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 thank you, it's reassuring to hear they look ok. I'm really hoping the steroids, extra progesterone and euploid embryo were the missing links.

@Gardenlady543 thank you I’ll join!
@thislittlebird the line’s progressing and like you say you’ve made changes. I know it’s easier said than done to say relax and stay positive! But it’s all in your favour. Have you been told to increase your steroids on positive confirmation?

@SallyLovelady no, I have not. 10mg started before transfer and is going to continue as is. They didn’t want me to take them at all, but I wanted to after I had implantation/chemical when on steroids before and had what seemed like a strong immune response to my 6th embryo in April. My NK cells were within range but I felt my body was a little overreactive, I have eczema, asthma, allergies, lots of immune system related things, so we agreed to low dose.

Congratulations @thislittlebird , I get the cautious optimism with the previous chemical and lines being light this early on, but the progression looks good and I really hope this is the one for you. When I had my chemical in May my first line on a CB was fainter than your first one and I believed I tested at 11dpt, when I retested the following morning there was no progression at all. These look good x

@clhiu thank you! It's tough isn't it, when you've had failures and losses. I don't feel excited just tense really, like ok that's a box ticked, now the next one is getting past the next few days.

How are you feeling today?

@thislittlebird Congratulations. I always like Clearblue but found fmu to be better especially in the early days when hcg is still increasing. Good luck

@2021ivfagain Thanks, anxious days ahead! I felt like FRER had it in for me lol. I noticed on US reddit posts that they also have a pink dye Clearblue, we seem to have fewer options.

Hi Everyone, sorry to just barge in so late ... 9 threads?! Haha im not sure I can read back through all that so I apologise in advance.

I've had 3 failed transfers now (ICSI, day 5 blasts, clinic rates them 10/10). MFI in terms of motility which is why they did ICSI. We are private with Care.

Last time we had a consult she said if the last transfer failed we could look at extra tests that do the fake prep round and then they take a biopsy of the lining to test it?

I'm not sure exactly which one it is she will suggest we do so wanted to get some info from you all. From what I've read, the chances are I'll need some antibiotics/probiotics depending on results. Is it worth me starting probiotics now to get ahead of the game?

I'm currently just beating myself up that there's still something wrong despite everything.

Thanks for any info 💛

@Lyrabee they are most likely talking about ERA EMMA ALICE, it costs about £1500, it's all done by one lab Igenomix, you can babe the ERA alone or the EMMA ALICE alone. ERA looks for receptivity, like the way they describe it, it sound great, but I was taken in my this, I remember the lab saying something along the lines of people with implantation failure have a much higher chance of not being receptive and when we change the timing based on this it works on the next go 70% of the time. I went into the next cycle thinking, this absolutely has to work for me now... it didn't. I ended up doing another ERA and getting a result saying I still wasn't receptive even though we changed the timing as they suggested. In the end we just ignored my result and moved away from medicated FET and into modified natural FET which have more chance of working, and we just did the normal timing.

I wrote a post here on the microbiome, reddit.com/r/infertility/s/0Aqlk49G9T
I had actually been taking loads of probiotics and my diet was high in probiotic food, I'd even gone on a course called "go femental" and I had 0.00% lactobacillus (good bacteria) twice. I needed to shift the dysbiotic bacteria in order to recolonize. If you do start taking vaginal probiotics you'll want to stop 10-14 days before the biopsy so they don't just pick up the stuff you're putting in.

At care they may also recommend level 1 implantation failure bloods, they cost about £1500 and it's a Thrombophilia and autoimmune screen.

Thanks @Gardenlady543 thats really helpful. It sounds like you've been through the ringer. I'll go have a read of your post on reddit.

How long did it take to get the biome to where it needed to be if you don't mind me asking?

@Lyrabee I'd say about 6 months, but because I was reassured it would be fine I'd gone ahead with the transfer, I did the test and treated it and we did a euploid transfer after I had taken the antibiotics and probiotics recommended with the ERA timing. No implantation. So we repeated again, treated again. Euploid transfer again. No implantation. Then I moved to a menstrual fluid test and that was normal. I ended up banking embryos and then needing surgery for fibroids and going down the immune route. Now I could have retested the microbiome especially because the surgery could have messed it up, but it seemed like I was prone to BV infections and I had more of an idea when things were normal and not using vaginal pH sticks, so I ended up treating myself prophylactically with metronidazole in the cycle before a transfer, then doing daily vaginal probiotics in my FET and doxycycline for 3 days at transfer time.

The thing about the ERA EMMA ALICE, is you have the mock cycle for the biopsy, then you can wait around a month for the result and then you could lose another cycle for treatment, so you're at 3 cycles of time by this point.

Thanks @Gardenlady543 we know it will be next year now before we do another transfer. It's a hard pill to swallow. I'm worried the biopsy will show nothing is wrong and we will just be going round in circles.
I've never done a natural cycle, only the medicated. Last one was with lubion. Its always a test and a wait and see with everything we do. I'm getting incredibly frustrated about it and just trying to be kinder to myself.

@Lyrabee I'm in a recurrent implantation failure group and the most common responses people get are check for endometriosis and see a reproductive immunologist. I'm not sure how much ERA EMMA ALICE add to a case, like my EMMA ALICE was horrendously bad and I corrected it and it didn't work for me still until I had fibroid surgery and a immune protocol. The ERA I'm not keen on there are a few stories in the implantation failure group with foaled transfers following the timing and it working when they went back to standard timing. I know someone who's specialists always does the transfer after 4 days of progesterone rather than 5 as they see it work more often in their patients doing that.

