz2467 ! Believe me you’ll sound like a pro a few months in.

Clinic now making arrangements for me to have hysteroscopy and biopsy next cycle. Feeling a bit more positive now that we have a plan. They’ve also advised in first instance to try high dose transdermal oestrogen plus some oral. I was on 6mg oral only to start this time round and then up to 12mg from the day 12 scan. They’re proposing 12mg oral from the start plus alt days 100mcg patch. I guess the prep for the ERA biopsy now gives us a chance to see if my lining responds better to this regimen. Otherwise I’ll be asking about mild stimulation and/or vaginal sildenafil for next FET cycle.

@Enfys23 I'm fine really, just needed a moan!

Oh that's good. It sounds a very sensible plan. I was on 12mg oral (or sometimes mix of oral and vaginal) estrogen tablets plus 2x 100 patches changed every other day. Also viagra (oral) and aspirin plus neupogen infusion into uterus, all to supposedly help to thicken my lining. No idea if anything made any difference!

@Enfys23 are you in the UK, I think there is just one country in Europe that does vaginal viagra as some clinic there arranged to have the vaginal preparation made up. This was when I looked into things a while back. I took oral and it was not for me, I got muscle aches that were intolerable.

Great plan for the hysteroscopy and biopsy. I think you'll know more once that's done. Make sure if they biopsy for ERA that they do EMMA ALICE at the same time.

Thanks @seven201 and @Gardenlady543 it’s reassuring they’re really thinking things through and making some changes. The biopsy is going to be all three for sure @Gardenlady543 - just had the quote! Eek

Oh and yes in the UK @Gardenlady543

I’ve started bleeding already. Does this mean it’s my day 1 tomorrow (it was after midday when I started). It’s light but definitely fairly pink red at times and enough to wear a pantyliner.

Thank you 😊 @Enfys23 if it's quite light and pinky, I'd say cd1 is tomorrow. Glad you hace a plan and can get started.

Thank you for thinking of me @seven201 @Janefx40 @Gardenlady543

My update is that egg collection is happening! 😳 I am back tomorrow for a final scan just to see if we've pushed the follicles over the line and check my bloods. But I've got my egg collection plan for Monday. There's 4 visible follicles now, largest is 17mm. I think I'll regret not giving it a try. But will see what tomorrow brings.
The best news is my lining is 7.1mm 🙌 I know compared to others it's probably not that great, but after months of barely 6mm, it's great news. Doctor was happy with how it all looked and said he's happy to do the transfer but let's get those eggs 🙃 genuinely couldn't make it up. I'm taking next week off. I'm looking forward to that sedation.

Love to all xx ❤️