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

@2021ivfagain ps. I only used norethesterone for 12 days this time round. I had a single dose rectal antibiotic after 3dsis and same after endometrial scratch a couple of weeks ago. Won't be taking anymore antibiotics before transfer.

@Gardenlady543 I hope you are all okay :) do you mind if I send you a direct message? X

@Prayformiracles Can you do a natural modified transfer with stims to thicken lining as I did? Then you will not need to use progynova vaginally. You just to progesterone which you can take rectally as I did using cyclogest and lubion.

@2021ivfagain thank you. Its too late. I have been on progynova for 9 days already. And so tired!!

To be fair nothing has ever given me or consultant reason to switch protocol. Its just the nurse saying these things could happen.

Consultant has said I can use balance activ and vagibiom if I want. But.
I have decided to follow advice of nutritionist and stop them both. She has been the one who has helped me to increase vaginal lactobacillus when no one else knew how to do it e.g. Consultant just kept telling me to continue using probiotics and that alone was not doing the trick. When I checked my lactobacillus months back I had stopped using vaginal pribiotocs for ten days before to check If they were holding and they did so fingers crossed its the same now.
I haven't read anywhere that the meds kill lactobacillus, only antibiotics.
I have done so much work foe thros one fet over almost 2 years that hopefully nothing else will make or break it now and what will be will be. 🙏

@Loz2467 you can, but when I click on it it says private messaging disabled.

@Gardenlady543 ahh yeah I’ve just noticed that how strange! X

@Prayformiracles Good luck with your transfer. I think you have done everything possible. With my transfer, I worries about lining being too thick. In the end, it was ok. It was between 9mm-10mm on transfer day which they said was good. The other transfer was 15mm but implantation still occurred. I think I was told 8-10mm is optimal.

With regards to progynova, I think at CRGH they would want you to take it until week 10. Vagibiom is more subtle than balance activ. Whenever I have used Vagibiom, it has shown up on my swab testing. Unfortunately, as I took clindamycin in the past (2023) I had to use vaginal probiotics for the transfer last year (2024). I stopped day before transfer. I kept an eye on vaginal ph. When I could feel ph getting more alkaline (less acidic), I would use flora femme on its own. Then 2 weeks after transfer Vagibiom on its own.

@2021ivfagain THANK YOU

my lining was measuring 8.6 and they have given me another 48 hours of progynova before I start progesterone because of their own schedule. I really just hope that's not too much. I don't know whether to take matters in my own hands and reduce the progynova but I don't want to be a rebel.
Do you know if lining keeps thickening once you start progesterone (as still on the progynova) ??
I read somewhere past 10mm isn't great at fet but nurse says it can't get too thick. I don't believe her. And she was also really rude in her attitude through my whole appointment yesterday. I would complain about her but I don't want the stress right now.

I have stopped balance activ so i havent used it atvall in this cycle (apart from one day) but have still been undecided about vagibiom and then end up using it on a whim so I have used it every 3 or 4 days. I can't feel anything re ph but then I never used to either. I don't think I'm prepared to use strip now at this late stage as i dont want to put anything else up there, even a strip, as even that is a source of potential infection.

I did era so they have timed on the usual 125 hours. My era was actually 124.5 hours so again wondering whether to take matters in mybown hands and start my first dose progesterone half hour after they told me to match the era timing of transfer.

@Prayformiracles My lining thinned down and compacted when I took progesterone but I was in a natural modified transfer with stims. I didn’t add progynova as oestrogen levels were already high enough (over 1500 near trigger). Anything up to 12mm is good in transfer day. The only time mine went too thick and cycle was cancelled was May last year when it got to 20mm after trigger as I had too many follicles but I had less monitoring.

This time I asked them to check lining on transfer day and it had thinned to between 9-10mm. Before trigger it was 12mm. 8-12mm is optimal. Anything outside these measurements is not as good but I had implantation in 2023 with 15mm although only one implanted. This time two implanted but I lost one at 8 weeks.

