ERA EMMA ALICE testing thread 7

[VenusStarr]

Hi all. We're on our 7th thread! Really hoping for some more positive news in the coming months.

@thislittlebird I can feel your hurt in what you wrote ❤️ just want to send you a hug.
I'm trying not to think about what covid has done to me and dh 😓

Hope you're OK @Janefx40

Thinking of you @seven201 hope you're doing ok. Its nerve-wracking and hopefully abit exciting for you ❤️

I'm pretty sure I've ovulated, so about 2dpo I think, but ive had some brown spotting mixed with ewcm (sorry, we're all friends here right?! 😅) so that's new 🙄

@VenusStarr spotting has scared me so many times in the past but never been connected to bad news in the end. Could even be something good

@seven201 hope you're ok however things are going.

@thislittlebird I'm nearly 46 and 28 weeks pregnant. You're not too old. But I do have more visible veins than I used to!

Thanks @Janefx40 for flagging about this new thread. Just reposting on here 😊

Hello,
firstly all the best of luck to all of you going through treatment, may you cope as best as you can with the stress, long timings and any set back.
I just wanted to hop on here as I’m headed towards my first ever embryo transfer, a frozen one, likely to happen mid to end of April.
Today it was the end of an ERA mock cycle and I had a hysteroscopy and endo quartet biopsy for ERA, EMMA, ALICE and NK cells. I also had NKC bloods.
There is no suspected issue with any of these areas however as I only have 1 genetically tested euploid embryo (low grade) and one only chance at a transfer (wouod love to afford more egg collection cycles but I can), my consultant felt prudent to assess absolutely everything possible to give me the best possible chance of successful implantation.
What’s usually the treatment for abnormal EMMA or ALICE please? Is it probiotics ot antibiotics? I must admit I’m not overly clear on the purpose of those tests.
thanks

@VenusStarr honestly it feels even more unlucky that we’ve all had to go through this during covid too. It’s so frustrating.

Ugh, hate when there’s anything new to your cycle, just another thing to worry about.

What are you guys doing now?

@Janefx40 I know it’s possible when older than I am, but it just feels like we’ve missed the boat. My mother claims to have had an early ish menopause and I can’t say for sure when that was, but for me I’ve noticed changes in (tmi) all this vaginal irritation (bv? Microbiome? Thrush? All of the above?) over the last few years, which I definitely didn’t used to have. Got my first grey hair, struggle with my weight more, weird veins popping up. It just all feels like such a visual reminder of my age and we still can’t pass go.

Hopefully all is good 28 weeks in!

@VenusStarr thanks for the add. I’m
not familiar with superovulation cycles, do you get monitored to check ovulation etc. ? What’s next step? Everything crossed.

@Janefx40 Amazing to hear you’re at 28 weeks, I’m now 44 and heading into a stim cycle. You’re so thoughtful to keep checking in on us still fighting the fight. Hoping all continues to go well for you.

@thislittlebird so sorry you’ve been messed about and it’s wasted precious time. I had similar issues with mismanagement in early days, which led to 2 years delay. It makes me angry thinking about it. As you said, everyone’s chances are different with age being one factor. Have you had your AFC and AMH checked recently? That’s a better indicator, though I hear you with the grey hair etc. You asked a while ago about my stim cycle stats past 40. Let me know if you still want these. Hope the appt goes ok tomorrow.

@2021ivfagain thanks for asking after me :) Your lining thickness looks good to me. What size are your follicles? Your expectation of 3 blasts seems reasonable based on your day 3s. It can happen on one cycle at age 40. You’re doing all you can and some things will be out of your control.

@Enfys23 good luck for FET prep. I started pred a few days before my FET. Can’t recall about the clexane. Worth asking your consultant again about timings. I used fFertility Network for stim meds. Originally was same price to my clinic but then swapped Gonal F for Ovaleap and that made the difference. Saved £300 (I’m on a lot of Ovaleap!). For FET drugs (Lubion and clexane/inhixa), I found Asda the cheapest.

@seven201 hoping things are still looking good with line progression. It’s so nerve wracking.

@Gardenlady543 hope Tues goes well and glad to hear you’ll be taking time off near FET.

@Loz2467 relief that you got the meds in time. Re your infection, do you know it’s cleared now? If clear, maintain with probiotics but if not, antibiotics may be required first.

@ Kerry sorry I cant tag you properly. Your AFC and FSH look fine to me so unsure why clinic is delaying. Fair enough if you have time and happy with the delay to get optimum afc and FSH. My clinic don’t even measure FSH anymore.

