Go with ERA timings or standard timings?

[Skittles11]

Hello Would welcome any thoughts.

I had an ERA done in February this year (2023) which indicated I was pre-receptive. So I needed an extra 27 hours of progesterone before my transfer.

We applied these timings in July with a PGTA tested embryo. On that cycle we also used immune medications and blood thinners after tests showed this may help. The cycle failed.

Going back to two years ago, I became pregnant through IVF using standard transfer timings (no extra progesterone) and no immune treatment. I did not carry to term due to chromosomal problems but this had nothing to do with the presence or absence of extra progesterone (ERA) or immune treatments.

I am unsure now whether to go with the ERA timings or just the standard ones.

Given the transfer using new timings failed, even with a tested embryo, I now have my doubts. Also I am unsure about immune treatments but on balance think I would continue with that.

What have others done? Would value your shared views x x

[Blueberry211]

Hi Skittles, I transferred 2 with standard timings, one chemical and the other worked- i am 38 weeks pregnant. I transferred 3 others with corrected progesterone ( following ERA)- i had two negatives and one chemical. If I have to fo for another round, I would transfer with standard timings.

[Skittles11 in reply to Blueberry211]

Thank you Blueberry. Can I ask what did your consultant make of you going to standard timings, against the result of the ERA, was it something they suggested?

[Blueberry211 in reply to Skittles11]

I changed clinic and the new consultant did not believe in ERA. He claimed the results are not as accurate as they claim to be, and I must say he was right in my case

[Doodlebug23]

My clinic aren’t keen on either so your experience does give me hope that I’m hopefully not missing something. Maybe it really is just a numbers game and a bit of pot luck? 🥺

[Meliana]

I don't believe in accuracy of ERA personally as I added extra hours of progesterone based on the ERA results for my fourth donor egg transfer and it was negative. This absolutely crushed me as it was my best embryo- a 5 day 3AA and now I only have one 6 day 3BA left. The only positive pregnancy test I had with IVF was with standard timing. As other people have commented many doctors also believe ERA is not accurate and don't use this test.

[HedgehogMad]

The ERA has recently been shown in studies to actually produce worse results than standard timings. So for that reason we never did it (although we did do lots of other tests!) Natural cycles are much less rigid and have slightly better success rates than medicated so might be worth considering if that's an option for you? I would advise ignoring ERA based on the most recent studies xxx

[Skittles11 in reply to HedgehogMad]

Hey Thanks for this. Are you able to point me in the direction of the recent studies that demonstrate this?

I don't think natural cycles are an option for me sadly, pin pointing my ovulation seems very difficult (the home tests say I haven't ovulated when scans say I have, that sort of thing). Otherwise I would have tried it. X

[HedgehogMad]

jamanetwork.com/journals/ja... (largest study to date)

remembryo.com/era-timed-eup...

The last one is a helpful summary of the evidence by an embryologist, not sure if you can see it behind the paywall but it describes the evidence very well.

Sometimes they can do a modified natural cycle where they trigger your ovulation? I've had a few of those. But it can make it more unpredictable than a medicated transfer cycle.

Wishing you all the luck for your next transfer 🙏