Just tested this morning and it’s another BFN we are both devastated. That’s 4 now and 2 chemicals. Onto number 7 😔 I think our next stage is to have the uNK cells test but not even too sure this is the right thing to do next! Apparently our embryo quality is good and our clinic mentioned the uNK testing if this one doesn’t work. Does this sound like the right next step? Has anyone else had this where ‘apparently’ there are no problems (clearly there are) but have repeat implantation failure and went on to do that particular test. Or should we be doing the one where it checks the quality of the chromosomes? We have both a been a bit blasé to this point just going with the flow with what our clinic say and we don’t know enough otherwise anyway to question it but has anyone done anything differently? I’m quickly and definitely losing my mind. I hope anyone else testing today get their BFP!
6th failed cycle 😢: Just tested this... - Fertility Network UK
6th failed cycle 😢
Has anyone ever done a bundle of tests that tests for lots of different things and can tell me (roughly) what cost we would be looking at? I’m sure I’ve seen people mention a bundle of ALICE, EMMA and another one all carried out at once. Is there one where we can get uNK cells and other things tested or is this more a question for my follow up appointment?
I'm sorry for your negative 💕I'd definitely start looking at the ERA/Alice/EMMA tests and also immunology (NK cells and T3/T4 receptivity). I'm afraid they're not cheap tests (roughly £3k altogether from memory depending on where you go) but if you're able they're probably the best next step.
I wish you all the best ✨
Thank you 💛 We will definitely look into these xxx
The tests you're thinking of are the ERA (Endometrial Receptivity Analysis - checks that the time the clinic is transferring your embryo is during the most receptive time for your uterus at a chemical level as some women naturally fall earlier later than the most common window of implantation), EMMA (checks the microbiome within the uterus, the idea being that lactobacillus dominant uterine biomes are ideal) and ALICE (can detect if there are bacteria causing chronic emdometritis) tests.
All 3 tests require a biopsy of your uterine lining, so if you're going under for a biopsy, you may as well pay to have all 3 tests done from that sample. It is also cheaper if you buy all 3 tests together, they call it the "EndomeTRIO". They are all registered tests by an international company called "Igenomix". Look at their website for full info.
The cost of the 3 testing kits together is around £1,000, but the total cost will depend on what your clinic charges for tracking your cycle and doing the biopsy. For the ERA, you have to do a mock FET cycle, exactly the same as how you want to do your transfer cycle, whether natural or medicated, with your normal bloods and scans. On the day that you would normally have an embryo transferred, they take a biopsy of the endometrium instead. EMMA and ALICE don't have to be at any particular time of your cycle, so the biopsy taken at the time of the ERA is good for all of them. The biopsy is sent to Igenomix, they don the testing, and send back a report around a month later.
This is really helpful thanks so much for taking the time to reply. I’ve never heard of Igenomix before so I’ll do some research 💛 xx
You're welcome. Yes, I hadn't either, but then I suppose we normally focus on the clinics as that's where we are treated, rather than the biotech companies creating the tests behind the scenes. I had actually thought the clinics do their own tests, but they really just coordinate them. Igenomix is the lab that created the patented tests, so any clinic that offers ERA/ EMMA/ ALICE is using their testing kits. I think most of the time you just ask the clinic and they give you the full price for the cycle, which includes them buying the testing kits and sending them off (but the website is more detailed than what the specialists normally explain!).
Hi, I have had quite a similar experience to you with "unexplained infertility" (I hate this term, it just means they don't know what's going on, because obviously there is a reason!) where our "high quality" embryos keep getting transferred when "everything looks perfect", but none of them have ever implanted, not even a chemical pregnancy.