@Gardenlady543 it's never going to be an exact science I guess. I've had many iv scans and a hycosy and none of then have showed anything alarming.
Naturally my surge in the ovulation window was always quite late and it never matched up with things like EWCM which I got early. My periods are also quite light and only last 2/3 days.

Thank you for all the info you've given, I've got my appt on 5th October so will know more of the plan then

@Lyrabee my periods are the same what's your lining like in medicated FET? Mine was thick enough and triple lined but they described it as patchy and not quite right. The lining quality was a lot better for me with mild stims.

@Gardenlady543 I don't think they told me on my fresh transfer but on my first FET I had progynova estrodiol and my lining was triple layered and about 12 thick.

For My second FET, I had zumenon estradiol and my lining got to 8 by day 10 but because it was so thick the first time they wanted it to get thicker so they made me wait another 5 days for a scan - it got to 8.7

I have 2 x cyclogests for the fresh and the first FET but had irritation the first time and diarrhea the second time. They tested my progesterone on the first FET as well and I assume it was fine because they gave no other indication.

The third FET I had 1 x cyclogest and 1 x lubion. Still got diarrhea the day after transfer but only the once then it settled unlike the first FET.

Theyve never told me it looks patchy but I was concerned that my second FET was quite late so I'd been on the estrodiol for 3 weeks. They don't do any scan before they transfer, only the one 5 days before.

@Lyrabee they do an abdominal ultrasound for the transfer though don't they? After I start progesterone my lining didn't look right. Because I have light and short periods I ended up being investigated for ashermans syndrome, it's where there are adhesions and scarring in the uterus, but your hycosy should have showed that up. I found the best progesterone for me was prontogest and 2 x cyclogest. The prontogest is intramuscular but it gets levels up well. Clinic usually have quite low progesterone ranges, my RI likes it over 80 though and the specialist clinics in London like it over 100.

@Gardenlady543 that's interesting. I'm going to revisit my results from all my scans now I know more and I'll ask what my progesterone level was when they did the blood test for the first FET. She said they didn't do one on my second because they wouldn't expect it to be low if I'm on lubion.
Yeah they do the abdominal us while they transfer but they never say anything about how it looks only that I have a full bladder 😆

@Lyrabee they tended to act like everything was fine on transfer day with me and then when I had the follow up appointment after an unsuccessful cycle I'd find out it didn't look good. I'm sure yours looked fine if they haven't mentioned it before though. I do think discussing a natural modified FET with low dose stims would be useful for you though, to see what they say, I took meriofert 75 units a day, this helped with my naturally thin lining but allowed the cycle to follow my own hormones.

Gentle congrats @SallyLovelady @thislittlebird 💗

@Lyrabee im also private with care fertility and had 3 failed transfers now. I’m waiting for my follow up apt after this failure but I wanted to ask for a modified natural due to my adenonmyosis but I’ll have to see if they will allow it. Theyve also suggested for me the ERA, EMMA and ALICE. But like you say it seems to be the antibiotics anyway so I’ve ordered some of those to use in my withdrawal bleed. Not sure about the ERA like @Gardenlady543 said but then again I think the window might be shifted for adeno and endo. (I’ve had a lap and don’t have endo) L.

Or another option was to ask for buserelin on day 21 of my withdrawal bleed and then go into another medicated FET.

Im just not sure what she will allow me to do really!

I added pred this time even though I haven’t had NK cell testing but surely this couldn’t cause the failure. Could be my embryo too as it isn’t tested.

Hmm thanks @Gardenlady543 I've made a note to see what she says.

@Loz2467 I'm sorry about your transfers :( which care are you at? it sounds like you're able to talk to your consultant a lot quicker than me, i always have to wait 3 weeks for my follow ups. I've been told I can't go straight into another transfer each time though - its very annoying as my embroys arent tested eithet and the oayment plan we are on means i have to use up all my frozens before theyll do another collection. Which antibiotics have you ordered?

@Lyrabee mines the same :( I haven’t got a date for follow up yet but it’s usually around 4 weeks and in that time all the estrogen and having bleeds will flare my adeno and I’ve lived in down Reg pretty much since March time which has been really rough! I’m at Manchester. What about you? We must be on the same - the 2 cycle multi cycle package?

ive ordered metrzidrole and doxycycline to take together for a full week. I mean my adenomyosis is a focal patch on my lining so that could be causing the issues but I’ve had 2 hyterscopy which say it isn’t in the cavity and I can’t have it removed because of the placement anyway. So I almost feel at a loss with it all.x

@Loz2467 aaah I'm at Manchester too :) we've done the 3 cycle 100% refund package. But at this rate we won't even have chance to have 3 collections because of all the waiting.

I see, so do you already take antibiotics for your adenomyosis? When I had my hycosy they said I had a little of that but they didn't think it was enough to be a problem. But now I'm questioning it as I don't know much about it

@Lyrabee i nearly did that one too but glad I didn’t because of timing and this down regulation it’s taken me 9 months to do 3 transfers! So the antibiotics are incase I’ve got endometritis etc. I need to read @Gardenlady543 post on it. But I was going to do this followed by probiotics. The adeno it depends if it’s mild and yours sounds like it. Mines focal and on the lining and shows on my scans and didn’t shrink with down Reg. I’d highly recommend down regulation - although I haven’t been successful it does work for many women. It’s an injection called prostap. The side effects aren’t great but it’s worth a try. X

@Loz2467 there are so many delays! We had a rough start with them which is a shame because the staff are generally really nice. Although my last FET I was rushed in and out.

I've heard people talk of down reg but I don't know what it is, I'll have to ask about it and yes think there was a tiny bit and they said it's like beginnings of it that may or may not get worse. Nobody else has said anything since