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

@CailinInUK I don't think it was that long between the treatment and the result, in the end I gave up on testing after a good result. I'd done three tests and two courses of antibiotics. It was clear that I was prone to gardnerella, so I kept an eye on the pH and any odor and then took a week of metronidazole the month before my FET, daily vaginal probiotics, and three days of doxycycline around the transfer. I'd done my last microbiome test in late 2021 and the transfer that worked was May 2023 and between that time I'd had numerous procedures and open fibroid surgery. If you've already paid for the retest I would probably hold off on treatment until it's back, but at some point you likely need to pick a point to stop testing and move forward with the results you have or you could end up in a constant loop.

@Gardenlady543 thanks so much for reading my long essay and replying so promptly, much appreciated! I've already bought my retest, took the swabs already, will take the menstrual sample next week, and will get the quick turnaround results within five days (a new service by Fertilysis). So I'll have results back before I transfer, though I will have started the cycle so will pay the cancel fee if I pull out. Willing to do this to save my sanity by having to defer for another month!
Am using the probiotics and keeping an eye on pH. All seems good.
So that's my plan. Start my FET cycle in around one week, unless something else crops up!

@CailinInUK we have an egg quality issue (not a numbers issue) I have pcos and endo. Hubby has mfi too, out of 23 embryos only ever had 2 to transfer, none to freeze.

Morning ladies, quick question,,,

Care don’t test progesterone or oestrogen before a fresh transfer. Dr Gorgy said progesterone should be above 80. What should oestrogen be?
I decided to test privately today. Fresh transfer should be on Weds. thanks 🤞🏼🙏🏼

@ChickenT2b I had trouble finding info on the best range, I think for a frozen transfer I concluded around 1500. But as you've had a collection yours could be several thousand, that's normal in a fresh transfer.

@CailinInUK that sounds like a good plan, I hope it comes back normal so you can be reassured and go ahead.

@Gardenlady543 thank you. My estrogen has come back at 6393 pmol which seems high so I’ve emailed CARE to see what they say. I hope my HCG boosters don’t increase it further.

Progesterone at 234 nmol. Can prog be too high or is it higher the better? 🤷🏻‍♀️

@ChickenT2b progesterone should be fine, people at the London clinic that monitor regularly often have really high progesterone in the hundreds. Some clinics feel fresh transfers should be avoided because of the high estradiol, this is completely normal though and is what you'd expect in a fresh cycles.

@CailinInUK really hope the repeat is okay so you can go into the transfer with confidence.

@ChickenT2b thinking of you and hope all goes well. Your oestrogen sounds normal given number of follicles in your fresh cycle.

@Gardenlady543 Sadly things haven’t worked out well and I was admitted yesterday with internal bleeding and taken to emergency theatre last night. My HCG was rising again and the ectopic pregnancy had increased in size. I had to sign some forms about histopathology and what to do with the pregnancy after. All feels very surreal.
I don’t regret trying expectant management - if I could have avoided surgery (especially so soon after my endo excision lap) and losing my tube that would have been ideal.
I’m finding it hard that I’m on a ward of pregnant women (headache, hyperemesis etc).
I really hope I’ll be home later with some cuddles from DH.

@CailinInUK I agree with@Gardenlady543 . In 2022-2023 I was testing a lot but then had constant BV due to overuse of broad spectrum antibiotics from IVF treatment. With my last pregnancy, what worked for me was taking probiotics vaginal mostly every day and stopping on transfer day only. I restarted probiotics evening of transfer. I even took Vagibiom up until transfer day. I used flora femme twice a day from day after transfer. From 5 days after transfer I used Vagibiom in evenings and flora femme in morning. From 11 days after transfer I reintroduced canesbalance with canesflor in evening and Vagibiom in mornings. This combination worked and treated slight bv. In fact I retested and bv went. I found acid treatment and constant probiotics worked well for me.

Now I use canesbalance in evening with canesflor or lakcid intima and Vagibiom in the morning. I also only stopped canesbalance day before transfer with my consultant’s advice.

I hope you are able to treat the infections in time. I am avoiding steroids as my son is 3 now and always bringing home colds, stomach bugs etc. My mum has also been in hospital for 2 months so I have to be careful about her immune system too.

I can understand you want to progress with transfer too. I am taking norethisterone to prepare to start end of the month.

Could you take probiotics like me up until transfer day and then continue day after transfer or evening after transfer. It worked for me last time. The reason my miscarriage happened was due to an abnormality. I did repeat testing and found out probiotics etc helped to keep bv at bay especially when I was allowed to reintroduce canesbalance again at 10 days after transfer. However, I always feel when symptoms are coming on. Do you get that?

I hope all goes well with treating any infections. Whenever I took oral antibiotics, I always continued with vaginal and oral probiotics and canesbalance, but have found oral probiotics don’t work so well for bv.