@Lori2022 sorry you’re tired of it all. Keep the fight if you can. What’s next step for you?

My down reg scan went fine so did my first stim injections last night for my PGT-M cycle. I had to hold back the tears. Surreal being in this position when I thought I’d be 8 months pregnant now. I had the post mortem review the other day and no major findings. Nothing significant looked wrong. So sad to read the details of my baby boy in that manner.

@clhiu sorry I missed you first time. Yes, antibiotics and probiotics are usually the treatment for suboptimal ALICE and EMMA results. When do you find out? @Gardenlady543 wrote a great post on it on Reddit. If I find it I’ll post it.
Its good you’re being thorough before transferring your precious euploid.

@CailinInUK

I did my egg retrieval at 40 when my fsh was much better. I think your ovarian reserve was better than mine as I last did a long protocol at 38 when I got pregnant with my son in 2020. Now I’m 41 and a few months away from 42. My fsh is high. However, I’m really anxious today as my left ovary is responding too fast to the meriofert injections. I’m also doing a superovulated FET cycle which I thoroughly recommend. It’s kind of natural frozen cycle with monitoring and mild stimulation. I’m only on 225iu meriofert every other day but I’m on cd11 and I tested a Clearblue Advanced and it picked up high fertility which means I might need to trigger earlier. I’m on the way to CRGH today but rearranged my work as I was triggering on Wednesday! My left side seems stronger than my right ovary. The strange thing is when I had my baseline scan they checked and all my follicles were below 6 on day 3, but my left is responding fast. Is that a bad sign? I did take more dhea this time for 3 weeks just to make sure fsh was ok.

Sorry for long post. Hope you’re all doing ok.

@CailinInUK I’m doing a frozen transfer so the number of follicles just help the lining grow.

I’ve just read the rest of your message. I’m sorry you’re upset. You’ve been through a lot. I’m hoping this is your lucky cycle. You must have a good ovarian reserve to do the long protocol. Take it one day at a time.

@2021ivfagain I’m doing almost the same exact same protocol for my FET with CRGH. Superovulation, however in my case they also recommended a mock cycle and hysteroscopy first, this cycle concluded yesterday.
I was put on 300iu Meriofert on alternating days, which was meant to last for 11 days from baseline scan, for a total of 6 injections and trigger was initially pencilled for day 12. Well my lining and ovaries responded much faster than expected to the medication (I was quite sad to see all those extra follicles growing and not being able to make into an egg collection 🙁, felt like such a waste) and I ended up triggering on day 8 after just 4 injections, but I wasn’t told that was an issue, I guess that’s why they monitor you as sometimes things move faster for some. All in all I don’t think it’s a bad sign at all no, except perhaps for the wasted medication.

@CailinInUK have my follow up 15th March, by then all results should be back hopefully.
I am so so sorry to hear about what you’re going through and finding no reason for the loss, my heart breaks for you

@Loz2467 so glad you've got your meds and no longer delayed!

@2021ivfagain hope all is going well in there! You do seem to respond fast! I don't see why that would be bad though.

@thislittlebird sorry you're having such a rough time. I hope Mondays appointment goes as well as it can.

@VenusStarr so are you trying naturally this cycle or just on the count down until you start? I wouldn't worry about the spotting.

Welcome @clhiu. As others have said it's antibiotics if they find an infection and probiotics if you have low levels of good bacteria/high levels of bad.

@CailinInUK well done for getting going about, that's a big achievement. Sorry to hear you've had the post-mortem. That must be a horrible letter to receive.

All fine with me I think. Made the mistake of googling 'late implantation' and it's all about higher rates of miscarriage. I wish I could stay away from bloody Google! Does anyone know what you're meant to do vaginal probiotics wise after a positive pregnancy test? I've not been told and I can't imagine CRP knowing much about that. Sorry to ask.

Thank you for your replies ladies, I really appreciate it

Are most of the tests people have via private clinics or does the NHS offer them too?

@seven201 I hope your lines are getting darker! When I was first scanned after referral to the fertility clinic, it was 2.9mm and this was almost 2 years ago. Since then I have been on Letrozole, had a laparoscopy and hysteroscopy, put on weight and gone from a BMI of 16 to 21/22 ish. I’m on the NHS and have one FET left. I don’t have periods anymore so I don’t think trying on a natural cycle is an option unfortunately, unless anyone knows otherwise?

