Has anyone taken Prednisone and intralipid for ERA test or only for real transfer?

[PaulaDag]

Hi All,

I have just started my ERA test (my clinic don’t do Alice and Emma) and am taking Noresterone at the moment.

I asked my fertility clinic about matching everything we intend to take for medicated FET into the ERA for an accurate result and they said I don’t need to, just to add cyclogest and lubion, but I could add fragmin and aspirin also if I want to (which is part of my nk cells plan with another specialist clinic). Consultant said specifically don’t worry about the prednisone and intralipid when I pressed.

I emailed my other specialist who will treat for NK cells for the real transfers and he said I need to take everything, prednisone and an intralipid for the ERA test which took me by surprise.

Now I’m really confused as I don’t want to spoil the era test and for it not be accurate.

For your ERAs did you match everything or just some of the things possible? Did you take prednisone and have an intralipid for your ERA test?

Also is there an alternative to Alice and Emma? I’ve heard of vaginal microbiome test but is that different to Alice and Emma?

For the ERA we'd initially planned to take the following per day:-

4 cyclogest

2 lubion

1 75 mg aspirin

1 fragmin

Thanks x

[Eternalwarrior]

Hello lovely!I had ERA/EMMA/ALICE tests and I was in the same situation as you. I was really worried when my consultant told me that I didn't need to take prednisone, heparin or aspirin for the tests and only for the real transfer. He just insisted the most important thing was to use the same progesterone dose during the tests and for the real transfer.

I reluctantly followed his advice and that transfer worked! I wish you all the best xx

[PaulaDag in reply to Eternalwarrior]

Hello lovely, thanks for your message. Yes I've been really worried and it never helps when two specialist contradict each other 😅. I think the progesterone is all covered so I'll try to relax about it. Thanks x

[Cinderella5]

I was told I didnt have to take any of those things for ERA. Just the usual prep for lining and progesterone....whatever you would normally take for an FET. Mine worked for results and we also have twins now too. Dont worry! I would take painkillers prior if nobody else had told you to.xx

[Eternalwarrior in reply to Cinderella5]

Sorry I forgot to say that I only took progesterone for my ERA/EMMA/ALICE tests because I went on a natural cycle but if it had been a medicated cycle, I should have taken the usual prep for lining/oestrogen too x

[PaulaDag in reply to Cinderella5]

That's good to know, thanks. This is my first medicated FET so it feels like my knowledge is right back at zero 😩. I had a natural FET last Jan but it seems completely different to medicated. Learning all the time!

I am actually dreading the biopsy part! I had an endo scratch last time and it absolutely killed, although was short lived. Is it worse than the endo scratch pain? 😭xx

[Cinderella5 in reply to PaulaDag]

No worse and in some ways a bit better as it's just a quick nip....painful but short and sharp! You'll be fine and so worth it....we got our boys!xx

[PaulaDag in reply to Cinderella5]

Ok thanks. Yep you're right, it'll all be worse it if we get a family. Hope you and the boys are well ❤️ xx

[Millbanks]

You shouldn’t need to take prednisolone and intralipids for the ERA test. You’re not doing a mock cycle and it’ll just be extra expense which won’t give you anything useful. Xx

[PaulaDag in reply to Millbanks]

Thanks Millbanks. Your message reassures me that my initial thoughts were correct. I don't get why the Epsom clinic said I must take prednisolone and intralipids before ERA. I'll write back to them saying we'll skip it.

What is a mock cycle? How is it different to an ERA? I've kind of gone through the egg collections and know all about that but I don't know much about the transfer side of things. Its all such a big learning curve

Hope you and bubba are doing well xx

[Millbanks in reply to PaulaDag]

Sounds like a good plan!! I think some people do a practice transfer, so to take all the meds and see how the lining preps etc. I’ve never done one, only just straight transfers. I did do the ERA which was really helpful.

We’re good thank you! 28 weeks now - can’t believe it xxx

[PaulaDag in reply to Millbanks]

I can't believe its 28 weeks already - it only seems like yesterday that you announced the pregnancy. Time flies!

Yes I think I'd go for straight transfers too. Did you need any extra progesterone or is it just that the same progesterone get started earlier/later than 5 days? I keep getting confused as to the purpose of ERA being when to start progesterone in hours versus how much progesterone to take. I guess I could get my levels checked just before the biopsy too. Did you have levels tested in ERA?

xxx

[Millbanks in reply to PaulaDag]

I know - insane isn't it! Time has flown but equally feels like it has taken forever... the anxiety was full on.

So the ERA just tells you how many hours of progesterone you need. When I did the test it showed that I needed 137 hours of progesterone for my endometrium to be receptive (I think you have about a 3 hour window each side of that).

So that will tell you exactly what time to start taking it.

The amount of it isn't related - not to the timing anyway. I always started on 1 cyclogest a the correct time, then upped the dose as prescribed.

I would also have a blood test on the day of transfer to look at the progesterone levels - as this is important too - I think it needs to be over 50nmol - so they can up it if needs be

xx

[PaulaDag in reply to Millbanks]

Yes I can imagine the anxiety is overwhelming.

