ERA Test?

[Greyeverything]

Hi everyone,

Cant find the answer to my question anywhere so thought I would ask you lovely ladies and see if anyone has any advice or has had a similar experience.

I’ve had 3 transfers so far, one fresh resulting in BFN, one frozen resulting in BFN and my most recent frozen was a chemical pregnancy. I tested early 🤦🏼‍♀️ and got a positive 2 days in a row which then gradually faded and was BFN by OTD.

Prior to the third transfer I had discussed getting the ERA test done if we got another negative result. When I went from my follow up after the chemical pregnancy I asked if I still needed to have the ERA as it would appear that this last embryo did implant, it just didn’t stick. Consultant said it probably wasn’t necessary.

Currently just taking a bit of a break before transfer number 4 and I’m starting to wonder if I should have the ERA test done after all?

Does anyone have any experience of this? If I had a chemical pregnancy does that mean that implantation took place meaning that there probably isn’t an issue with my implantation window and that we did time the transfer right last time it just wasn’t viable for whatever reason?

Or is there a chance the receptivity window is wrong?

Just not sure what to do as it’s an expensive and invasive test to have if it’s not needed!

Advice welcome 😊

[Cinderella5]

Hey, I had this done as we have had a number of failures with good embryos which were from my OE and DE. So far we have had 5xBFN, 1 late BFP which we lost at 6wks, 1 BFP which ended up a CP as hCG started to drop and then a BFN. In the cycles we had BFP's we had moved my transfer to day 6 instead of day 5. Our clinic recommended that we try this ERA test as they couldnt quite work out why we had not had success for far and felt we were either transferring too early or too late. I agreed as its mighty frustrating when you have top quality embryos, mostly 4AA and even an A class hatched and hatching blastocyst. They also mentioned we might want to try PGS but I wasnt up for that as I beleive it can harm the embryo. We got our results back (look at my last post) which showed we should tranfser at 133 hours (which is day 6). We have worked back my previous transfers and the 2 that we got BFP's on were transferred borderline too early or too late on day 6 and of course this explained why our 5 day transfers didnt work at all. I cant say 100% that tranfserring at 133 hours of beginning progesterone will get me the desired result but it looks promising and our history sort of goes with this too. Hope that all makes sense. Can only try and see what happens next.xx

[Greyeverything in reply to Cinderella5]

Interesting that the ones where you had positives were the ones where you deviated from day 5 day transfer which makes sense given your ERA result. For me the transfer when I finally got a positive (albeit short lived) was 5 days so I’m thinking that I maybe I do have the timing right because that embryo implanted initially for me to have a positive test.

Just don’t know whether the ERA would help in my case. Surely if we were timing it wrong I wouldn’t have got a BFP at all?

I’m going to call the clinic to discuss but to be honest they aren’t that helpful with stuff like that as I’m NHS so it’s very one size fits all 😩

[Cinderella5 in reply to Greyeverything]

For my last BFP it was short lived but I was getting positives from day 7 (I didnt test before this but probably would have gotten a BFP on day 6, maybe 5) which looked to be progressing well but hCG levels started to fall again. This was the one that was put back a little later than my ERA suggested time. Like I say, its maybe just a coincidence how things worked out with that one and it may have just been bad luck. Im more than aware there are no guarantees as we could easily transfer at the right time and still get a BFN. Its hard to know what to do isnt it and all these extra tests are so expensive! The NHS is a very one size fits all, I found that too and I doubt they have much experience with ERA testing. Just thought it might be helpful to see my experience.xx

[DianeArnold Partner Nurse Fertility Network UK]

Hi Greyeverything. Read "Cinderella's" response carefully, as she has described her journey so far, perfectly and had indeed tried the ERA test on her womb lining. The early positive test you had, was probably a bit of trigger shot yet to have left your body, so try not to test early. I do have a couple of lists of questions I could email you in confidence if you think they may help at all. Most won't be appropriate, but there may be a few you can use when seeing your specialist next. Email me if you want them. I can message my email address to you if you haven't got it. Good luck with it all. Diane

[Greyeverything in reply to DianeArnold]

I didn’t have the trigger shot as it was a FET. I tested as 7dp5dt and it tested positive at 8dp5dt a bit darker then at 9dp5dt started to fade. Consultant agreed it was a chemical pregnancy.

I’m not due to see the clinic again I just have to call up when I want to start another FET but I’m wondering whether to do an ERA test first. It would seem that implantation took place initially which I though would suggest we have the timing right but just wanted to see what other people’s experiences were and if anyone was in a similar position.

Thanks

[DianeArnold Partner Nurse Fertility Network UK in reply to Greyeverything]

Hi. Sorry, I should have noticed. Yes, It might be an idea to have the ERA test done, then hopefully a decision can be made when to do a transfer. At least you will have tried, and I do agree it's worth a shot. Diane

[Fingerscrossed38 in reply to Greyeverything]

I still used a trigger shot with my FET as I go with my natural cycle.

[Fingerscrossed38]

I had a chemical of a pgs normal embryo with my first FET in August. I was devastated.

I went back to my Dr armed with a million questions and he said we should do an ERA/Alice/Emma. I said why when it obviously implanted. He gave me this analogy:

The embryo is waiting on a platform for a train. The train arrives (transfer) and as the train is leaving the platform (progesterone/timing) the little embryo jumps on. It makes it onto the train (bfp) but because he was standing at the end of the platform there just wasn't enough of a run up (progesterone) to securely grab onto the train and he falls off (chemical). The ERA will determine whether or not the timing/progesterone/platform needs adjusting. It is highly likely. As it was in my case, we did need to adjust the timing and add 12 extra hours (platform) of progesterone before transferring again. We did this in Nov with our next FET and got a sticky one (so far!).

My Alice/Emma result also came back with really low levels of good bacteria so I needed a course of vaginal probiotics. There was no detection of bad bacteria or infection so I didn't need antibiotics.

I also got tested for rarer blood clotting issues since all the regular blood clotting panel tests came back normal. I discovered I had pai-1 blood clotting issue so need clexane daily till 6 weeks post birth, any long haul flights in the future and during surgery!

I also had my progesterone levels monitored closely 2 days prior to transfer, on transfer day and 2 days after transfer day and they needed adjusting and in the end I was put on prontogest progesterone in oil injections which hurt as they're intramuscular but it's worth it as it keeps my levels nice and high.

I needed to add 3 x 2mg Progynova too to balance the high levels of progesterone.

Lastly I added intralipids a week before transfer, again when I got my bfp at 5dp5dt and then every fortnight until 12weeks! It may be over kill but I've got a history of early losses and aggressive high Nk cells (during pregnancy only) and I'm throwing the kitchen sink at this one! So far so good!

Hope this helps xx