ERA EMMA ALICE testing thread 9

[Gardenlady543]

@2021ivfagain @Enfys23 @clhiu @CailinInUK @Spin101 @Loz2467 @Mybabydream @Janefx40 @ChickenT2b @kerrym87 @Sar1010 @AM08 @thislittlebird @IVF22 @APSR
@Faithhopelove83 @KLM25 @VenusStarr
@BewilderedBee @Dochas12111 @seven201 @StillWishingHoping

We've maxed out the other one so here's thread 9 😊

@Gardenlady543 that’s helpful thank you! For my pred dose it’s 10mg from day 7 then upping to 20mg on transfer day but the Greek dr in London recommends adeno patients up to 20mg on start of prog? I’m just worried to take too much because I haven’t had the Nk cells testing.

if I take too much can it also reject the embryo?

@clhiu How are you getting on? Yesterday was my wedding anniversary so it was difficult as I had to decide the best option for the miscarriage. I opted for medication to take home as I didn’t want to be in limbo waiting. The nhs are testing the product free of charge. I keep thinking about the fact both my consultant and myself decided against steroids as my bv kept coming back, but I only had slightly high nk cells in blood. My main issue was bv, which I sorted, and the second was low nk cells in endometrium which I had treatment for.

@Gardenlady543 Do you know when it would be safe to resume vaginal probiotics and canesbalance? I feel this combination has been the one thing that has helped my microbiome a lot. I’ve been told to wait for all bleeding to stop, even spotting, and then take a pregnancy test 2 weeks after. I did ask about a scan to check everything is ok, but my hospital don’t think it necessary. I suppose I need to check with CRGH. My follow-up consultation isn’t until 2nd September. It was originally booked for 19th September. It seems a long time to wait either way. I really need to do natural modified FET again if possible, but problem is I am 42 now and worried about periods restarting and having to control fsh again. Norethesterone and zumenon plus dhea was the only thing that worked. I can only get these on prescription from my IVF clinic. I don’t know what to do. The issue is I might need these to restart things again. When I did oestrogen priming this time, I was on norethisterone a long time and most days I took 3 zumenon a day. Then reverted back to 2 a day in last week of priming.

@Loz2467 in the USA they call it the kitchen sink protocol and put people in steroids without any testing, so I think you'll be fine.

@2021ivfagain good to hear about you I have been thinking of you. I hope you are doing ok, that is good that the hospital will do the testing. I think try and hold off from putting anything in vaginally. I know I held off until I had a normal period after my surgery.

@2021ivfagain sorry to hear this fell on your wedding anniversary, almost adding insult to injury. Glad you have made a decision on management and moving to next steps. Is it a new drug they are trialling in that case? I think the standard one that’s usually offered is misoprostol, but I don’t believe that to be a trial. When I had my surgeries I was told to take a test 3 weeks after the surgery despite spotting and I did have light spotting for 2+ weeks after both times. For my natural 6 week loss I was told to take a test 10 days after the day they saw me for the confirmation scan and beta HCG, regardless of spotting, HGC at 6.4 weeks was just 55. I guess it must be slightly different with medical management. Those 3 weeks felt a bit like a lifetime to be honest as I wanted to get back on it. Each time the test was negative so that was final confirmation everything had worked. I do find it a little but rubbish that the NHS doesn’t offer a scan after a week or two just to check everything has cleared.
Not sure about vaginal probiotics, but I was told to avoid putting anything up there until I got a negative test because of the infection risk so maybe wait it out until you’ve tested.
I’m doing ok, thanks for asking, bracing myself for another BFN tomorrow.

@clhiu Yes I will be taking that too. My hcg at 4w 5d was 1186 so I don’t know how long it will take to go to 0. I was told to take a pregnancy test two weeks after any blood stops so spotting included. Yes I have been using vaginal probiotics but will not take anymore as starting trigger medicine tomorrow morning. I’m dreading it all. I know it’s a silly question but cervix opens when bleeding. Does it go back to normal when bleeding stops?

My friend advised me to have an aqua scan or 3d sis scan but CRGH is the only place I know of. Did you have a scan afterwards? I suppose it’s different if you had surgery instead.

I hope you have a positive test tomorrow.

