ERA EMMA ALICE testing thread 10

[Gardenlady543]

Last thread is maxed out... happy for anyone new to join to chat about anything ERA EMMA ALICE or pretty much anything else fertility investigations and treatment related

@2021ivfagain @Enfys23 @clhiu @CailinInUK @Loz2467 @Mybabydream @ChickenT2b @kerrym87 @Sar1010 @thislittlebird @APSR @VenusStarr
@Dochas12111 @SallyLovelady @Lyrabee @Lauralozzle @Sera9 @Twigg12 @Wren123 @Summerishere83 @Vicky81B

Hi all. I am on the ERA cycle. They told me to put the vaginal progynova in before the crinone gel, but want me to use all meds at 8am so one quickly after the other. They were strict on saying the time needs to be recorded exactly to the minute. Won't the vaginal progynova tablet potentially be effected/fall out by using the crinone immediately after it?
Just wondered if this sounds right to others / what order and times other people have been advised to use the meds? Its prob too late now but still curious. Thank you x

Also a really silly question but will taking blood (6tubes) during progesterone week of era cycle effect the progesterone or effect any era results?

@Prayformiracles the start time of progesterone needs to be recorded to the minute but after that you can take the meds when it works for you, as long as you space things out eg twice a day should be around 12 hours apart. I wouldn't have thought it would fall out. The blood test won't affect things.

Thank you so much.
Now I'm feeling deflated about something else with my era. I didn't realise that utrogestan (the progesterone pills) needed to be taken on an empty stomach. It took me 24 hours to realise so I was actually taking them straight after my meals. I thought perhaps i would just replicate this for the first 24 hours for the real fet. But tonight I had my dinner at 6.45pm and supposed to be taking utrogestan at 8pm which doesn't follow the 'rules' about 2 hours to empty stomach. I just feel like I may have messed up my era / future fet when this is my last opportunity :( Don't even know if this makes sense to anyone. Maybe I should write down what I have done in the era even if it's not strictly correct and just do exactly same for the fet cycle.

@Prayformiracles it's unusual to be on oral progesterone in a FET cycle most people take vaginal and rectal progesterone or IM/ sc injections, the only thing taking it with meals would do is reduce the absorption of the drug, that would lead to a lower progesterone level in the blood. The theory for the ERA is down to the start time you took the first dose of progesterone, not the blood level of it. What you're doing at the moment is a mock FET cycle, it's better to do things wrong in a practice run than the actual FET.

Won't the blood level of progesterone also have an impact on timing because of how much they think has been absorbed in the blood by that time?

For progestetone, They give crinone vaginal gel twice daily, an oil-based bum injection three times per week and utrogestan tablets 3 times per day.

@Prayformiracles the theory is that it's the start of exposure to progesterone in the endometrium that leads to a sequence of events that makes the endometrium receptive, and that it's standard timing for it to take 120 hours but that some people take less time and some more. It's not about the blood concentration or they would be taking into account the blood level as part of their calculations. I don't believe in it by the way, since a number of studies have come out showing it makes no difference whether people follow the usual timing or their personalised timing. I would look at this as a practice run and try not to stress yourself with keeping to such a specific schedule outside of the start time.

It's the last attempt so I need to believe that all these things (era, Emma, Alice, nk) have the potential to make a difference :)

@Gardenlady543 ive decided to continue IVIG every 4 weeks to 20 weeks (taking me to 24) and then discuss with Gorgy again. Currently weaning off prednisolone and have stopped Neupogen.
Im 13 + 3 today but still keep expecting the worse even though we had our nhs scan on Monday. How long did you continue the weekly scans for?

@ChickenT2b weekly scans until around 20-24 weeks I think, by 24 weeks I had more consistent movements and dropped to every two weeks plus had 3 extra NHS scans.

Hi guys, I got a positive HCG result this morning - 118. I can’t believe it tbh. Feel completely in shock. I’m back for another HCG on Monday so I’m really hoping it’ll be on a good trend.

@Dochas12111 congratulations!such amazing news!

Was the treatment different this time round? X

@Dochas12111 tentative congrats!

Has anyone been given lmwh injections for FET, my consultant asked if my VTE risk had changed before we start our next transfer (likely failed due to embryo issue as placenta layer not as good as inner cell mass and didnt fully expand). I sent him my KIR /karyotype of Bx yesterday and the clinic has sent me meds list with inhixa on. I had just asked about aspirin and alot of evidence I've searched for seems to be contradictory

Congrats @Dochas12111 ❤️ that's great news!

@kerrym87 yes I took inhixa (LMWH) for a PAI-1 mutation and c4m2 mutation. Some clinics put everyone on it especially in USA. The dosage is the prophylaxic dose.

