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

@Serendipity24 thank you! Good luck on improving your result. Will you retest? What vaginal probiotics are you using now?

Thanks @Gardenlady543 yes endometrial biopsy seems overkill for me right now. And does have risk and cycle lost.

@Enfys23 the reason we didn’t go with ARGc was that they proposed the same protocol I was already following for egg collection at my other clinics. At the time we were struggling to make any embryos so I went with a clinic that proposed different protocols to try improve egg collection. I think ARGC are more specialists in improving chances at transfer as they use so many add on medications and monitor closely.

are you thinking of changing clinic? Do you have any frozen embryos? Best of luck getting back to it. I hope you are feeling as ok as you can. I agree if you could avoid a biopsy that would be better for you. It wears you down all the constant procedures.

@Gardenlady543 how are you getting on? Any plans to go ahead with embryo transfers?

@Enfys23 I changed my probiotics after the poor results and currently I am taking Fem Dophilus Advanced and Physioflor, both oral. I'm starting Vagibiom and Balance Active gel from today. I haven't decided whether to test again or when if I do.

Hi all. Feel very 'stuck' again and reaching out for advice/support. My most recent invivo vaginal microbiome test showed prevotella bivia and ureaplasma. My Consultant thinks there is no point pre-trreating ureaplasma because when I am in the fet cycle they give doxycycline antibiotoc at day 7 anyway which is the same treatment they would give for ureaplasma anyway. With respect to prevotella he says it is the least worrying. He says we could treat it but isnt sure if we should because I have zero lactobacillus in vagina and endometrium (the probiotics have not worked for past 9 months). I do not have gardnerella etc, which is what he would be more concerned about. Is it a sensible approach? My acupuncturist seems to think it is a bit mad to put an embryo in with these things and my recently appointed nutritionist just wants to follow the consultants guidelines. I dont know if I should push for antibiotics or trust that it could just make things worse and that having prevotella may not be too detrimental. Very stuck and alone as I don't know what to believe is the best course of action.

Hi @Prayformiracles there is a girl on Instagram who works with people re microbiome - Niamh Burke. Maybe it’s be worth having a consult with someone like that?

@Prayformiracles Can you cancel your cycle? I’m sorry you’re going through this. I have read that clindamycin treats prevotella. I had recurring gardnerella due to antibiotics destroying my microbiome but I didn’t learn until later on that you just keep going with probiotics and acid products like balance activ. Do you mind me asking if you are doing a medicated or natural FET? The thing is I’m 43 now so time is not in my side to do many more natural FET. But if you are younger you have time to sort out your microbiome. I had clindamycin twice but then probiotics and balance activ and Vagibiom for months sorted it out. It’s not a quick fix. I read that just taking antibiotics will only temporarily solve the issue. I took probiotics throughout my transfer.

@Dochas12111 thank you. Its really hard investing in yet another person when I am already getting opinions from Consultant, acupuncturist amd a fertility nutritionist. The nutritionist is propsing some different supplements so at least try something bit different. Still won't sort out the infections.

@2021ivfagain you can ask me anything. I'm 41. I'm not in a cycle. When I start it will be a frozen cycle. Final final embryo. I just finished era and 4 days later started bleeding. I have been bleeding for 14 days and it's still going. I was worried but Consultant says it's not a problem and can happen after stopping progesterones. I know it's never a quick fix but after 9 months of waiting for microbiome (and on/off ivf for 6 years) I have finally reached my end. I didn't know this would happen to me but I am finally reaching breaking point where I don't know how much longer I can keep going for. I am not complaining because I have my 3 tear old DD. It has just got extra difficult trying for sibling.
What I'm stuck with is whether or not to push for more antibiotics now .. against the inclination of the professional Consultant

@Prayformiracles I know how you feel. I wanted a sibling for my son who I had at 39. I went straight to ivf IMSI and had a better cycle at 40 with 100% blastocyst rate but we didn’t PGS because historically we never had many to test due to husband’s morphology. I now have 5 blastocysts left. I’m preparing for my transfer but lining gets too thick due to oestrogen getting high. I do modified natural FET.

I would certainly ask about treating prevotella with antibiotics but you don’t have to stop the probiotics. If you are doing era, could you get the garlic tablets as they are a natural antibiotic which are sometimes as effective as metronidazole. You stop garlic tablets when you do start blood thinners or if you use stims. That’s what Invivo nutritionist told me. I still take 2 a day. The unscented Vagibiom which you can get from eBay you can take all through transfer. I stopped day of transfer and just used flora femme a few days after transfer and then went back to Vagibiom either twice a day or once.

When I had recurring gardnerella, I was advised to get antibiotics for my husband. I didn’t do that as we didn’t have sex for a year. Things like thrush and gardnerella can be passed on.