Not a stupid question at all @2021ivfagain, they’re new waters to navigate, but yes rest assured the cervix should go back to normal once the effect of the tables wanes so probably within 1-2 days.
My cervix also had to be opened for my two ERPCs (the first time via misoprostol
as I chose to have an MVA which is done without sedation and the second mechanically as I had a D&C and was under general anaesthetic) and for my hysteroscopy, I noticed no difference in my cervix after any of those procedures.
The NHS didn’t offer any follow-up scans. As part of my first set of recurrent MC investigations with CRGH i had a standard 3D Scan after the first 3 (2 spontaneous and the MVA) about 2 months after the surgery and that didn’t find anything. I then had a hysterocopy about 6 months after the second surgery and I was also given the all clear then. But no, nothing in the immediate aftermath of any MC.

I hope the drugs work quickly and don’t cause too much discomfort tomorrow, I’ll be thinking about you ❤️

@2021ivfagain I am so so sorry for your loss. I just want to echo the others that there is absolutely nothing you did or any product you used or food you ate that caused this to happen. Life can just be very very unfair as we unfortunately all know too well. Please being kind to yourself. I hope that you are being well cared for by DH. ❤️

@ Garden lady- did your era report come out as receptive? What did you follow? Did you do your transfer as per ERA?
My report suggests to do the transfer after146+- 3 hrs of progesterone. Tentative transfer date is 8th sep. I’m mainly worried since this ERA doesn’t have much scientific evidence and is considered red on hfea add-ons. Should I just go ahead with the transfer as per the report or follow the general trend of 5 days on progesterone and do the transfer the next day?

@APSR I'm pretty against the ERA, I did it and it said prereceptive and I needed an extra 24 hours of progesterone, with no need to repeat, (“according to our internal data 89% of women with similar endometrial profile reached receptivity with 1 more day of progesterone administration (confidence internal of 95% (86-91%), so in these cases new endometrial biopsy is not needed.) I decided to repeat at the new timing anyway as I had to repeat the EMMA ALICE and it said I was still early receptive and to add an extra 12 hours. So a whole 1.5 days later. I following this timing twice with euploid embryos and had no implantation. There are a few studies coming out showing it makes no difference if people follow the timing or not and I'm wondering whether this was showing an endometrial issue rather than something that could be fixed, as I had the submucosal fibroids I had removed, so maybe they were affecting the environment? I moved to a modified natural FET and we did the transfer at the normal timing, twice once with a chemical and the second is this pregnancy I must have implanted at the usual time with this, as I tested for the first time at 6dp and it showed up on FRER, wondfu and clear blue FM.

Thanks @Gardenlady543. So you were on progesterone for 5 days and transfer was done the next day right ? What all types of progesterone were you on ?
I have been prescribed Cyclogest, lubion and prontogest, as my progesterone was pretty low on my last cycle that failed and my consultant said it should be above 100.

@APSR I triggered at 8pm on a Monday, the LH surge would have been Tuesday and ovulation Wednesday. My first dose of Progesteone was Wednesday morning. Transfer was on the Monday after 5 full days of progesterone. I took protogest 100mg and cyclogest 400mg twice a day.

I hope it’s ok to do this, but I have an overwhelming need to share on here that today is exactly 2 years since my first ever positive pregnancy test. I don’t remember feeling happiness as great before, I was walking on literal clouds. I since saw that second line 4 more times and still haven’t got a living child, despite the money and effort thrown at this and my chances become slimmer and slimmer by the month. I feel incredible sadness today, that is all I needed to say 💔

@clhiu 😔 thinking of you ❤️x

@clhiu of course it's ok to talk about this, I am so sorry that today is such a sad anniversary for you. I'm thinking of you ❤️

I’ve done something I regret and joined an immunology group on Facebook. I’m assuming a lot of you have seen it but now my brain is frazzled! And I’m even more anxious now with my adenomyosis diagnosis and wondering if I need a uterine biopsy for NK cell testing and receptivity. :(

@clhiu huge hugs to you. The longer this journey, the more anniversaries and reminders we have. So many reminders on a daily basis of the previous temporary joys and the almighty lows. They say time is a healer but in ways, it’s the opposite on this journey. I’m not looking forward to Nov, which will be one year since our late miscarriage.
It may seem that your chances become slimmer on a monthly basis but in reality they are similar. I’m sorry you’re disillusioned by PGT-a due to the unsuccessful attempt. You may have been ‘just unlucky’ that time. It may be your quickest way to a baby (you got a euploid on first attempt at age 40) but I appreciate and don’t underestimate the financial issues. I sincerely hope you experience the happiness you had before and that it is long lived x

@2021ivfagain thinking of you a lot too x

@clhiu I’m so sorry it brings so much sadness. Next month will be 3 years since my last positive pregnancy test. I really didn’t think I’d still be in this position years later. I hope tomorrow is a lighter day for you. Sending hugs. X

Sending lots of love @clhiu there is still hope though I know it doesn’t feel like this sometimes. You are doing so well. It is a horribly hard and sad journey, always feel free to share here. These devastating milestones are so challenging.

