Emma Alice opinions

[Aftertherain1]

Hello fellow IVF warriors.

Apologies, I know Emma / Alice testing gets posted a lot but I would value any similar experiences.

Quick back story - Miscarriage December 2022 (untested embryo, age 41) and 2 egg collections and 2 FET since both with euploid embryos. Didn’t even make it to OTD (upped progesterone on second FET too) and bled 5dp5dt both times. I have a niche from previous c section which produces fluid hence why all transfers were FET (fluid dries after taking progesterone) as oestrogen medication likely makes it worse. Anyway, had laparoscopic surgery in October to repair the niche. Fast forward to now and the niche is now very small but still producing a bit of fluid and our medicated EndomeTrio has just been cancelled and our clinic want to try natural cycle as they think the Progynova creates more fluid but they said that if the fluid is gone then they would do a transfer and would not recommend the Emma / Alice in this case. I’m so confused as surely if I have an infection / low good bacteria it would be the same whether it’s a medicated cycle or natural? I just don’t know what to do - try a transfer (if fluid is gone) without testing or push for Emma / Alice. I know ERA isn’t as relevant in natural cycle (& I’ve had 2 pregnancies - 1 living child on standard 5 day progesterone) I also know these tests are red on HFEA website.

We have two PGTA embryos left then that’s it sadly so I’m scared they’ll just fail again so want to do a natural cycle as never done one before but I just don’t know whether to do Emma / Alice (necessary/ waste of money)

Also to add to the total mess of my IVF journey, after my laparoscopy in October I was prescribed antibiotics and then the canesflor vaginal probiotics as there was ‘cultures’ in my urine (no UTI and they think just sample contamination) but I took them anyway and I’m led to believe that the medication for whatever they find in Emma / Alice is just that. Arghhhhhhhhhh.

Any thoughts at all? Anyone been in a similar situation? Sorry for the long post and thank you if you’ve read this far.

Wishing everyone all the luck for the year ahead xxx

[paintthesky]

My journey wasn’t the same but I did have an Emma/Alice test… & after £1k tests, was prescribed £15 Canesflor off-the-shelf from Boots. However, it did lead to a successful pregnancy. I’m not sure if it’s a coincidence tbh.

Good luck x

[RACMumm]

I returned to ivf after having my boys in 2010/2012. They were fresh transfers and never an issue. Fast forward and I decided to try and last time. I had 1 fresh transfer & 4 frozen transfers. The 4th was successful & baby arrived in December. The first two fet's were medicated. I, too, had previous c-sections but only normal levels of fluid were found. Ifelt timing was off in the frozen cycle so I requested a natural / modified natural transfer for my 3rd & 4th transfers. The 3rd ended in am early loss at 6 weeks. My initial suggested I check for endometrial NK cells & also for endometritis. I went to Germany to have these tests done as they cost less than half what it costs in Ireland. They found elevated NK cells but no endometritis.

Fir my 4th transfer I again did a modified natural but the clinic added in low levels of gonal f on days 3, 5, 7 & 9. I also took canesflor for 7 days once my period had stopped in my transfer cycle. I had immunoglobulin infusions (a week before transfer, when I got my positive & 4 weeks later). I also took steroids to deal with rhe high NK cells. I can check back over my protocol to see if there was anything else. This cycle turned out to be the charm! I can never remember which test is which h but the endometritis & NK cells I feel are the most important rather than ERA to check timing if you plan to do a natural cycle. Best of luck & don't give up. I'm proof it can happen & I was older too.

[MontsJ in reply to RACMumm]

Thank you for sharing your story, persistence paid off! Would you be happy to send me some details of the testing you had done in Germany as I’m exploring this. Many thanks 😊

[RACMumm in reply to MontsJ]

Of course, I'll DM you details 😊

[Aftertherain1 in reply to RACMumm]

Thank you so much for replying. I always thought my NK cells were ok as I had my son 3 years ago (first pregnancy) but interesting that yours were elevated despite two previous pregnancies. Would you be able to DM me the clinic in Germany? What does the Gonal F do?

I’ll opt for a natural modified FET as I’m really hoping the fluid won’t be there (I’ve only ever done medicated) What does an endometrial biopsy look for instead of Emma/Alice? I’ll ask my clinic about that on my next appointment. Congratulations on your latest arrival xxx

[Doodlebug23]

My clinic don’t recommend EMMA/ALICE and say that they aren’t proven enough. For my next cycle they have prescribed steroids, and I plan to get the vaginal probiotics from Boots x

[Twiglet2]

there is nowhere near me does the tests so after lots of research into travel to get them etc I decided I didn’t have the ££ or the time so just took the canesflor anyways as I had at least 6 weeks before transfer as at very least I shouldn’t get thrush 😆 🤷🏻‍♀️ that transfer did implant but I had a misscariage at 9 weeks (looks like embryo issue as it was measuring behind, it was untested) so not sure if it helped or not but I don’t think it hindered and it’s the furthest we’ve been in along while so that might be worth a go to do the canesflor again if you aren’t having the tests and can go ahead if the fluid is gone? Or if it’s been really recently you e maybe already done the treatment needed! Xx

[Aftertherain1 in reply to Twiglet2]

Thanks Twiglet, I took the antibiotics late October then the Canesflor for a week afterwards then one a week for the next 3 weeks. I’m taking oral probiotics at the moment. I wonder how long the Canesflor last so to speak?

[Yellowlove]

My clinic don’t recommend Emma Alice but instead suggested an endometrial biopsy after failed transfers and testing for NK cells xx

[Aftertherain1 in reply to Yellowlove]

Thanks for replying. What do they test in the endometrial biopsy?

[Yellowlove]

They take a small chunk of the uterus to look for infections, bacterias, endometriosis, abnormalities and problems in the uterus basically. If they’d have found something I think I would have gone onto medications before the next transfer. They didn’t find anything, but they said apparently in most cases they do, so it can help to provide answers x

[Aftertherain1 in reply to Yellowlove]

Thank you so much. I’ll ask about this at my next appointment x