Wow so you needed more than 5 days of progesterone.

Maybe the amount I'm due to take for the era is overkill at 4 cyclogest and 2 lubion. Does that seem high to you? It came about as during my natural FET the progesterone was low on transfer day at 46 nmols. I guess they are trying to match what i will likely take for my real medicated FET? God it's all so confusing 😩.

xx

[Millbanks in reply to PaulaDag]

Yes I needed about 6.5 days - it definitely made a difference

I was on the same amount (4 x cyclogest // 2 x lubion) for my last 2 transfers as my levels were always low. I have naturally low progesterone too so it was needed.

Don't worry about taking that amount, apart from being inconvenient it can only be good. xx

[PaulaDag in reply to Millbanks]

OK makes sense, it can’t be a bad thing to take that amount for the era as well then as that way I get to see my levels in advance too. Once again you reassure me, thanks a lot 🤗

[Millbanks in reply to PaulaDag]

Yes exactly!! Ahh you're welcome - always happy to help xxx

[Cinderella5 in reply to PaulaDag]

Hi Paula, I also need extra progesterone....144 hours (6 days) instead of the usual 120 hours (5 days). I was also on fairly high progesterone as it was shown previously that my levels at transfer weren't high enough. In fact with my successful transfer I was on even more as we were trying anything to get that transfer to work alongside the ERA. It might be worth checking your levels at ERA too. I ended up on 2 cyclogest 400mg and 2 lubion per day.xx

[PaulaDag in reply to Cinderella5]

Thanks Cinderella. Yes you’re right I think I’m definitely going to ask them to check my levels at era as it has the added benefit of knowing if we need to adjust it before real transfer.

My levels for the natural fet was 46nmols based on 2x cyclogest and 1x lubion so definitely seems as if my prog wasn’t enough. Although for fresh transfers it was ok if I remember rightly. Xx

[Cinderella5 in reply to PaulaDag]

Yes it's actually a really good opportunity to check your levels and if you can replicate for your actual FET with confidence or adjust if necessary! All the best.xx

[PaulaDag in reply to Cinderella5]

Thanks xxx

[SCHNOW]

When I did my ERA/Emma/Alice/NK, I only took the medications for usual medicated FET transfer. No Aspirin, steroids or Intralipid. I had miscarriages before so I know I will be within the time but the main purpose was to have the exact hours timing and to check whether I have NK problem. The ERA test shows normal but I only found out I had high NK during this test. I went for specialist for NK treatments together with my FET. I am 29+ weeks pregnant now. I only used steroids aspirin Intralipid during my current pregnancy, not the mock cycle. Seems there is no direct link between immunology treatment and timing for transfer and when to start these immunology treatments depend on your FET timing so I don’t think it matters. It will adjust anyway according to your FET.

[PaulaDag in reply to SCHNOW]

Thanks for your message and congrats on your pregnancy 🎉. Its good to know the immunology meds worked for you - fingers crossed for me too xx

[Bozo_the_pumpkin]

I thought prednisone, heparin and intrallipids are specifically used to help with implantation and so that the embryo is not rejected by the body. As there is no actual transfer during and ERA cycle, I would not have thought these extra drugs are needed. With my ERA I took only the progynova and progesterone. The progesterone was most important. I agree with others.. extra expense that’s not needed

[PaulaDag in reply to Bozo_the_pumpkin]

Thanks for your message. Yes it definitely seems as if it would be a waste of money. I am going to write back to the Epsom clinic and skip the pred and intralipids x

[AuroraXen]

Hi Paula, I'm wondering about something similar! I'm going to get a bunch of tests all in one, via one biopsy (ERA, NK tests, and some sort of biome tests similar to but not exactly the ALICE/EMMA tests). The consultant I'm doing them with (at a different clinic to my 'own') wants to give me a medicated cycle with progynova and cyclogest. I'm a bit worried though as presumably whatever I take for these tests will need to be the protocol I use for my next FET, and my last FET was semi-natural (only a trigger to time the ovulation and then lubion as I bled with my two fresh transfers and lubion seems better for me). Anyway, I'm speaking to him tomorrow so will find out then what's what i guess! xx

[PaulaDag in reply to AuroraXen]

Hi AuroraXen, oh really I didn't know you can do a biome test at the same time as the ERA, maybe I'll ask my clinic about this. Yes i was under the impression that ERAs were only relevant to medicated FET and not natural FET but i could be wrong. Good luck with the consultation today xx

[Bump12]

Just been reading all the reassuring stories here 💕 PaulaDag How did you get along? I wanted to know as well if you did the ERA and then you change your protocol or if you get treated for endometritis if that would change your era results? Xx

[PaulaDag in reply to Bump12]

Hi Bump12, it was fine. The era came back as receptive at the time of the biopsy which was 5 days and 4/5 hours so my real medicated transfer needs to be around that time. Should be next Tuesday all being well 🤞. I’m heading off for my first intralipid today so bit nervous but hopefully it’ll go OK :).

