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 😊

@Sera9 I believe igenomix say the era is valid for two years including if you have a successful pregnancy in that time. It is only valid with the cycle type you have though. So if you need to change the protocol and take different meds or move from medicated to modified natural it's not transferable. I'm not a fan of the era, there are a few studies from last year showing it makes no difference. I had success by ignoring my result and doing a modified natural FET. So you won't find studies about how long it's relevant for.

For Emma Alice you need to get on and treat any issue really, as you don't want to hold off on treating bacteria that shouldn't be there if that's found.

I've had 6 biopsies, they are uncomfortable, it feels like a period cramp when they take the biopsy but it's over quickly. You can take pain killers before if that would help you.

Hello ladies, I start IVF in 2-3 weeks! Can’t believe it!
I have my uNK biopsy with Gorgy on 6th too so a little nervous about that. Only had peripheral NK testing to date which was very high so fingers crossed it’s come down after 3 months of steroids and endo excision.

and today, my fertilysis microbiome retest came back after having BV and very low lactobacilli. Super happy with my lactobacilli now, question: can it be too high?! Results attached.

and what’s the best treatment for Candida would you say @Gardenlady543 ? Is this caused by high lactobacilli at all? Or maybe from the antibiotics I took for BV…

@ChickenT2b great news, they have recommended oral and vaginal thrush treatment but the oral treatment is a big NO in pregnancy and with ivf so close I personally wouldn't risk it. Do you have symptoms? As symptoms will help you know if you've got it under control, but your options with topical treatment are the caneston pessaries, I like the gel capsule, that absorbs better for me and then regular use of the cream over the next few days. You could also look at the lower dose pessaries that you could use daily (www.theindependentpharmacy.co.uk/thrush/canesten-pessary) they do them in 100mg pessaries to use daily for 6 days or 200mg for 3 days there. Other products like the gel capsule you should be able to get from pharmacies and the supermarket.

@Gardenlady543

Thank you so much for your reply.
I really appreciate your insights x

@Loz2467
I’m so deeply sorry for your loss, especially following your late loss. Having had a late loss myself, I can’t imagine coping with having another one. It will be no consolation but it could be that it was a chromosomal issue and nothing you did or could’ve done would have prevented this. Have you opted to test the foetus?

@kerrym87 how did your EC go? Is it Day 4 or Day 5 today? Hoping for the best for you and that the modifications made this cycle will work.

@ChickenT2b good to hear from you and that you’re nearing your next cycle. It’s been a long time coming. Fertilysis didn’t comment on your ‘very high’ lactobacillus except to say ‘normal’ significance so I expect that it’s ok to have that level.

@Dochas12111
Did you opt for another biopsy in the end? What stage are you at now? I hope things are progressing in the right direction. The delays are draining.

@Enfys23
Sounds like a good plan to review in March and keep healthy in the mean time. Sorry I don’t know about natural conception / prednisolone, having never tried naturally.
@clhiu might know? Hope you're getting on ok @clhiu.

@Gardenlady543 I trust it’s all going well and lovey to still hear from you.

Update from me:
Recall I had a bad Fertilysis microbiome report from Oct, COVID in October, very good ERA Emma Alice report in Nov. Planned for Jan/Feb transfer but got some kind of bad cold/flu with fever in Jan so was recommended to postpone to March.

Since then I’ve sent another sample to Fertilysis for microbiome testing and results due ~12 Feb. (I purchased this before I got my good Emma Alice results).
I saw Dr Raj Rai in St Mary’s Lindo Wing London for a private consultation this week. Worthwhile but also emotionally triggering as we went through my history including the late miscarriage post mortem report. Looked like there was blood flow issues to the baby and he wondered why I wasn’t on aspirin. I know I had several risk factors like age (44), IVF, and PAI-4G/5G so I’ll have to check my maternity notes as to why I wasn’t prescribed. Devastating to know this simple thing might have prevented the loss and why I didn’t spot this, but I understand it could have been something else too.
In my case, Dr Rai recommends clexane from 48 hrs before transfer (vs consultant saying on day of transfer) until 24 weeks, assuming normal Doppler; aspirin from 8 weeks to 36 weeks. He doesn’t recommend any immune meds- no steroids, no intralipids etc, he says there’s no good evidence.
He also recommended a hysteroscopy (as its gold standard) and at the same time a biopsy for chronic endometritis. I’ve already done a saline scan and ALICE test in an attempt to cover those bases but I might opt for the hysteroscopy as it’s probably our last transfer. He agreed with the natural rather than medicated FET, though questioned why I was having a modified natural stimulated cycle when my lining doesn’t have any issues.
Now aiming to transfer late March, which seems a destiny away due to all the delays.