Lovely news @Dochas12111 sending good vibes for Monday ❤️

Thanks all,

@Prayformiracles this is my second BFP. First is now my DD. Both times it took us months to prep for transfer (April-Nov 1st time, September- June this time).

This time round I did a hycosy/saline scan to make sure uterus looked ok. Did immune bloods and I'm on steroids and it took x3 Emma/Alice biopsies and treatment cycles to get my good bacteria from 0% to 90%. Abstained from any intercourse once the 3rd biopsy showed the good result.

Acupuncture pre and post transfer but not otherwise. Rested in bed from transfer until the next morning (previous failed transfers I followed the advice to act normally.)

Tested progesterone at transfer and ever few days during the TWW to make sure it was high - had to add in Prontogest injections (it was v low day of transfer which also could explain previous fails)

I also did x2 ERA’s prior to first transfer which found my exact receptive window needed an extra day of progesterone (other failed transfers were on day 5 as standard)

@Dochas12111 thank you so much for that detailed reply.
Can i ask you how you got your lactobacillus from 0 to 90%?
Also my clinic only check the progesterone on transfer date, not throughout the 2ww. Is it worth asking for this to be checked or is this only necessary if its low to start with?

I have a DD too. She was the second of three frozen embryo transfers. (Also did one fresh before decided on freezing). At the transfer for DD i did emma and alice and my lactobacillus was 90%. I didn't think to recheck it before the third fet unfortunately. So we then did another three egg collections and have one precious embryo waiting in the freezer. This is definitely the last time. I have been preparing for it since last autumn when my vaginal microbiome showed no lactobacillus. I eventually got it up so proceeded with emma and alice but whilst alice was fine, I had 0 lactibacillus in endometrium despite taking canesflor for 6 months. So for past 2 months I have changed my vaginal and oral probiotics. And I am taking the vaginal ones twice daily every day apart from during bleed. Just did era yesterday with nk testing and repeat emma. I really hope the lactobacillus have improved. Feel so anxious that it hasn't just because it didn't improve after 6 months of canesflor. But reminding myself I am using different probiotics now so hope they are making a difference.

@Prayformiracles I think it’s more the antibiotics getting rid of the bad bacteria to be honest. First Emma/alice treatment was Canesflor plus amoxicillin, no change still 0% and second treatment was clindimycin and Canesflor in same amount. So I think it was that the second antibiotic was stronger and got rid of the bad bacteria and allowed the Canesflor to build up the good. That’s my unprofessional opinion though!

I took Canesflor daily for 2 weeks then every 2 days until transfer. I also took a good quality oral probiotic. I did the same probiotic treatment for both the only difference was the antibiotic.

I asked for my progesterone to be checked during TWW - I just wanted to make sure it stayed high in case that was an issue.

@Dochas12111 Thank you. I had antibiotics in December because my vaginal microbiome test showed infections but they were cleared and I increased vaginal lactobacillus so I proceeded to emma and alice but alice showed nothing; no bad bacteria to treat. Unless I am missing something? It is the emma or alice that shows up the bad bacteria isn't it? I was reported to have no bad bacteria yet no lactobacillus.

Thanks for advice re checking progesterone every few days during 2ww, it can't harm can it!

@Gardenlady543 thanks. I can't remember what Dr gorgy tested for and I don't think what you've mentioned for yours is in my results.

Good luck for the test today @Dochas12111 will you find out the result today?

Thinking of you today @Dochas12111

saw this event tonight and thought it may interest https://www.myivfanswers.com/events/uterine-microbiota-and-ivf-outcomes-all-you-need-to-know/

Thanks @Gardenlady543 and @Enfys23 the result today was 500. So on track so far fingers crossed.

@Prayformiracles I didn’t realise you had no bad bacteria! I remembered I read a post on a different website about a nutritionist helping treat someone in the same situation - I hunted it out - see below. Her name is Niamh Burke and she’s on insta.

rollercoaster.ie/community/fertility-issues/lactobacillus-information/paged/5/

when do you get your result back?

How are you @Enfys23 are you ttc naturally again this month?

@Dochas12111 Wooh 🙌 that's a great result, have you got any more betas booked in or does your clinic go for the scan next?

Scan next at 6 plus 5!!! A long wait 😂😂

That is brilliant @Dochas12111 ! Hope the scan comes round in no time.

@Dochas12111 we are finally having our first proper holiday in a couple of years which has been really good for me.
We are but I’m not too sure this month any good. I’ve had lh surge really early again on day 9 (I was doing better about having it day 11-13). So not sure egg or lining will have been in right state. I slept really badly with taking the pred post ovulation last cycle and that’s sort of drifted into the beginning of this cycle so maybe poor sleep affecting things for me. Makes me nervous to take the pred again now.