My protocol didn’t change as such between the ERA and upcoming FET. So for the ERA I took all the usual Norethisterone, oestrogen, progesterone but also took aspirin and fragmin. For the real transfer next week I’m taking all that plus prednisone and intralipid. The latter two don’t affect the lining or receptivity which is why I didn’t take them for the era.

My clinic seems to indicate that you should match era and medicated fet as much as possible. And that if I chose to do a natural fet then the era results do not count as they can’t be sure unless I do another era under a natural fet protocol! So I’ll probably stick with medicated fets from now on.

I don’t think being treated for endometritis would change the era results. I’m assuming it would be a course of antibiotics to treat the infection following by probiotics to put good flora back. I’ve recently done a Invivo vaginal microbiome test and had some bad bacteria so did a course of doxycycline followed by probiotics. My clinic didn’t offer Alice and Emma and I didn’t really want a second biopsy so opted for that.

Good luck with your journey xx

[Bump12 in reply to PaulaDag]

How exciting that it might be next week? What’s your lining like now? I will keep my fingers crossed for you 🤞

That’s quite interesting to know that you can’t do a natural cycle now because I thought all it is seeing is how much hog progesterone your body needed and that would be the same with a mediated or natural cycle isn’t it? Xx

[PaulaDag in reply to Bump12]

Thanks 🤞. I’m not sure on lining yet as my 2nd scan is tomorrow, hoping it’s ok.

That’s what I initially thought re natural and medicated but she said the era results are redundant for natural - I guess the oestrogen supplements is building the lining up in a medicated, whereas with natural there is no oestrogen. She said I could do an era in a natural to see if I’m receptive and I said no thanks 🤣.

I think they would let me do a natural fet if I wanted but they wouldn’t guarantee receptivity. I’ve had 4 natural miscarriages so I guess I’m receptive naturally?

What stage are you at now? xx

[Bump12 in reply to PaulaDag]

Good luck for your scan tomorrow I’m sure it will be ok🤞 That is quite interesting.

Yeah I would be the same with a natural cycle wouldn’t want to take any risk.

I had one failed ivf (genetically normal) so I decided to get ERA/EMMA/ALICE . Just had it done last week and waiting for the results now xx

[PaulaDag in reply to Bump12]

Good luck with the era results. Let me know how it goes 🤞 xx

[Bump12 in reply to PaulaDag]

Yes will do. Let me know how you lining is doing as well and good luck xxx

[PaulaDag in reply to Bump12]

Lining not thick enough at 6.5mm so they’ve upped my oestrogen and back for another scan on Monday 😩 xx

[Bump12 in reply to PaulaDag]

Hopefully it will fine for Monday. What dose of estrogen are you on now? Keep you legs up whenever possible feels that helps sometimes xx

[PaulaDag in reply to Bump12]

I hope so. Ok thanks will try that. They’ve upped me to 4x 2mg tablets and a patch on my bum changing every 48 hours. It was 3 tablets only before the scan. Have you struggled with lining? What’s helped for you? I’ve got beetroot shots and L’Arginine tablets not sure it it’ll help but heard it does xx

[Bump12 in reply to PaulaDag]

i have always struggled with lining so i'm probably not the best person to answer this. I'm on a few supplements this time to help with the lining but i think they take a few weeks to work. Just keep active and drink plenty of fluids and some pomegranate juice. heard that helps as well. But good luck for tomorrow xx

[Bump12 in reply to PaulaDag]

Got my ERA results - unfortunately it says I am pre-receptive - so I have to repeat my biopsy with 6.5 days of progesterone (so disappointed)

How did you get along with your lining? Xx

[PaulaDag in reply to Bump12]

Hi, oh no sorry to hear that re the ERA results but at least you have something to work on that you can change for the next transfer. Why do you need to repeat the biopsy? Surely they just adjust the progesterone to 6.5 days for the real transfer? I'd definitely be querying that as will be more delays for you, and don't see the benefit (unless I'm missing it).

My lining got there in the end so we went back for the 3rd scan and it was 9.6mm but this was after 15 days of oestrogen in total - plus extra oestrogen and patches from day 10. So we had our transfer on bank holiday Monday and now just waiting to see 🤞❤️ xx

[Bump12 in reply to PaulaDag]

9.6mm that's amazing!! fingers crossed for you and I hope you give us good news soon.

Yeah that's what I am thinking that why did they ask me to repeat it? is it just for confirmation that 6.5 days is right? My doctor said not to repeat and will just go for 6.5 days.But I cant help think what if I need 7 days?

I mean I had 5.5 days for the ERA and i'm thinking if I needed 6days the era would have showed it?

[Boo718]

Hiya I’m having mine done in may and we are just about to start the prep. We were told by our clinic that it must be exact so to note down times of everything so we do it exactly the same for the medicated fet xxx

[PaulaDag in reply to Boo718]

Hiya, yes I think with the era results they say there is a 3 hour window either way but I want the real transfer to be as close as possible to the same time as the era biopsy was taken :). Mine was taken at 5 days and 5hours and 15 mins ish ! Good luck with your era. Xx