@Enfys23 so sorry this is happening to you. I hope you’ll be free to go home soon to recover and begin to move forwards.

and thank you.

On route to transfer a fully expanded blastocyst grade 2.1 according to Care.
We have a full blast 1.2 and 2x 2.3 early blasts. Plus one possible more which is still early. 🤞🏼

@Enfys23 I'm so sorry, how are you feeling? I think you made the right decision, the doctors said it was fine to give things a chance to resolve on their own and had you been able to avoid medication and surgery that would have been for the best. And so horrible you have to be around the others, this really is so annoying and seems to be the case everywhere that they put people with losses around heavily pregnant people, even babies on some wards :( did the ectopic implant in the remaining tube? Have they removed that tube?

@2021ivfagain when you say there was an abnormality, have you got the baby's test results back? How do you feel about it?

@ChickenT2b excellent best of luck for today!

Hi all. I had my 3rd re biopsy yesterday for Emma/Alice. Both DH and my consultant are reluctant to do it again if the result is still 0. Consultant said he would recommend going for a transfer and giving antibiotics at time of transfer in case of infection - but to me that doesn’t solve the 0% good bacteria. However if there is no improvement I’m not sure what I can do. I’ve taken probiotics daily for a month straight at least - both vaginal and oral ones and after a week of a strong antibiotic so I’m not sure what more can be done! Last time it cleared up and good bacteria was 75% after antibiotics and probiotics.

@Enfys23 so sorry to hear this. Are they removing the tube? I hope you are home to DH soon.

@ChickenT2b best of luck with your transfer 😃

@2021ivfagain how are things now? Have you any plans for a transfer?

@CailinInUK good luck with your retest too - are you still planning a transfer soon or?

@Gardenlady543 hope you are enjoying bubs and the feeding issues are resolving.

@Enfys23 I’m really really sorry things ended up that way, it just sucks, especially when you have to be around pregnant people. I hope you’re at home now and taking care of yourself.
I totally understand why you wanted to avoid the surgery and losing a tube, that’s upsetting no matter what, but in case you haven’t heard this fact I’ll give it to you if it helps in any way. Losing 1 tube only lowers your chances of natural conception by 10%, not 50% as one might assume, as tubes apparently move around and can grab the eggs from whatever ovary ovulates. So it’s far from game over for you.
Sending love and a very big hug x

Thank you so much @ChickenT2b @Dochas12111 @Gardenlady543 @clhiu and for all your understanding.
I got home this afternoon, minus my left tube. I still have my right one - that does give me some hope @clhiu 🙏🏼, though it seems I ovulated from my right side and it ended up in the left tube which makes me wonder if my right tube works at all. Or maybe it reached the uterus then went for a wander up the left 🤷🏻‍♀️. However my left side is where all my endo was at it’s worst so I’m not surprised this would be where my fallopian tube was most affected.

@ChickenT2b I hope your transfer went well and you can now enjoy being PUPO ❤️

@Dochas12111 really hoping this biopsy result finally better so you can move ahead with transfer.

@Enfys23 So sorry about losing a Fallopian tube. I know it doesn’t seem it but the fact that you became pregnant is a positive. I’m so sorry you’ve been through this though.

@Gardenlady543 Yes it took 2 months for result to come back. Extra copy of a chromosome. I was 40 at time of egg collection even though I had a good reserve then. I often wonder if I should have had a different cycle but it’s too late now. I can’t do more retrievals so I can only hope there is a good embryo from what is left. If not, then I need to move on.

My mum has been in hospital 2 months. It’s been stressful. I’ve been fighting with care companies to organise things. One had a go at me today over the phone! My husband was so annoyed and got on the phone when he got back from work.

I’m hoping to do transfer next month so this is prep month of norethisterone. However, my son who is 3 keeps bringing germs home. I have had the odd glass of red wine and stayed up late sometimes so wondering if immune systems is low. Definitely not going on steroids. I’m teaching a lot at present. I did have a sore throat this evening so hoping to continue dosing up on garlic tablets etc. I’m on quite a few supplements to stay healthy but toddler brings home germs.

@Dochas12111 Just want to give you reassurance. When I did my transfer last year and got pregnant, I took vaginal clindamycin which actually helped then made things worse again and caused dryness. So I kept taking probiotics and vaginal canesbalance and things did not improve much so I did oral clindamycin and stopped 5 days before transfer as per advice of experienced consultant. I replenished with canesbalance and probiotics up until transfer. Then only stopped morning/afternoon of transfer and took flora femme evening of transfer day. The antibiotics wiped out all my lactobacillus Jensenni but also all killed bv. I kept taking probiotics twice a day and ph was raised until I added Vagibiom in morning and canesbalance with canesflor in evening. The pregnancy actually improved my microbiome oddly. I think my issue is taking norethisterone a lot but now I am on Vagibiom every morning and canesbalance with lakcid intima or canesflor. So I have two lots of acid treatment every day and it keeps ph normal.