Unfortunately, I'm still not sure of the cause in my case, but I can help you out with info on tests! I would definitely recommend doing more tests before putting the next embie in, otherwise it's honestly a waste. I've gotten quite fed up of specialists being so happy to keep moving forward with more and more transfers without finding the reason the others haven't worked. We also assumed the specialists were checking what needed to be checked, and trusted that they knew the best course of action, however, when it comes to unexplained infertility, they really are just moving through a checklist and stabbing in the dark. I know that it can feel like you are wasting time having tests done and waiting for results, etc, but better that than wasting embryos then having to go through more IVF rounds and expense, and ultimately more time wasted.
Do you have remaining embryos or will you need to have another round of IVF first?
Thankfully we still have 4 remaining. Yes it totally feels that way doesn’t it… like you’re wasting time whilst tests are done and then waiting for results. It’s really frustrating but needs must! Thanks so much for your reply xxx
That's great that you still have 4 remaining 🙂
I found the genetic testing really useful. When the reason is unexplained, it rules out one more variable (embryo health) and can help give you an indication of how many would have failed anyway. Everyone will create some chromosomally abnormal embryos... estimated 25-30% abnormal in your 20s and early 30s, approx 50% abnormal by late 30s, 70% abnormal by age 40. These often don't make it far as they will either not implant, implant but then fail early (chemical) or continue and fail later (miscarriage), but in a few cases of course they will continue to term the baby has a genetic condition. Our specialist told us that chemical pregnancies are often because the embryo was unviable, so if that did happen to be thee reason you had 2 chemical pregnancies, it may save you future heartache. If genetically normal embryos keep failing to implant, there's something else going on (as is the problem with me).
It is expensive to test each one, but you save the much greater expense of a full FET cycle with each embryo, the wasted time and stress on your body of completing a cycle with an embryo that isn't viable, and the emotional weight of having more failed transfers.
We tested our last batch of embryos when they were fresh, so I'm not sure what the risk of losing the embie is when they are frozen (because they thaw them to take a cell sample then refreeze). Probably still worth considering though, depending on that risk. Not meaning to be negative, but you could easily find that of the 4 remaining, only 2 are chromosomally normal. You'd definitely want to transfer those ones! Also, because the embryologists need to create a small hole in the zona pellucida to access the embryo cells for testing, a tested embryo has basically had assisted hatching (so you can also rule out hatching problems).
Thanks again your responses are so, so helpful! I’m thinking maybe I need the uNK cells and the genetic testing initially! And depending on those then go for the EndomeTRIO. I will discuss with the consultant and see what they say xxx
first of all I am so sorry to hear of your failed cycle.
I had a few miscarriages before we went through the ivf route and then two failed transfers with the nhs - when I went private they recommended the NK cells test. I have never been told about ALICE or EMMA. I did the NK test and mine came back high. I had breast surgery years ago and my body pushed out all the stitching so I did think there was something wrong with my immune system.
When I was treated for high NK levels I got pregnant the next round she is now nearly 6! I had another fresh round and have a 4 year old from that. And am now pregnant with my last frozen embryo.
I take prednisalone, Clexane (although they have stopped that as I’ve had bleeding) and have intralipids. I really do think this treatment is what has helped me get and stay pregnant. I know the test or medication for high NK cells isn’t cheap but I’m so glad we did it.
