Implantation Issues

Hi. I have been through 4 transfers with donor eggs. The first one was a miscarriage at 6 weeks. The other 3 were implantation failures. Following the 2nd and 3rd transfer, we went through KIR testing to check compatibility with donor and then had our three embryos PGTA tested. They all tested normal. I have had 4 ERA biopsies and found that my implantation window was at 7 days progesterone intake. The first transfer which resulted in my only positive result was at 5.5 days of progesterone. The ERA also showed high NK cells. I was out on hydrochloyoxine for this and given HCG injections for the 4th transfer which failed. We have now been advised to go back to 5.5 days progesterone ( this worries me as my last biopsy suggested 7 days) and to try Granocyte injections.

I’m so nervous to try again. Has anyone been through this or have any advice? Thank you 😊

[LouCollier]

firstly i'm so sorry for your loss and what you are going through.

For the high NK cells I was taking Prednisolone, just noticed it wasn't listed and might help

[Hidden in reply to LouCollier]

Thank you for this. ❤️

[Orangeflowers]

Hi, sorry this has been a hard journey for you. The decisions are also hard. If it was me I'd go with the consultants advice and try the standard progesterone timing. After all, you know you implanted with that. Have you tried 4 times in total and the 3 with 7 days didn't work but the 1 at 5.5 days did? For me the main thing would be implantation, regardless of what the era shows. Did you have attempts with your own eggs and get implementation? If so what was the progesterone timing then?

Some professionals have discredited the era and say there's no evidence for it and it could even be detrimental. There's a paper which shows that altering the timing based on the era results can lead to no implantation Vs leaving it at standard timing, especially for women in the study on donor eggs.

Each cycle is different and a unique environment which is why it is difficult to rely on the results of the era.

The era is rated red on HEFA I think. Despite its popularity it is controversial and some think that it costs a lot and is unfair to market to vulnerable women seeking answers.

Best thing to do would be to get a second opinion. Maybe try the implantation clinic at Coventry if you haven't already.

Hopefully this will just be bad luck and it will work out for you next time. Sure others will have suggestions of tweaks and things to add. Best of luck x 🤞

[Hidden in reply to Orangeflowers]

Thank you so much for this detailed response. For the 3 transfers we did all at 7 days. My egg reserve was very low which is why we went for donor. I was 45 when we started the journey. Age worries me as well!

You make a lot of sense. We are doing treatment in Spain so they recommended ERA each time as they said the window of implantation can shift after miscarriage. It really is a minefield. I’ve had the tests for NK cells and they are high. Was on medication for this but they are now suggesting Granocyte. It’s interesting to read your comments about the ERA testing. I’ve never seen this before but makes a lot of sense xx

[Boo718]

I had 2 chemicals from 5 days transfer the moved to day 6 following era and got the one that stuck not sure why you would go back to 5 xxx

[Hidden in reply to Boo718]

Congratulations! I hope our next round sticks 🤞🤞x

[Blessed5510]

I’m so sorry for your losses. Are your embryos tested? And are they checking for sperm DNA fragmentation? We are using DE as well. First transfer of tested embryo ended in miscarriage unfortunately. I wish you better luck!!

[Hidden in reply to Blessed5510]

Yes we had this round of embryos tested and they are all normal. It’s so hard going. I wish you the best of luck as well xxx

[Skittles11]

I'm so sorry, I don't have any particular advice but just wanted to say I feel for you. You have obviously tried various things to optimise your chances with the ERA, PGTA testing and KIR testing so I am sad for you that it hasn't worked yet. It is incredibly frustrating when you are doing so much to try help things along. I have a similar situation with ERA, I had a pregnancy take with standard timing however didn't have a live birth. But my ERA shows to transfer a day later. The evidence seems incredibly mixed and one consultant I spoke to said to disregard it completely whereas my current clinic said its up to me (another decision to make)... sorry, I wish it could be easier for us all xx

[Hidden in reply to Skittles11]

Thank you 😊 it’s so bloody hard and confusing. I feel that on the 5.5 days I got pregnant and then nothing after 4 ERA biopsies. Maybe we should revert back to that. All the very best to you too. Xxxx

[Batsford]

Hi 75Toria, I’d recommend considering seeing Professor Shehata at the CRP clinic in Epsom. He specialises in immune issues which can cause both implantation failure or early miscarriages. If you have high Natural Killer cells this may be the reason you are experiencing implantation failure and early miscarriages. I’m being treated by him at the moment - I had two implantation failures and 1 early miscarriage with my own eggs and 2 early miscarriages with donor eggs. Professor Shehata seems to have very good results and offers comprehensive testing. Best of luck!

[Hidden in reply to Batsford]

Thank you for the tip. I’m going to look into this. All the very best on your journey. It’s so tough!! Xx