Hope everyone is managing okay the moment.

@CailinInUK its day 4 today and its been a totally different ball game! 25 eggs from 26 follicles (which half appeared to catch up after last scan and from trigger) with 21 mature and 13 fertilised. Dreaded d5 update tomorrow and it will be a freeze all as I have mild ohss funnily enough. Feel like a beach ball 😂 shame as any embryos looking OK but not freezable will not be transferred but I'm not sure how many more failed transfers I want to do if I don't have to. Pgta tests for the rest. Sorry your journey has been delayed, like it always is in this game. We might end up transfer buddies as I think it'll be at least March until we transfer

@CailinInUK good to hear from you. The consult sounded worth doing albeit sorry to hear you had to go over your loss in detail. I am interested they suggested a biopsy for chronic endometris when you’ve had a clear Emma/alice biopsy - surely that rules it out?

we may be transfer buddies! I am planning a rebiopsy in Feb and hopefully if the results are good transfer in March. Honestly I’ve been feeling a bit low recently and unmotivated and exhausted and seeing lots of girls I follow getting pregnant with their second and it feels so impossible! I am barely managing to take my supplements and pessaries!

that said be just been told I have low iron so maybe that explains how I’ve been feeling! So that’s another thing I need to sort before transfer.

Anyone got any experience worh slower growing embryos? We have 3 early blasts and 4 morulas still doing their thing but not suitable for biopsy or freezing yet. They will culture another day. This us more than we've ever had and they haven't fragmented like before but I genuinely don't know what positive bits I should take and which bits I should prepare myself for in terms of outcome. Embryologist said she couldn't say at this stage either way but they were still doing stuff. Hormones are all over place , ohss manageable at home but it sucks and means we can't transfer anything fresh. It's so overwhelming.
Lots of people on here are going through so much and @Gardenlady543 I'm so pleased it finally worked for you x

@CailinInUK i just wrote a huge reply and it disappeared ! So I’ll try again! That must of been so triggering having to revisit everything but maybe another opinion has helped you feel some what reasurred in your choices. I’m in a similar situation because I’m now under the recurrent miscarriage clinic at st Mary’s Manchester so I need to email my full history over from 2019 as I was at a different hospital now and can’t get any information! Wouldn’t think it’s 2024 hey! But anyway that was difficult yesterday and then today is 3 years since loosing our baby girl and I’m no closer. Empty arms and empty stomach. I should have been 15 weeks today. Due date is literally just after my sons birthday again! :( so I’m hoping it’s a distraction but it never goes away. I get to see Prof Heazel who did many studies on the placenta and CHI using hydroxy and clexane etc. But I know it will take many months for my results and to see him.

I really don’t know what to do next: whether to do some antibiotics and then probiotics and treat BV etc like @Gardenlady543 said just to make sure all in a good place.

I don’t feel like I have the energy and finances for Dr Gorgy. I’m worried if adeno is causing my losses I actually don’t have a way around it as my adenonyoma cannot be removed. So I could pay thousands and thousands and it still not be okay. But ultimately I do think I have some immune issues maybe from our loss 3 years ago being due to covid?? And adenomyosis is considered an autoimmune. I just don’t know much about the immunes but trying to learn from the Facebook pages but they can also be very consuming and overwhelming.

or I don’t do anything for a few months whilst I wait for the results and consultation and maybe go on low dose naltrexone.

its the down Reg for me that takes so long in my IVF and I only have 3 early blasts left and then another full cycle paid for but I really don’t think I can do it :(

@Dochas12111 I’m with you feeling low and unmotivated! I’ve just no interest in anything and again seeing so many announcements and just grieving my pregnancy in general and how much all this has affected my life / relationship the last 3 years.