Good luck xx
Ah wow that’s amazing and congratulations on your current pregnancy! Thanks for your good luck wishes and taking the time to reply xxx
hiya I’m so sorry your going through this. We did the pgd test to check the embryos. We had a number of top quality embryos that were abnormal so saved the heart ache of transferring them. After 2 bfn and 2 chemicals we also did the era alice and Emma tests that showed I needed an extra day of medications before transfer. I hope your ok xxx
Thank you, I’ll look into the PGD test and ask about it in my follow up appointment xxx
Hello. I like you have had 6 failed transfers. We recently had embryo testing which is expensive - approx £1500 but it’s given us peace of mind that we’re still producing normal embryos. Regarding the NK cell testing, if you wanted to save time and money - my clinic have just put me on the steroids they would prescribe if the test showed I had a high proportion of NK cells. This is much cheaper and quicker than undergoing NK cells testing but it does slightly dampen the immune system which isn’t great, especially if they’re not even needed. Our clinic was happy for us to opt for this so may be something to consider. I also had an ERA which came back normal, it was expensive, painful and traumatic for me personally. It’s another option you could explore but the evidence isn’t massive pro this procedure. Anyways, hope this helps I can provide more details by DM if you had any questions. Xx
Thanks so much for your reply and sorry to hear you’re in a similar situation. Yes it’s really frustrating me that I have to have the test when I know some clinics just prescribe the steroids but I’m with the NHS so maybe that’s why? Are you with a private clinic? Xx
Oh right, yes i’m at a private clinic. I guess there are pros and cons to testing and not testing. I’m nearly 39 so the idea of taking a few months out to test always adds extra stress. Really hope you get some Answers
I'm so sorry....its so sad and so hard...I've just had my 3rd failed FET(I have secondary infertility after previously being able to conceive naturally).....my Dr has ordered for me to now have ERA test, hysteroscopy and a mega bloodtest today for the following, I'll list them all incase any help to anyone...Anti double stranded DNA antibodies, Antinuclear ab, C-reactive protein, cardiolipin antibodies, creatinine, extractable nuclear antibodies, lupus anticoagulant, prolactin, prothrombin mutation, thrombophilia screen, thyroid t3, thyroid t4, thyroid antibodies, TSH, b2 glycoprotein Ab
Sorry to hear you’ve had a recent failed cycle too, it’s so hard 😔 Thanks for your reply it was very helpful regarding the blood test and what it checks. Hope you get some answers soon which help you have a successful round next time 🧡 x
hi, I feel like we have similar situations. I’m about to go into my sixth cycle/seventh transfer.
the latter cycles I’ve had good quality blasts but always implantation failure, nothing else wrong with me or other half that they can see.
I did the NK cells test before my fifth cycle, I came back with some levels elevated so they put me on an immune protocol, I’ve done that for two transfers and still had implantation failure. More recently I’ve done the ERA/Emma/Alice tests, they showed no infections and my implantation window to be correct. Good that there was nothing wrong but frustrating to have no answers.
As we prep for sixth cycle we were also going to PGTA test the embryos, however, I’ve back tracked on this as I don’t usually get many and I’m worried I discard an embryo that could self correct. The time to ann outcome would be similar as we wouldn’t have that many transfers anyway. After further research I don’t think it’s reliable enough to give me the peace of mind I want. I can share a link someone sent to me about it that helped with my decision.
I don’t want to sound negative but just want to give you a perspective.
In summary, I think the ERA/Emma/Alice was worth having to rule out infection. The NK cells is debatable, as I did have implantation and get pregnant on an earlier transfer prior to using the immune protocol, so suggests I can fall pregnant. If it was that effective would I have been successful with better blasts plus that?
In terms of costs, my clinic charge around £2k for ERA, £1.5k for NK cell testing, and PGTA £1.5k plus fee per embryo.
Xx
This is very helpful, thanks so much. It has made me think about the NK testing as well. I’ve got everything crossed for your seventh transfer. Hopefully it’ll be 7th time lucky for both of us although I think mine will be quite a while away now! Xx
Hi there....I thought your post was mine it is so similar...I just had my last embyro transfer in Greece on the 30th of January and not pregnant..I have had 2 chemical pregnancies and 4 no pregnancies including this one so 6 altogether. I had the Emma Alice biopsy test done in August and it came back they said I had 0% good antibodies in my uterus which would explain no implantation(according to doctor) the test costs approximately 950.00 euros I'm in Ireland...I was then put on a course of antibiotics for 2 weeks followed by vaginal suppositories for 2 weeks...they then re-do the biopsy for free ( I was very happy about that) and it showed I had 97% good bacteria ..so I was really happy about the last transfer in Jan but bfn. I have reading on here about a laparoscopy I am going to enquire into that but googling the cost is 3000-4,500.00 euros...I'm not paying that...I am doing this on my own and I have no savings left...I'm gonna try get the money to go again in June.