@2021ivfagain thinking of you as you manage these difficult steps ❤️

@2021ivfagain sending hugs x
@clhiu I have been the same but for our transferred embryos due dates never had a positive test but its awful regardless.

Anyone that has input from Dr gorgy: I am wondering if any clinics that you go to let you do a refund package with them whilst taking instructions from him or whether that means I wouldn't be eligible to access the package (would be through access or create in leeds) x

@kerrym87 if Dr Gorgy is prescribing the meds as add ons, then the clinic won't actually know. I did a 2 cycle package (non refund) and took the meds without any issue and my clinic was aware, to be fair this is what helped it to work, so that saved them money.

@Loz2467 the immune stuff is overwhelming but that's why people go to a RI, the RI does the tests and puts the plan in place. Most people are on very similar protocols.

@Spin101 @Gardenlady543 @Loz2467 @CailinInUK @Enfys23 @kerrym87 thank you so much for your kind words. I feel better about things today, I also had a therapy session scheduled for that day and it helped. Awful isn’t it? having to keep looking back at anniversaries and realising how fast time passes throughout our ordeals.

After the second failed SO cycle, despite good ovarian response and good lining, I’m having one more attempt at that, plus throwing in the hyfosy and if I still don’t fall pregnant I’m dropping the SO altogether. Seems totally counter-intuitive that it would take me longer to fall pregnant on Letrozole than naturally when I’ve been responding well, but having looked into it, it sounds like by triggering ovulation manually, it’s possible the eggs being released are not mature, whilst by letting ovulation occur naturally it’s more like the mature egg would pop at the correct time.

@clhiu good that today’s a bit better for you.

I agree with your thoughts on SO versus trying naturally, though no direct personal experience. For my early stim cycles when I was 7 years younger I was getting a lower than expected number of mature eggs and those that became embryos were aneuploid, mostly complex abnormal. I believe it was mainly due to triggering too early. Since I pushed off a change, I’ve got euploids virtually every cycle between ages 38-44 (bar one at 44). I have an LH surge on Day 19-20 so my eggs naturally need more time than average before ready to pop. The clear advantage of SO is there should hopefully be more than one egg that’s released so it ups the chances in that respect, as long as they are triggered at right time.

I’ve got go ahead to do more stim cycles so will start long protocol down reg next week with EC late Sept.

Still mulling over whether to go medicated or modified natural FET in the future…

@kerrym87, @Enfys23 and @CailinInUK Thank you for your support. It’s been a tough week. I had to take my fetus to my local hospital to be tested. At the time, I was so focused on testing and now I feel guilty for not getting more upset at the time. I’ll never forget what it looked like. I hope this is not sounding morbid. I now feel so upset. I’m I have a 6-8 week wait. I keep worrying that either the blastocysts I had transferred were normal and that’s it or all were abnormal. I have never had so many blastocysts from one cycle but my husband’s morphology was better then as he had been on supplements for longer. He’s a lorry driver so his morphology has been a fight.

@CailinInUK I know the pregnancy did not last, but I responded really well to modified natural FET with stims. I had 300iu meriofert every other day which produced 4 mature eggs. My oestrogen was really high. My lh stayed at 2.8 until near I ovulated. I had 10000iu gonasi for trigger. I would happily do this type of transfer again. My oestrogen was 1621 on transfer day. I hope your next egg retrieval goes well. I understand you want more cycles. I only have one cycle to rely on.

@clhiu I’m sorry you’re going through this. Could you do natural IVF where you release just one egg and IMSI or icsi is performed and it’s transferred? I think it’s a lot cheaper. I remember reading about a 40- year old woman with fsh of 20 (which obviously is not you), getting pregnant. She said she could just get started every month without a delay.

Hope everyone doing as well as they can right now.

I’m just plodding on and trying to keep hope. I think some of you have seen Mr Ramsay on here. Do you think with DH having morphology 2-3% it would be worth seeking opinion or is the fact rest of his semen analysis fine mean we’d be wasting time /money/ Mr Ramsay’s time? We’re just wanting to feel we’ve done everything possible!

Oh and what male fertility supplements have people used? DH is on wellman conception but wondering if we should try something else. He wouldn’t take anything sachet like/ bad tasting! It would need to be tablet/capsule form. Anyone used Fertilsan M?