You have to decide what is right for you. If you are doing transfer, you can keep taking probiotics like I did but stop day of transfer. Then continue day after but avoid acid product probiotics eg Vagibiom until say 5 days after transfer. If you have flora femme, use it twice a day on its own. I will be doing this for my transfer. Vagibiom has helped me so much. In fact, when I took and had an invivo test it detected a small amount of lactobacillus crispatus.

Do you have any symptoms? When I had gardnerella, I had high ph but it was annoying but no smell. If you don’t have symptoms, you could take doctor’s advice, take doxycycline but also take vaginal probiotics and garlic tablets for a few weeks.

@Prayformiracles but keep with vaginal probiotics throughout pregnancy.

Hi all,

Sorry to just jump on like this but I’ve just had another failed transfer. Some backstory:

I’m 34 and we have had ICSI due to male factor.

We had one cycle where I got 2 eggs and both made good quality day 5 blastos. Fresh transfer failed and frozen transfer resulted in a chemical.

Currently on our second cycle (11 eggs collected, 10 mature, 10 fertilised and 8 frozen)

I’ve just found out our first frozen from this cycle has not worked. It was 4AA.

Would you get the testing done before the next transfer? My periods are regular and I ovulate etc, and nothing wrong with me (apparently).

Many thanks.

@amkw I’m sorry you’re going through this. At your age, most of your embryos should be normal. I would say your egg quality is excellent due to high fertilisation rate. My husband had poor morphology and icsi did not work for us. We did IMSI and this greatly improved things. Also, my husband went on a lot of supplements from It starts with the egg plus wheatgrass and a strict diet.

Did you have a medicated FET or a natural modified? The natural FET with progesterone sometimes works better. I know I did medicated and my body struggled to absorb the progesterone. Things worked out better with natural modified FET with progesterone added.

The only issue with testing is the amount of times they are frozen. I know you are young but have you thought about assisted hatching at day 3? That increases chance of implantation. But usually advocated more for frozen transfer or women over 38.

You could try a different protocol for transfer next time. At 34, the large majority of eggs are normal. It’s a good age.

Thank you so much for your reply @2021ivfagain It’s really helpful.

I had a natural FET. They said I didn’t need progesterone pessarys but I asked them if I could have them anyway and they said yes. Do you think the outcome would have been different if I’d have left out the pessarys? I just don’t know why this has failed - it looks like it didn’t even implant either.

Can they test embroyos for euploid even if they’re already frozen?

I can’t stop comparing my situation with my other friends who have had ivf. They both were successful on their first go and their embryos weren’t as good quality as mine 😫

@amkw I'm so very sorry you are having to go through an unsuccessful transfer. It really is devastating isn't it.
You are much younger than me but personally I preferred to take the risk to do pgs/pgta because I thought I'd prefer to only transfer embryos that were "normal" and at least had a chance of implanting. I did this when I was about 36/37 yrs old and went from having 6 blastocyst to having 3 normal embryos after pgs. However, my acupuncturist told me of a lady who went from six to zero. So you have to weigh that up too. For me, Despite three being chromosomally normal and good quality, one of those three led to a successful pregnancy, the other two failed to implant.The clinic has absolutely no explanation as to why the others did not achieve implantation. Sadly there are no guarantees. I also did emdometrial scratch but did this at both a successful and unsuccessful transfer.
You might feel its too soon for you but if I knew what I know now, I think I would have asked to do emma and alice before each transfer too. Hope some of that helps you for the future. But take time to look after yourself first after this difficult time.

@2021ivfagain thank you for your reply, I will come back to you soon.

@Prayformiracles Thank you very much for taking the time to respond. I will defintely be doing ERA as they’re too precious to be putting back in if its not a great environment. Can I ask what grade yours were and what one led to your successful one? ❤️

Can I get the PGT if they’ve already been frozen?

@amkw the grades of the euploids/chromosomally normal embryos were as follows:
6AB+ (didn't implant); 6B+B+ (Successful); 6B-B+ (didn't implant).
The other three that were aneuploud were 6b+b; 6b+b+; 6b+b+.

Yes you can pgt if already frozen. That's what I did as I had to do lots of rounds and batch (as had low fertilisation rate). But be aware of risks, they may not always survive the thaw/freeze process but I think its low risk, maybe 5% chance not surviving but please check the stats/facts for yourself as i can't remember.

@amkw have you had your DH properly test for DNA fragmentation in the sperm? This is often overlooked but can also be an issue. Unfortunately a good grade morphology wise of a blast doesn’t mean it’s genetically normal. Could be worth looking into this too and testing especially if you have 8 embryos. Sorry about your failed transfer. I had 3 friends who started ivf two years after I did and all three got pregnant before me so I know how you feel. Hang in there!

@amkw how are you?