I just can't see my life without a child in it...sorry about the rant
No need to apologise, I’m so sorry about your most recent transfer especially after seeing such an improvement after the antibiotics. It gives so much hope doesn’t it when you’re told things like that or something new is introduced. I’m wishing you all the luck in the world for June x
Depending on your age (if you're over 35), I'd definitely be looking at pgs testing. Usually the problem lies with the embryo. I had some amazing embryos in my time, although untested. All failed. I wasted a lot of time with embryos that on paper were great. I could've saved myself a lot of heartache.
Other than that, if be looking at ERA.
They say the cause of most implantation failure is the embryo 80% of the time and timing 20% of the time. Id definitely be looking at testing the embryos at this point. It could give you some answers x
I am so sorry to hear this. This fertility business certainly is very cruel. I don’t know if you’d be open to trying abroad. I had success in Athens with my consultant from the uk who moved home. She uses PRP which is a blood plasma method to enhance the uterine lining and promote implantation. I had VV thin lining and after years of trying to get it to grow, this worked. I had poor egg quality so had to do donor eggs but it was a pure miracle. Dm me if you would like to talk more about the option.
That’s amazing, so pleased to hear you had success. No we’ve not considered going abroad yet we still have 4 embryos left and then 1 more egg collection with the NHS so going to see how we get on with that. Thanks for your kind words x
best of luck with it those. Really hope you have success x
I did Alice and Emma, era and receptive. Showed that even after treatment for endo my receptivity was poor. Moved on with a gestational carrier, had triplets
Also tested and got a negative. Sharing a grieving day with you. This was my last chance. I’m single and 43, so high costs with low expectations aren’t really in my favour. I really hope you find your answers before trying again xx
Ah no I’m so, so sorry to hear that. It’s such a shitty process. Sending you lots of love and strength right now 💛💛💛 xxx
thank you ❤️xx
hi Alwaysbelieving, I think from my experience the two biggest reasons am embryo doesnt implant is either lining is not good (over 7 mm ideally 9) or embryo is not healthy. I pgs tested all of mine as I was also 39 and 5 came back healthy and 4 were abnormal. Had I not tested I could have potentially but in the four in a row that were not healthy! As for lining I’ve always had a good one but still take the progesterone and cyclacur. In my personally opinion and after 7 miscarriages and a ten year journey with two babies successfully done (one natural one ivf) I believe most of it has to do with the actual embryo and sticking to lining. I send you lots of virtual hugs and love on this difficult day for you ❤️
Oh I’m so sorry you had to go through seven miscarriages and a ten year journey that’s so heartbreaking and you are incredible. Thanks for taking the time to reply and the virtual hugs 🥰 they are very much needed at the moment x
Hello! My journey is long and complex as well. I have chose to test all my embryos. Unfortunately I had two chemicals and two BFN ( transferring all euploid embryos). I did era, alice , emma which showed I need 12 hrs less prog( post receptive). I had a chemical and two BFN following that test so I dont think it helped at all. I had peripheral NK cells and all type of testing you can imagine and up till now didnt help. I took aspirin and steroids for my transfers ( adding up, the last cycle took clexane and intralipids with a BFN).I did a hysteroscopy around two weeks ago and found a septum which was excised ( was not visible on US, hycosy, MRI). I am hoping this was the reason for no/ impaired implantation. I have uterine NK cell testing pending - i do not know what it will show. This journey is so hard and I am still trying to make sense of it all.
thanks for your reply and I’m so sorry you are going through it too. It’s exhausting isn’t it and consumes every ounce of your being 😔 I hope you get some answers soon and gives some direction on what to do next. Sending love x
Struggling after failed IVF
Third fresh failed (6th embryo) 😢
3rd failed ICSI round, where to next?
Third failed cycle 😭😭