@2021ivfagain Thank you for sharing your experience. It’s really nice to hear your lining got to >12mm! What is a superovulated cycle? Is it the same as mild stims? (I’m assuming not as you mentioned trigger). I tried acupuncture pre stims and got weird sensations in my hands in between sessions so stopped. I’ve been considering going back but now I have had an allergic reaction on my abdomen at the injection sites after stopping Lubion. It’s inflamed and has been increasing since Friday. I stopped injections on Thursday. I have no idea what is happening. When I did acupuncture last time, there were a lot of needles around my bellybutton so I wouldn’t want those right now 😅

@Gardenlady543 thank you for sharing that paper. I’m going to take a proper read this evening.

@VenusStarr I’m so sorry to hear about your MMC and your BFN. I’m glad your lining thickened up with the mild stims. Mine was was triple layer before my first FET. I think mild stims plus viagra might be the next best step for me

@Enfys23 thank you :) Really glad to hear you’ve got your updated protocol. I think if you have any doubts, definitely ask your consultant.

@CailinInUK I’m so sorry for your loss and it must have been so hard to read that letter 💔

@seven201 you can do one daily until the 6 week scan. Sounds like the tests are looking good, are you going to get a beta?

@clhiu the treatment will depend on the results, let us know the result when you get it. This is the post I wrote on the microbiome https://www.reddit.com/r/infertility/comments/rwsxwy/theuterineemicrobiomeemmaaliceemenstrualfluid/?utmmsource=share&utmmedium=iossapp&utm_name=iossmf

So good news is the blow torch came in handy and I made vegan crème brûlée (picture attached), bad news omg do I feel sick. Prednisolone 25mg starts tomorrow, so that's my last big sugar hit.

@Gardenlady543 one daily! I should do one tonight then (as not since about 5 days before trigger) but I guess you just don't poke too far in. Thank you so much, I didn't realise. I think my line is gradually getting darker but not a typical very dark 16dpo line. Trying to keep the faith!

I can't remember what you bought your blow torch for. What was it? Creme brûlée looks AMAZING!

@Spin101 I initially tried to get tests and treatment on nhs but there were staff shortages and it all took too long (it's been over 5 years for me including some wasted years thanks to misdiagnoses). I did have a laparoscopy and ovarian drilling on the nhs come to think of it. I regret my ivf clinic, if I'd gone for one that does more thorough initial tests then I wouldn't have wasted years. I also already have a dc so wouldn't have been entitled to ivf, so the nhs couldn't have done too much for me. When it comes to immune treatment (I have that for recurrent miscarriage) the nhs are limited to the drugs they can offer you. I wanted the whole shebang so am paying a fortune for all the bells and whistles.

@seven201 You don't have to do one daily, actually I just looked at the study protocol and they will give participants a vaginal probiotic twice a week until the 6 week scan bmjopen.bmj.com/content/bmjopen/10/10/e035866.full.pdf I regret stopping after transfer as my pH changed in my last FET. So I'm going to do one daily and stop a couple of days before the transfer and then recommence daily a couple of days after.

@seven201 blow torch is to light the moxibustion. DH says it smells like someone has been smoking in the home!

Hahaha! You must use your blow torch as much as possible. I wonder if you could do a slice of toast? Maybe some fancy Japanese scorched vegetable dish!

Thanks so much for the link, I will take a look.

@clhiu
I’m at CRGH too. I also did mock cycle but last November with Emma, Alice, era and nk cells. I only have 7 day 3 embryos frozen left as I was originally doing batching but I had delays due to passport etc which cost time and covid. I did do two other egg retrievals but egg quality became worse in a short time. I’m TTC my second.

It’s strange that you’re on a higher dose of meriofert! My consultant told me it’s usually 150 meriofert every other day, but they upped mine to 225 every other day and it has worked. However, I also do oestrogen priming due to having high fsh, so I think that helps me as well.

When is your transfer?

@seven201 this really did escalate for me, I thought well if I have the blow torch I need to make creme brûlée, but to do that I had to buy ramekins and I ended up buying a set with a Bain-Marie and it turns out the vegan version doesn't even need a Bain-Marie!! So now I need a recipe that uses one of them!! This is like the centrifuge all over again!

@Gardenlady543
It sounds like you have a good plan. With the steroids do you have to avoid sugar completely? I like 90% dark chocolate as a treat but not taken steroids for a longer period.

Are you close to the trigger? I’m on cd11 and have to go to CRGH for another scan and blood test.

