Is an ERA protocol (in terms of estrogen) fixed for your next transfer?

[AuroraXen]

Hi all, I'm having a biopsy soon for combined ERA, uNK and microbiome testing, before doing any more transfers. I was a bit confused about protocols for this. My only FET was a natural/modified FET as my cycles and lining are ok naturally - so we used an ovulation trigger and progesterone (lubion injections). The clinic doing the implantation test, however, always puts women on estrogen, then cyclogest once you start the progesterone. Does this mean my future transfers will need to be done with estrogen too? And with cyclogest alone?

I only ask because a) I guess I'm trying to minimise what I put into my body, since getting a cyst last year, so just want to take what I really need, and b) I haven't felt too well on estrogen... bit of vertigo and generally just 'slow', if that makes sense 😂 But of course, if they say I should have estrogen next time, then bring it on!

I think the consultant said the test results will actually tell them what kind of progesterone to do, not just when to start it (so it doesn't mean i can't use lubion again next time, for instance). Is that right? A bit clueless on these tests 🤯xx

[SUMMERTIME02]

Hey I'm doing the endometrio (era,emma and alice) test. I'm currently on a medicated cycle and my biopsy will be on Thursday (cd 21). So I've been on estrogen from cd1 and progesterone since cd 16.

From my understanding the next frozen cycle will closely mirror my current cycle, unless tests show tweaking is required.

That being said, if you're on a medicated cycle for your test, you most likely will be on a medicated cycle for your transfer cycle following your results. Unless your being tested on a natural cycle, where meds aren't needed.

I still find it all confusing as i had rather just done a transfer, but now I'm doing this I'm hoping for the best and hope it helps with my next transfer.

[AuroraXen in reply to SUMMERTIME02]

Thanks Lovely. Yep, I think you're right, my impression was always whatever the ERA test is done with, that's the basis for your next transfer... Good luck with your biopsy! Mine is in a week. Means a trip down and night in London, and lots of expense again... so I REALLY hope it will help me 😔 Guess I just need to feel we're doing what we can? It will take 5 weeks to get the results from the 3 tests, but hoping we don't need to redo it (I know sometimes the biopsy doesn't work??) xx

[SUMMERTIME02 in reply to AuroraXen]

Well im naively hoping i can start my next cycle in march, i don't think i'll be able to though. my clinic said the results can take 3-4 weeks, but the wait is down to the doctor making an appointment following the results which can further add to the time Feeling super impatient now! good luck to you too xx

[soccerkt6]

Heya

I don't have any insight here but following this thread as I have the same question! I'm about to do a natural modified FET (with added progesterone) and if it doesn't work, I was thinking about doing an ERA next. However, I'm not clear if an ERA is relevant for natural FETs or if it only matters for medicated transfers...

[AuroraXen in reply to soccerkt6]

It's so confusing isn't it... and I can't find a clear outline online, of what the results will look like, how they can be implemented, what they will mean for future transfers, nothing. I'll find out in a week when I have my biopsy (will make a note to ask properly!) and will update here xx

[soccerkt6 in reply to AuroraXen]

Thanks, lovely! I hope your biopsy goes smoothly.

And thanks for asking this question... I feel like so far the thread has raised more questions than it's answered 😂but it's really helpful to have a bit more insight into the process xx

[IVFat40]

Hello hun, when I did the ERA test I was advised that the FET following it should mirror as exactly as possible the ERA cycle (unless of course it showed me pre/post receptive and then the transfer timing would need to be adjusted accordingly). I chose to do a natural modified ERA cycle, as that's what I wanted my future FETs to be; so for me that meant a trigger shot (Ovitrelle) and then progesterone (cyclogest). My ERA actually showed I was receptive, so we did the next FET copying exactly the ERA cycle (medication, timings and everything); I was incredibly lucky and got pregnant on that FET. I actually do feel the ERA helped as it enabled me to pin down exactly the right FET protocol for me. Sending so much good luck hun.

[AuroraXen in reply to IVFat40]

Thank you! Argh see that's what i thought. For that reason I asked if I could do just trigger and progesterone for the test but they said they always use estrogen 🙄 Which means I guess I'm likely stuck with it for FETs... I was confused though as the consultant indicated that wasn't necessarily the case, as the test is all about getting the progesterone timing and levels right, not estrogen, and implied I wouldn't have to take progynova tabs on my next FET. If the results say I'm receptive on whatever I'm taking right now, I'll defo stick with that as long as I can 😂 (they warned me the results are only relevant for a short time, but honestly, I'm planning to use the timings for any future transfers once I've had that tested). I'll ask at my biopsy and see if i can gain any clarity (which I'm dreading!! sounds really unpleasant, sigh). So glad the ERA helped you, at least confirmed your protocol was right for you! xx

[IVFat40 in reply to AuroraXen]

Just to say hun from my own experience I really wouldn't worry too much about the biopsy, I've had 4 in all now and although they're not fun they genuinely weren't too bad, over very quickly as well. I took an over the counter pain killer before each (can't remember which one but the clinic will be able to recommend). Good luck lovely.

[Millbanks]

Hi lovely, not to add to the confusion.... but when I had my ERA protocol they gave me buserelin (not 100% sure why) so on my next FET they said it needed to be exactly the same as the ERA protocol. Started me on Buserelin and I got a cyst so had to abandon the cycle. Then when we started again they said they wouldn't give me buserelin as it had likely caused the cyst... so the ERA cycle was effectively different to the next FET.

My point being that it obviously doesn't have to be exact - and if you want to do a more natural cycle and avoid oestrogen then you should talk to them about it.

As far as I know you do need a balance of oestrogen and progesterone and sometimes it's easier for them to just take over your cycle so they know exactly where you are at - but I've never had my oestrogen levels tested for an FET - only progesterone on transfer day - so not sure how important it is (except for growing the lining)

Sorry that was a bit rambling! Hope it makes sense!

xx

[Milly_Oz]

Hi there, I’ve done ERA tests and going ahead with my FET on the same protocol. Mine is a HRT cycle so I take oestrogen from day 1 and then the progesterone from around day 13 if the lining is right. However I understand that it really is the progesterone levels that are timed to the hour in the cycle so that’s the key one. For me the oestrogen is about stopping me ovulating and also building the lining. Hope that helps.

Do ask lots of questions…it can be confusing and things aren’t always explained very well. Good luck!