@CailinInUK Is your child in nursery? How do you cope with planning transfer/viruses?

@Gardenlady543 when and how did you wean off prontogest? I remember reading in some post of yours about your progesterone level going down after you stopped some medication. Also, did you continue taking vaginal and oral probiotics?

Morning ladies, feeling pretty low today. I’m 90% sure my first fresh transfer has failed. I’ve been testing everyday due to the booster shots. The line is now barely visible at 7dp5dt. Looks like most people have some progression by now.

I just wanted to know what happens next for an FET? Do you wait for your period and then plan a transfer for some time around ovulation? Or not necessarily around ovulation? 🤷🏻‍♀️

Does everyone try the same protocol twice or do you always change something? I don’t want to waste money seeing Dr Gorgy again if he’s just going to say do the same thing.

@2021ivfagain sorry to hear about your mum, how are you feeling now about everything?

@Enfys23 how is your recovery going and how are you feeling?

@Dochas12111 do you have your results yet?

@APSR I stopped prontogest at 12 weeks and cyclogest at 14 weeks then I tested the levels after a few days it was low compared to the chart on this website so I took 1 cyclogest a day naprotechnology.com/progesterone/

I'm sorry @ChickenT2b :( my clinic had me do a cycle off and then start with the next bleed. They do an appointment after an unsuccessful cycle to discuss the next cycle and if anything should change. You don't always change things because the chance of an untested embryo working is 1 in 3 even in optimal conditions so you can need to give a certain protocol a chance unless there are signs things should change.

@Gardenlady543 thanks for letting me know. Did you continue with 1 Cyclogest till the end?

@APSR until 28 weeks then I stopped and retested and the level was fine.

@ChickenT2b
I’m really sorry, there usually is some line progression at 7dp5dt on the sensitive tests. As @gardenlady said, it’s usually recommended to wait one cycle.

I’m Day 8 of my mild stim modified natural FET. Two follicles growing, 14mm and 12mm. Lining is 6.5mm. Consultant has recommended starting pituary suppression (ganirelix) tomorrow and then another scan on Friday. I wanted to avoid ganirelix as didn’t have it for my lock cycle and I know @Gardenlady543 you didn’t want to use it either as your follicles collapsed and a friend recommended against. I can't find any evidence either way online.

I think he might ask me to trigger on Friday(Day 10). I’d like to stretch it out to Monday but then the follicle may be too large. Clinic don’t do same day bloods anymore so we only get the results the next day, which doesn’t help monitoring the P2, E2 and LH. @Gardenlady543 what day of cycle did you trigger?

I’m really unsure what to do:
1. Do as consultant says
2. Ask for scan and possible trigger on Saturday. No ganirelix.
3. Push it to Monday and risk LH rise/cancellation of cycle.
Any thoughts anyone??
I’m willing to cancel if it’s not right due to how the days fall . This is my only tested embryo.

For my mock cycle/ERA, I took no ganirelix, triggered on Day 14 when two follicles 17mm and lining 10.5mm.

Hi @Gardenlady543 no need for you to let me know your numbers from your last FET as found them on thread 8! Mine are very similar to yours for Day 8 and you triggered Day 11. My Day 11 falls on Saturday (no scans that day unless they do a big favour) so I'm pushing it and may well LH surge by Monday. I'd rather that and face cancellation than trigger on Day 10 tomorrow.

@CailinInUK someone told me using the antagonist affected implantation but I don't know where they got that info. The staff would say it doesn't shut the body down but only agreed with me that it did in my case as it happened in the cycle before in me unexpectedly. They said I could avoid it if I did daily LH sticks over the weekend when they were closed. I would push for the day 11 scan if they will do it. If you trigger on a Saturday the transfer will need to be on a Saturday, will they do that?

Cheers @Gardenlady543
I've asked consultant to give me a call today to discuss. He doesn't work on Fridays.
Yes Day 11 scan on Sat and possible trigger on Sat is my preference. Day 13 is pushing it but it might be ok. I triggered on Day 13 for my mock cycle.
They sometimes do transfers on Saturdays but it's not the norm.
Given my nine years with them, 16 IVF cycles (PGT-A and PGT-M), three FETs, one DD, one late loss, in the past they've said they'll do whatever they can to accommodate. We shall see!

@CailinInUK yeah this is the thing, I was a complex patient with multiple unsuccessful transfers and you tend to have more individual treatment. My clinic don't routinely do modified natural FETs but clearly that was the thing that worked for me.