With the vaginal probiotics, which ones are you starting after transfer? I ordered more vagibiom but will stop soon. My consultant told me to keep with canesflor after transfer but I’m wondering if he’s being over cautious. Did you use Flora Femme in the week leading up to transfer?

@2021ivfagain I still eat some sugary stuff but it's probably best I avoid things like this which is very sugary, I like dark chocolate as well. I will do vagibiom early on, so now and will use things like canesflor, flora femme, gynolact and physioflor as I get closer around transfer time. I'm CD6 today, I finish letrozole today, then pred and clexane start tomorrow and first scan is Tuesday, also intralipids Tuesday afternoon. My prediction is I won't get the 7 day countdown to transfer until a week on Monday, but I expect they will scan me at least a couple of times this week.

@Spin101 A superovulated frozen transfer cycle is when you do have a mild dose of stims, usually every other day. I’m on 225iu meriofert every other day until trigger. When at least one follicle is 18mm or above, you trigger. Then two days later you return to have a scan and bloods to confirm ovulation. Then the next day you start blood thinners, steroids, lubion and cyclogest twice a day. On day of transfer (5th day of progesterone) I’m also having an infusion to help with low nk cells in endometrium. Superovulated cycle also involves daily checking of ovulation tracking. I use Clearblue Advanced. It told me today I had high fertility.

I suppose this protocol is really good for getting a good lining. I’m on cd11 and it’s currently between 9.7-10mm.

I think the superovulated FET cycle will be better for your lining. I’m sorry you have not been able to get be benefit from acupuncture. Do you see someone who specialises in fertility?

I'm going to look at getting some of those probiotics too. I usually do canesflor but did do a different one that came from america at the start of this cycle. I'm on 25 pred and eat too much chocolate. I didn't realise I wasn't meant to (for pred, I know we're meant to be 'good' for treatment generally) but I get stressed if I can't have some treats, and that's not good either. Can't win. I'm on high dose of metformin so will use that as an excuse for allowing myself to be so crap

I love how much your blow torch has escalated garden! We've used one to burn off the stuck on dead ivy to our brick house on the past. Maybe you can do some gardening with it tomorrow! I'm glad you're getting going again with the treatment, it seems to have lifted your spirits somewhat.

@seven201 I’m so sorry about your recurrent miscarriages. This journey really is a rollercoaster and the wasted time is so frustrating. I’m grateful for having one cycle on the NHS. It is impossible to avoids the long waiting times for follow ups.

@2021ivfagain thank you so much for that detail. So helpful to understand the different protocols. Can I ask what your lining was pre treatment and are you having this protocol for immune reasons? I’d like to jot a few options down for my follow up with my consultant though I’m not sure what will be available on the NHS. I’m hoping I can pay for extras

@Gardenlady543
I might try to like 100% dark chocolate but currently have 85-90%.

My IVF nutritionist said that I am safe to use canesbalance until 5 days before transfer. Is it ok to use vagibiom plus canesbalance as vagibiom lacks glycogen? I will have to stop 6 or 7 days before transfer and just use Flora femme.

My ph is still not right and I think it’s stress, but also my lowering oestrogen levels now. I can’t cancel my cycle. I’m still quite dry vaginally now even on cd11 but afc has dropped a lot. I’m wondering whether this is causing my problems. I’m worried about not being able to use canesbalance for a while. I know it’s safe in pregnancy but not around conception. Did you think canesbalance is safe a week after transfer?

@clhiu
It looks like a thorough protocol for you. I completely understand that you want to cover everything.

@Spin101 My lining on cd3 before meriofert was 4.6mm. In the luteal phase I was doing oestrogen priming with zumenon and norethisterone. I also took 75mg dhea this time to ensure fsh was low enough. I took dhea just for a few weeks. I did an emma, era, Alice and nk cells biopsy in November as I only have 7 day 3 embryos frozen which will equate to 3 blastocysts as predicted by consultant. I have slightly high nk cells in blood so will be on steroids and slightly low nk cells in endometrium so will have an infusion day of transfer. My era was receptive so transferring only on 5th day of taking progesterone. Also on blood thinners as this is standard with CRGH.

The superovulated FET cycle is best for my lining. I don’t have major immune issues.

@Gardenlady543 Are there any supplements you are taking alongside steroids? Are you taking calcium supplements and extra vitamin D with steroids? I’m on a high dose of vitamin D in the winter but worried about dropping with the side effects of steroids. What are you doing?