As for Vagibiom, the ingredients are natural so it’s not as intense as balance activ but I still use them now in second trimester. I avoided them on transfer day and for a week after. I only used flora femme. I’m prone to gardnerella and all the antibiotics destroyed my own lactobacillus so Vagibiom was found on my swab once as it contains crispatus.

They told me cyclogest 8am, 2pm and 8pm and lubion 8am and 8pm. I tried to stick to it near transfer and afterwards but after 7 weeks I adjusted times to 9am as it was tiring.

@2021ivfagain thanks for your message. So you had implantation happen with both 10mm and 15mm at different transfer days. I remember you lost one and I'm so sorry again 😔

Do you think I should ask them to measure lining on transfer day or do I not really need to know at the stage?

They told me same times for cyclogest, lubion and crinone. They wany cyclogest orally taken on an empty stomach so I have adjusted to 7.30 so I can eat breakfast at 8.30am and take the progynova and steroids as I think they are better with food. So many timings to navigate three times per day around meals/empty stomach/2 hours away from supplements etc.

Also tested my thyroid 2 days ago. I had issues with it for 5 months but it got sorted and thats why i started this cycle. But this time My tsh is good but my free t3 and free t4 are at the very lowest end of normal range. Another worry!

Does anyone know much about acupuncture. I have basically had it fortnightly for two years. And I read mixed reviews/studies about whether to do it once/twice on ET day, I even found a study yesterday saying it can't decrease your chances whereas many say it might increase. Now I don't know. My acupuncturist says she usually does them before amd after within 24 hours of the transfer. I'm now thinking maybe do it 24 hours before but none on the day amd none after. Anyone else had experiences with this?,

• found a study saying it CAN decrease chances

@Prayformiracles Yes. Last time it was between 9-10mm. Lining had shrunk due to progesterone but I was not on progynova. Both implanted. Only one implanted when lining was about 15mm.

Cyclogest rectally not orally. I tended to eat breakfast first to get bowel moving before using cyclogest.

I did acupuncture leading up to transfer. Then day before and day after. I think you’re worrying too much. I had so much stress. My son even kicked my car seat when he was tired on transfer day! I was stressed as trying to fund nursery for my son and he was also sick during tww.

Yeh I know I am worrying too much.

Hi everyone, I've just had a BFN from a euploid day 5 good quality embryo transfer, feeling super low and already thinking about what to do next!

My consultant mentioned ALICE/ERA/EMMA to me as poss option. Has anyone had all 3 at same time, and
did it take ages to get results?

Ttc 2 years with a TFMR, adhesions with 2 hysteroscopies to remove, a chemical, 2 ECs, 1 cancelled FET for thin lining and 1 failed FET and I just don't want to lose any (more!) time. I'm 38.

I've done a vaginial microbiome test which showed i have a good amount of Lactobacillus crispatus but v low in other Lactobacillus so have been on vaginal pessaries for 2 months to hopefully help that, but my clinic weren't too fussed as don't have bad bacteria and I have the crispatus, I'm wondering if anyone has done the EMMA test and vaginal microbiome and was it similar/not in the results?

Thin lining has been an issue for me, it got to 6.8 for this transfer which they felt was good enough but of course now I'm wondering if thats why it didn't work (thoough could be anything I guess!)

I'd anyone here has had thin lining and then done these tests I'd love to hear if it revealed/helped anything! I suspect mine is from my scarring/adhesions and either it just is what it is, or might have to have yet another hysteroscopy to investigate that again

I'm just exhausted by it all

Hello everyone. Sorry to storm
in with a question after such a long time and not having caught up with all your latest.
I’ve been having an extremely difficult time with infertility and became very frustrated.
I’ve taken out a new credit card and decided to have ovarian PRP with Dr Gorgy, have my baseline scan on Wednesday.
He didn’t tell me this on our consultation, but the nurse mentioned that I will be needing to take Neupogen as it improves the quality of the plasma, needles to say this came as very unexpected to me. I’m not sure about the dosage or how many days, but I’m scared about side effects. Anybody who had this before can talk me through side effects they experienced please? @Gardenlady543 I believe you had this procedure done with Gorgy, were you put on Neupogen, anything you’d want to warn about? I believe it’s pretty intense stuff. Thanking you all as always x

Sorry to hear this @Orangewillow
I recently did the ema/alice/era along with a hysterscopy. I also struggle with thin lining. Typically my lining gets to about 6.5-7. The highest it got was 7.5 on my last FET, and that resulted in a chemical. I don't have any scars or adhesions.

