I have 2 frozen embryos to transfer, which are my last and so precious. Prior to transfer I am having the dEFT at Coventry, which will tell me if my cell populations are receptive or not. The Dr there indicated that EMMA and ALICE are more wellness tests for the worried and even if they indicate a issue it might not be the reason preventing pregnancy anyway. It's been indicated that if the dEFT indicates I'm receptive that's the main thing, and it would be highly unlikely that I have a problem with my bacteria etc that's making me not receptive.
Has anyone had dEFT and EMMA/ ALICE?
I'm not planning to have ERA as it's indicated that changing the implantation window from standard can worsen outcomes for some women in the latest meta-analysis.
Has anyone had EMMA/ Alice and feels it made a difference to outcomes?
If you have EMMA do you need Alice too? The CARE website indicates perhaps not.
Any experiences appreciated.
Good luck or happy onward journeys to all 🤞 😊
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Hey, I don't have an answer to your question but thought i'd comment so I get notifications if anyone else comes back on it as i'm in a similar situ. Am also getting the deft test done in a couple of weeks and Emma/Alice (and ERA actually) were on my list of things to get next if the results from that came back normal (even though Brosen said ERA was a load of crap hahah). Am also doing extra thyroid bloods done this week, though that is more intrigue for overall health as well as another quest for my recurrent miscarriages.
When are you having your deft test done? What is your history if you don't mind me asking? x
Thanks. It's difficult to decide what to do isn't it!? From what I gather the dEFT sounds similar to the era in some respects anyway - ie looking at gene expression in cell populations. It just doesn't look at timing of transfer and looks at NK cells in addition. I wonder if it's a bit of an effort to disassociate from the era.
I'm having a medicated mock cycle with the dEFT on Fri 18 aug. When's yours?
I have had 6 failed double transfers (all but one) over the last year. I think the most likely reason could be age and egg quality though for me. I've only ever had one positive pregnancy test, for my daughter and I'm super lucky and fortunate for that.
See I thought that before my appointment with Dr Brosen! I couldn’t understand the differences. When I asked him if they were the same he said no not at all, then went on to explain how the ERA was tested on mice which obviously is very different to human bodies. I’m going to see what my results come back as but if there’s something else I can determine from the ERA then I’ll do it as I just want to find answers!
Oh nice, that sounds good. Not sure when mine will be exactly but I think perhaps the week before you. I do natural cycles with IVF so just waiting for ovulation.
I’m sorry you’ve had so many failed transfers. That really sucks. Obviously great you have your daughter but it still doesn’t make the negatives any easier I can imagine. Let’s hope we both get answers with this deft test ey!!
Thanks! He said the mice thing to me too. The era might have been developed from a mouse model but there's loads of women it's tested on now. My main concern is that the research shows that if you use the results to adjust the transfer time it can do more harm than good.
The problem is, as the dEFT is still research based, it won't necessarily provide an answer.
Let's hope it does some good for both of us though! Do you know when you'll have another IVF round/ transfer after this? I think results take 5-6 weeks?
Yeah I know it's red on the HFEA, though so many women have had success from getting answers from the ERA though and that's very hard to ignore. Perhaps it was just coincidence, I don't know but I think if we have the money in a few months it might be worth trying. What is the new research about it being more harm than good? I'd be interested in reading that.
Very true, I followed a women's story on TikTok who had multiple early losses like me who saw Brosen and the team, discovered her lining starts to break down (i.e was low) so not supporting pregnancy and she had low NK cells, she started sitagliptin and got pregnant naturally and kept the pregnancy. So that is staying in my mind re: the deft test! This was a few months ago so not sure if Brosen still prescribes that but it has given me hope!
He told me 3-4 weeks for the results though i'm keeping 5-6 in my mind so I'm not disappointed in case it does take longer! I'm actually doing another egg retrieval (final one using my NHS funding) to try to replace the 2 embryos I lost recently. FETs are a lot cheaper than egg retrievals so figured that would be better seeing as we're getting private tests done. Are you doing a FET straight after your mock cycle/deft results?