@kerrym87 just DMd you but I think definitely some positives there. It’s a good number still in the running and my clinic said that as long as they’re becoming a blast on day 5 they are happy. really hope you feel better soon. Fingers crossed so much for the update tomorrow.

@Dochas12111 so sorry to hear this. It’s completely natural to go through these spells. Hopefully bit of an energy boost with iron will help.

@CailinInUK wow that sounds lots of useful info but also so overwhelming and emotionally triggering. Hope you’re taking a moment to yourself.

@Loz2467 its going to be important to let yourself grieve properly to decide on how you want to proceed. Sending hugs.

I need a bit of a hand hold.
As I mentioned before, Prof Brosens from the Warwick implantation clinic advised if trying in a natural cycle, to start pred soon as I have a positive of any kind (given we’ll be trying naturally potentially many months he didn’t want me to yo-yo on and off pred). So I’ve been early testing past few days (today 11DPO). Already started progesterone post ovulation.
Last night (10dpo) I did a Wondfo and a very VERY faint but hint of pink line appeared within the testing time, so that’s 10dpo. I’ve never had a positive test in years now of trying except the brief CP after our last embryo transfer. So was worried it was just indent. But I’ve used most of the wondfo pack already and they’ve been white as snow.
I did another this morning but the urine looked a lot more dilute than last night’s (I was thirsty so drank fair amount of fluid before bed, probably as didn’t drink enough at work!), there’s a squinter of something in bright lights but not much, but did appear in the testing time.
I decided to just start the pred this morning in case.
I am just going a little out of my mind. Would you test again tonight, or tomorrow, or wait a few days now? Would you try a different brand?
such a rollercoaster of feeling maybe just maybe it’s something for first time ever, or maybe nothing at all, or maybe it’s another CP.
DH away with work so don’t want to cause him stress and can’t speak to him much. Have no one else to share this with so sorry for the rambles 😖

@Enfys23 could you chat to clinic to get a blood test done? Some people find a later afternoon/evening one shows better and u think people swear by first response early response. As I've never had a bfp myself ill take their word for it. I go the opposite and get scared to test, I think it can take 9-11dp5dt for some people to get a positive result. Sending hugs and crossed everything x

I hope this isn’t upsetting for those having awful time right now but I caved and retested this evening. The wondfo was quite clear quickly and the clear blue digital says pregnant. I’m in completely disbelief. I can’t believe that the first cycle trying post endo surgery has resulted in a natural first ever BFP. Thank you @Gardenlady543 for mentioning the person who just had no implantation until their excision surgery done as that helped give me a push. Huge huge fear about what happens now as I know it’s crazy early but trying to push the happy to the front right now as at least one step forward than ever been before.

@Enfys23 congratulations on your first ever natural BFP!! I’m really pleased to hear this as I know you’ve had such a difficult time. I hope this is the one for you. Will you book BETA HGC next? X

@CailinInUK sound alike you have a very in depth plan. I start LMWH on CD8. Hopefully the fetilysis tests will be normal too.

@kerrym87 that's an amazing result with the number of eggs, as far as I'm aware especially when it comes to PGTA tested embryos (this is what you'll do with the freeze all is that right? Day 5 and day 6 have similar success rates so hopefully you get a good update tomorrow.

@Dochas12111 I didn't do well with iron tablets so ended up paying privately for an iron infusion.

@Loz2467 I'm sorry things are so tough, it is definitely a lot of energy and expensive to do the investigations with a reproductive immunologist.

@Enfys23 wow this is amazing news, 10dpo is pretty much as early as you can expect a positive to show up so it's not surprising it was light. I wouldn't do evening tests moving forwards, I would do maximum daily, if possible every 2 days. Hcg doubles every 2-3 days so looking for progression between morning and evening tends to just cause stress. Blood tests would be better if you can arrange one and then another in 72 hours and if that's good then I would look at booking in a private scan at 6.5 weeks. Such amazing news!!

Everything is ok with me, not sure if I mentioned but the baby lost a lot of weight and was admitted to hospital. Then I was back in with abnormal bleeding but an infection was ruled out. We are ok now, but we are triple feeding and relying solely on pumped milk which is a lot of work and tiring.