I had my results come back normal except needing some vaginal probiotics.

My consultant said some ladies just naturally have thinner linings. There's lots of success stories on Reddit of BFPs with thinner linings. I had my biopsy when my lining was 6.5 and it was still enough for them to test.

Going into my new FET next month with one of my last two blasts (both untested)

@Prayformiracles I was always told to avoid acupuncture on transfer day but do leading up to transfer, day before and day after. In the pandemic, I did it leading up the egg collection but stopped well before transfer due to risk of Covid. Acupuncture can be calming but it’s not essential.

@clhiu I took neupogen infusion before my last two transfers as I had low nk cells in endometrium. It was inserted in vaginally. I had no side effects from it. It can increase implantation.

Thanks very much @2021ivfagain just had my 3rd and last injection last night and I was fine actually, didn’t notice any side effects.
I just had the PRP procedure with Dr Gorgy and went well. Back to trying naturally now as more IVF is financially out of the question. I’m just hoping this treatment will help with egg quality and OR in general. I may have a second round of it in a couple of months for best effectiveness.

@Orangewillow I’m sorry to hear about your failed euploid transfer. That’s what happened to me and was super upsetting, especially since I’d only managed to obtain a single euploidy out of that cycle. Because I only had one, I was advised to have the full ERA/EMMA/ALICE/NKC (endo and bloods) beforehand as well as a hysteoscopy. Everything came back normal except for low lactobacillus for which I was prescribed vaginal
probiotics and supplemented these with oral
ones too and slightly raised NKC toxicity for which I was prescribed intralipids as part of the protocol. I followed all the advice, but sadly my transfer was a chemical. Sorry if my story isn’t a very positive one, my euploid wasn’t a good grade either so perhaps there was more in that than anything else. For many I hear addressing those issues can make all the difference so if you can afford to have those tests I’d say go ahead before your next transfer x

Thanks @clhiu that's really helpful to hear. I think for my own peace of mind/what remains of my sanity it's probably better to check everything possible before going again so I know I've covered everything I can. It's just incredibly hard that there's still no guarantee despite doing everything possible!

I’ve another question please. Can anyone remember whether they were prescribed a cycle of Metronidazole during their egg collection or transfer cycle? I’m having to take a preventative 3 days course following the PRP procedure and I believe it to be strong stuff that’s probably going to mess with my microbiome. It says on the leaflet not to take if you’re trying to have a baby, which is counterintuitive since I had the procedure to have a baby specifically. I believe you had it a few times @2021ivfagain, was it ever for a transfer that was successful? Thanks

@clhiu I had neupogen infusion twice vaginally only after ovulation had been confirmed for natural modified transfer. Yes both times it was for transfer. It was because I had low nk cells in endometrium. I only had it on one day each time.

I’m now pregnant with an embryo created when I was 40. I was pregnant with twins as they put back two but lost one at 8 weeks. But it has been a long journey to get here. So much has happened. My Dad has passed away recently. I’m 44 in June.

When you take metronidazole, take balance activ and a cheap vaginal probiotic. Then use flora femme with balance activ. When my ph felt high the month before transfer, I took balance activ 3-4 times a day. I found constant use of norethisterone stripped away some of good bacteria too.

Thank you so much for the quick reply @2021ivfagain do you know if BalanceActiv and Florafemme make vaginal PH alkalike or acidic? Because I’m trying natural conception only it’s important that my PH remains alkaline and nor too acidic. Thanks

@clhiu It makes it more acidic. You could just use Vagibiom for a bit as it’s natural but avoid the scented one. I find it does not make things very acidic at all but does help my microbiome with lactobacillus crispatus etc. Flora femme on its own prevents ph getting too high (alkaline).

The problem is after antibiotics it does kill some of your good bacteria which needs to be replenished.

@clhiu I didn’t take any antibiotics this time.