Sorry I missed this. There are a few recent systematic reviews and meta-analysis. For example "conventional and modern markers of endometrial receptivity" published by Craciunes, Quenby and Bronsens. That showed that standard embryo transfer had a higher implantation rate than personalised embryo transfer, at least in subgroup analysis for donor cycles.
Huy, Thuy et al July 2022 also showed ERA did not improve outcomes.
I'm looking at getting my results back in September now (got my dEFT next Friday). I don't think results will be in time for my September cycle so I'm planning on a holiday and FET in October. Hoping there might still be a benefit of the biopsy cut by then but may be too late, so may consider a scratch not sure..
Did you have your dEFT yet and have you firmed up your plan? Wishing you luck 🤞 x
Oh that's interesting! Thanks for sending. Something to think about anyways!
Ah that's fair, a holiday sounds great though, it's so important to have some fun during these stressful times! I also assumed the biopsy was like a scratch so you should benefit from it for 2-3months post so I reckon you'll be fine.
I ended up having my dEFT last weds, as I ovulated earlier than usual. I'm not going to lie it bloody hurt like hell but was over in 10 seconds (the worst bit anyways). When they offer you gas and air, TAKE IT. Even if you are one of the lucky ones that don't think it's that bad (I guess everyone is different, I think I'm quite extra sensitive 'down there'). I didn't end up meeting Brosen, smiled at him briefly in the corridor but he was busy, a really lovely doctor did mine, he was so kind. They said it should take about 3-4 weeks for results so should be in time before my next cycle but I'm holding off anyways as I have a holiday/friends wedding (which is all inclusive) mid November and I really don't want to be early pregnant or miscarry on holiday so waiting will be hard!! So unlikely not going to try naturally or do any IVF transfers until Dec/Jan depending on timings. I might look into any other tests whilst I wait but that also depends on money...
I did the dEFT test on day 20 of my cycle and my period has arrived today so 5 days later, bit earlier that usual for me but as I ovulated earlier it makes sense. Plus they said it could be lighter/heavier/earlier/later due to the biopsy.
If you have any questions about the dEFT process do let me know x
I've had the dEFT test (and NK cells) through Prof Brosens and I was not receptive so I took steroids on my last transfer which still didn't work, but he is amazing though - so you're in good hands for that test.
No I didn't re-test as the steroids were just for the transfer and TWW, and I opted to do my FET instead. I did find it painful but I had to have my cervix clipped open for it - took gas and air and Prof Brosen's is very kind and caring, it doesn't last long, a few minutes at most. My transfers are done under sedation due to pain as I'm a complicated case so I suspect that didn't help.
Hello I just wanted to message on here as I’m also thinking about doing the dEFT in the next few weeks and your message has come at a valuable time while I have been wondering whether to go ahead or not! I hope yours goes well and this thread has confirmed for me I’d like to go ahead. Have had 5 chemicals pregnancies and convinced myself it’s something to do with my lining.
However I had eye surgery recently and worried all the general anaesthetic I had and my steroid eye drops might affect results (prob silly). Prof Brosens said it shouldn’t affect it and as long as recovered can proceed. So hopefully I’m doing the right thing. I have no idea any more at this point!
On your question about EMMA/ALICE, another consultant I spoke to has dismissed it when I asked. But then again I’ve read about women finding infections and then becoming pregnant after their antibiotics (coincidence or not, unknown). It is so hard to know what value you can get from these add-ons and who and what to believe. However both this consultant and Prof Brosens advised against the ERA.
Thank you so much for sharing your experiences and thoughts. Let us know how you get on with the dEFT if you do it. Mine's on Friday. Wishing you luck x 🤞
hi, I’ve just come across your post and I’m in a similar situation to you. I have a daughter who is 3 in October from a double transfer and have since had 3 failed ( 2 x single and 1 double).