@2021ivfagain thank you for your message. I think I am doing everything you state: Oral and vaginal probiotics,Garlic supplements as well as other bits since started seeing a fertility nutritionist. I have had a 21 day bleed post era/nk biopsy so have been unable to use vaginal probitoocs for a while now. I think it is ending today. The nutritionist advised me to use balance activ for 7 days per month before restarting the vaginal probiotics. I have just ordered a semem microbiome test for my husband to check he is not passing things in to me. Its a slow process as it will be a 3-5 week turnaround for these results. We are abstaining from sex until we know more/get treated,even thiugh we only have protected sex anyway (to try to stop any infections arising). I am also doing one final vaginal mirobiome test via a different company. Also 3-6 weeks for results. Feels so slow after thinking it was time for the transfer and having done era. Im hoping this shows i am dominant in some other good bacteria because emma amd invivo only check lactobacillus and not other good bacterias. The question mark remains about whether or not to take antibiotics for prevotella at all and when? Surely sooner than later is better otherwise what's the point in all the probiotics now. Obviously it would be great if the garlic cleared it up without antibiotics but there's no way of knowing that without waiting for the next microbiome test and results to see if it has cleared up. Lots of work and waiting.

I have received nk results. Not got Mey head round it yet. A bit high in the bloods and one nk marker low in the nk biopsy. Because of this they said no to steroids and yes to intralipids. I'm quite scared. I have read that they don't know what effect intralipids have on the foetus. I'm debating whether to have any treatment at all.

We didn’t have dna fragmentation test but I’m going to ask all of these questions at my follow up appointment. Thanks for your reply ❤️ I’m just feeling lost x

Hi, thanks for asking. I’ve been really down this past week to the point where I think I’ve genuinely had a mini break down. Got my positive head back on now though. I’ve got 7 embryos in the freezer now and that’s a good start. I’m waiting on my follow up appointment to come through and I’m going to go to that loaded with questions. Im going to demand a fully monitored FET as natural FETs aren’t working for me!

What are intrapilids exactly? I think you can read horror stories about everything on the internet can’t you.I’m trying to take Google with a pinch of salt as you always get good things and bad things coming up. I’m sure i’ve read of ladies on this forum having intrapilids and everything has been completely fine though. It’s so unfair that we have to make these decisions when we are not qualified to do so and we don’t even have any understanding fully of it all. ❤️

@Prayformiracles I take two Design for Health garlic tablets in the evening. They only interact with stims and blood thinners.

My nutritionist advised me to take balance activ but for longer than 7 days per month. Obviously you need to avoid them near transfer but balance activ is your prebiotic which limits bad bacteria and promotes growth of lactobacillus. I would take Vagibiom once a day and balance activ with a vaginal probiotic in the evening. My nutritionist used to tell me to take them on their own. I listened to this and nothing changed as my lactobacillus was low. I did have lactobacillus Jensenni but norethisterone and constant antibiotics lowered it. One thing I learnt is not to stop balance activ until day before transfer. You know these are safe in pregnancy but not for natural conception as they affect men’s sperm but they are fine to use before and 10 days after transfer. That’s what I did and continued with Vagibiom unscented at least once a day with balance activ plus canesflor in evening. My consultant also recommended I did this as well. It’s better to take balance activ and probiotics as if pregnant antibiotics might be more risky until second trimester.

Do you mind me asking where your husband is having the test done? I would say with protected sex there’s less risk of passing things back and forth. I found when my vaginal ph is below 4.4, things are better. I did not have sex with my husband for 12 months when I had recurring bv last year so it was not my husband giving it to me. It was frequent norethisterone lowering my ph as well as metronidazole, less probiotics and not using Vagibiom as often. I learnt that I had to take vaginal probiotics plus balance activ twice a day or something once with Vagibiom in morning to be a game change. Vagibiom has acid in it. I needed acid product plus a probiotic twice a day.

I did era and my results came back slightly high in bloods for nk cells but low nk cells in endometrium which affects implantation. In the end due to money and my toddler going to nursery as well as recurring infections, I decided against steroids and infusions. My consultant also agreed that the recurring infections would be worse with steroids and intralipids but you must decide for yourself. I was advised by consultant only to stop vaginal probiotics on day of transfer. Then continue day after transfer. I even took two vaginal probiotics day before transfer. One of those of Vagibiom, the other was balance activ plus flora femme. I must admit that I did not have much success with oral probiotics. They can work but only when issues are under control and with conjunction with vaginal.

@Prayformiracles I must say that the day after transfer until 5 days after transfer I just used flora femme twice a day (no balance activ or Vagibiom): once in morning and once in evening. My symptoms were bad in terms of discharge but I still got pregnant. When I got to day 6 after transfer I started using Vagibiom in evening and flora femme on its own in the evening. Then from day 10 after transfer took Vagibiom in the morning and balance activ plus canesflor in the evening so I had two acid products a day. This started to help a lot. I continued this.