@Gardenlady543 thanks so much for your reassurance, yes pgta is planned. I'm sorry you've had such a rough time, pumping is hard work and you'll be fed up with the sheer amount of no doubt conflicting and we'll meant but unhelpful advice around feeding ! Hope things continue to improve x

Thank you @clhiu @Gardenlady543 Weirdly my urine is most concentrated towards end of day. Probs just don’t drink enough when doing afternoon clinics then do some form of exercise whereas morning seems more dilute! I’ll definitely look to get HCG done now. Bit of reassurance maybe.

@Gardenlady543 sorry it’s been tough. It is such hard work and not a lot of support with feeding. Well done for powering through. Hope you have some people looking after you too ❤️

@Enfys23 That is AMAZING news. Gentle congrats to you!! What dose pred have they advised to start? Just curious. I’ve never tried it in a natural cycle. Did you ever have immunes testing?

@Gardenlady543 that sounds tough but well done on the feeding and recovering from your c section too!

I think I need to heal first and get some test results: I was going to do doxy and metrizdroze this week but I’ve got a funeral tomorrow where I might need a couple of drinks to get through so I didn’t start them.

I don’t even know when I’ll ovulate as things after a loss are crazy anyway plus I’d kind of stopped bleeding then it came back last night / today and I’ve not ovulated on my own for a long time due to the IVF and down regulation.

Thank you @Loz2467 it’s starting to sink in a little. I had basic immunes done via my CARE clinic/GP which found I have a raised cardiolipin antibody (Antiphospholipid antibody). And then I’ve had the endometrial biopsy via the implantation clinic at Warwick with Professor Brosens research clinic which showed high NK cells. I was advised by him to start 20mg pred from as soon as I get a positive test as well as progesterone luteal support. I've also been told to start clexane 40mg now my test positive given the cardiolipin antibodies.

@Enfys23 That’s great and removing your endo has obviously lowered all your inflammation. I think for me my inflammation is wild. I’m really estrogen dominant from my adenomyosis so I don’t think the immune protocol I was on was enough for it to be okay. That’s just my gut instinct! Sorry for TMI but even since having the Adeno I started getting a week of the fertile mucus before ovulation rather than my usual 3 days then all the full week of brown spotting before my period so they are WAY off balance! My down regulation will be starting to wear off now which is frustrating as I worked so much on that. I wonder when I have my follow up at Tommys with prof Heazeal if he will be able to point me in the right direction. But honestly at this point I can’t see myself continuing IVF :(

@Loz2467 this is a bit out there, but my friend saw this person, she went through years of implantation failure and lost a pregnancy from IVF. She got pregnant 2 weeks after starting the herbalist treatment and has a baby now. They seem good with testing hormones and dealing with hormone imbalance. If you are pretty much decided on stopping IVF and not going down the immunology route, it may be worth exploring. No evidence base for this kind of stuff but that's the same for reproductive immhnology.

www.tcm-healthcare.co.uk/about-us

I’m getting worried this will be a CP. Line still faint. It comes up within the 2-3 mins on Wondfonbut now 13dpo and no real progress from 11dpo. I’ve done a medichecks blood test yesterday but probably won’t get result until next week. Only place I could get HCG is via ultrasound direct and they don’t have availability until end of next week - I’ve provisionally booked two tests with them (just over 48h apart as only spots they had), but not sure I’ll make it to then. Not sleeping well with the pred and with worry over this, then worrying poor sleep will affect things 😫🤪😖. At least DH home tonight.
Hope everyone else doing okay.

@Enfys23 ultrasound direct send the blood by post I believe so there will be a bit of a wait for the result. Take the prednisolone as early as you can in the day. If you can't sleep i used over the counter nytol 50mg, it's used in antihistamine protocols and I took it the whole way through pregnancy, it knocked me out quickly.

Thanks @Gardenlady543 I spoke to them and they’ve apparently said the results are ready 8 hours later - we’ll see!! I’m just so nervous it disappears and my period starts. Maybe I just need to stop testing.

@Enfys23 oh that's good maybe this branch has a deal with a local lab. Can you call up and see if they can slip you in earlier? It's so hard but it's such early days and you really can't tell much. Doubling between 10dpo and 13dpo could literally be hcg going from 10 to 20, probably even less and would still be really faint.