Like you I have 2 embryos left. I don’t understand why they have all failed tbh as they have all been top graded embryos. What is the deft test? The last two will be my final attempt to give my daughter a sibling 😕
Hello, nice to here from someone in a similar situation
I think the main reason my embryos probably failed is my age, their stage of development and likelihood of being genetically abnormal.
How old are you? If you're getting top quality embryos then it could just be a case of needing more tries and having bad luck. How many embryos do you get by day 5 per collection? Although they are top quality morphologically they might have genetic abnormalities. Did you consider PGTA testing?
dEFT testing is basically looking at if your endometrium is receptive or not at the time when you would theoretically transfer. It looks at different cell populations which either support or impede implementation and NK cells are assessed. There's 3 things looked at in the same biopsy which is taken.
Have you considered any other tests prior to transfer? I'm just doing basic bloods and csnesflor probiotics alongside the dEFT if nothing else is indicated.
Thank you! I am 35, however I had a fresh cycle at 31 and had 8 (5 day blastocysts) they were all 5AA /BA and I think the last two I’ve got left are 4BB and 5BA.
I think maybe it’s just down to the embryological issues or bad luck 🤷🏻♀️the clinic said I could do an endometrial test however they didn’t see an issue since I have fallen pregnant on my first cycle and my lining has always been a good thickness. I have thought about pgta but we’re worried about the thawing refreezing process being our last two.
How many cycles have you had? I won’t do a fresh one again after this x
It sounds like maybe you've just had bad luck. I'm thinking given your age at collection and grade your next ones will take. Maybe have the dEFT to rule anything out. I've had too many failed fresh cycles - 6 following my first success x
Hey, after a follow up doctors appointment following my recent double failed my doctor recommended the ERA test. She said they could be doing the transfer in the wrong ‘window’ although why its taken 3 failed cycles and 4 embryos later to say this 🤷🏻♀️she also mentioned a hysteriscopy? Have you had this at all? We wanted to get started asap with the next round but obv will have to do a mock cycle now with this testing and see what the results bring. Hope your test goes well x
Hey so personally I wouldn't recommend the ERA, HEFA flags it red and recent meta-analysis have shown it can do more harm then good. I think the dEFT in Coventry might be a better bet.
I had a hysteroscopy after a tiny polyp was detected on a routine scan. It was removed during the hysteroscopy. I've been advised it's not worth having another one as anything significant would show up on a scan.
I would have thought PGTA genetic testing would be useful for you to see if the embryos are normal and any abnormal ones don't have much chance. Good luck 🤞
If it was me I wouldn't test any embryos already frozen as the extra freeze thaw is extra stress for the embryo. I'd consider testing new embryos though x
Hello, yes you can self refer, just call the number on the Coventry Implantation clinic website (prof Brosens). It's £160 for a 30 min online consultation, then £700 for the dEFT. Good luck🤞
and do you do a mock cycle like a frozen transfer? Will your clinic do this for you?
I have my consult on 8th sept with prof brosens and then hopefully can do a mock cycle. My clinic havent really agreed yet but surely it wont be a problem if i pay for the meds? Normally at day 8 after 8 days of estorgen i would have a scan to check lining and if all ok start progesteron? Is that when u let implantation clinic know from that date? What happens if lining isnt adequate in a mock cycle and u need more time on estrogen? How does that work with prof brosens?
There is a option to do the dEFT in a non medicated cycle, which I think is most common. It's more relevant if you are planning natural pregnancy or fresh cycles. You just monitor ovulation then book in for the dEFT something like 5-10 days after ovulating.
If you do the medicated mock cycle, you book in the dEFT about 5-10 days after starting progesterone.
Coventry don't arrange the mock medicated cycle or when to start progesterone, they just take progesterone bloods on the day.
The mock medicated cycle is a more expensive way so I wouldn't necessarily recommend unless you find your ovulation difficult to pin point.
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