Advice: RIF, ERA and PRP

[SushiTilly]

Hi Everyone

I've been searching for people's experience of RIF and their dilemma to use ERA tests.

I had my third failed Donor Egg cycle, two cycles with two 5AA blastocyst. In theory it should have implanted.

My husband had Karyotype and semen fragmentation test it came out fine. Young egg donor with sperm that is ok, meant we got high quality embryo.

The clinic is advising on ERA, which requires extra £1,700 plus extra travel and medicine, easy FET costs £1.6k. They mentioned PRP treatment for week leading up to FET. If I start all this now my transfer be May.

Clinic advised if didn't work then test embryo next time.

After reading HFEA, ESHRE guidelines and other IVF doctors on YouTube they advise ERA doesn't seem worth it, as research shows there is inconclusive evidence it works. Current trials where it is claiming to work are not reliable due to methods. My clinic advised ERA treatment in clinic is different to research....that raises more suspicious pov.

Has anyone had PRP? What is your experience?

I know clinics will try their best to help, add on should be low cost given they're not conclusively effective. (Imho)

I'm told about probiotics via Dr Google again IVF doctor online advised there isn't proof that probiotics works based on clinical trials in fact it reduces microbion in specific studies.

What to do is hard...any advice in these sorts of dilemma would be great. Xx

[DianeArnold Partner Nurse Fertility Network UK]

Hi. Have you had a look at the aVice about treatment add ons on the HFEA website. They have a traffic light system of advice. wwwhfea.gov.uk. Diane

[SushiTilly in reply to DianeArnold]

Yes Diane, I have been looking at HFEA it does seem red all the way. As some women are saying is it red for those experiencing RIF?

[Chel91]

I had RIF with 10 failed embryos created in my 20s. I did ERA and mine came back normal. For my successful cycle I added 12 hours of extra progesterone (just because I felt like it). My point being, it wasn't helpful for me. I did it because I was just blindly doing anything at the time, but in hindsight it doesn't seem like much evidence / doesn't even make much sense. I think likely our receptivity may alter month to month anyway, and for modified natural transfers the information wouldn't be helpful anyway. Which might be another option if your clinic offers it to you.

I almost did the uterine PRP, but I messed up my timing as my clinic is a long trip away so I didn't do it. I think PRP seems more encouraging, especially for those that might suffer with chronic endometritis it seems to make some sense, but there are hardly any studies for it. Most are for ovarian PRP or to using it to thicken lining, but I think over time it might be used more. Good luck with whatever you decide xx

[SushiTilly in reply to Chel91]

Thank you for taking the time to respond to my post. It does help to get feedback.

My clinic is now advising ERA and PRP, HFEA and Dr Tim Child on BFN podcast say it's not worth it. I don't have any known issue with endrometrium so I feel unsure how PRP would help, I don't have any autoimmune issues or bacteria infections vaginally. I know progesterone wasn't optimal last time (7.8) for day of transfer and I had not optimal progesterone first time round, never tested for it, and best protocol first time round but day three embryo.

Maybe I don't technically have RIF unless progesterone and embryo is optional. I don't know, I feel really low and exhausted.

So unsure what to do, but I'm going for second opinion with clinic for another chat.

[Chel91 in reply to SushiTilly]

I think what your gut instinct tells you / what you are comfortable with is most important. You're right if you don't feel you're at the threshold for RIF then maybe you just want to try a regular transfer again. You still have really great odds of success. It's so tough not knowing why and having to make all these decisions. I totally empathize because I've been there myself.

For me I had already done 10 embryos so I was in a really different place. Dr Tim Childs / HFEA give advice based on what is helpful for "most fertility patients", which is obviously not specifically addressing us ladies that have RIF / RPL. Some of us have unique issues that the HFEA doesn't cover whatsoever. I personally was at the point that I couldn't do more transfers or tests so I threw everything at it xx

[SushiTilly]

Hi Chel91

I was reading your story, you're a remarkable woman. Ability to keep going forward is immense.

Yes, your right, go with instincts. I don't feel up for ERA with lack of evidence. PRP is still in infancy.

I am coming to conclusions that HFEA and private clinics could do more, they could run more free trials of add on in the clinics or provide more clear data based on your group (e.g. RIF) how effective is the add on.

I did get more advice from impartial service, another follow up the clinic. In the end both parties will expect me to make the decision. I have nothing but my instincts. Hope and pray what we decide is the best.

One day there will be breakthrough on implantation, for now it does seem like numbers game.

[Chel91 in reply to SushiTilly]

Thank you hun. Sending you lots of luck! There is light at the end of the tunnel and that's the main thing xx

[SushiTilly]

Update: I received a quote for ERA and PRP, excluding meds, scans and travel it's only 2,800 Euro, with actual FET on top it's another 1,600 Euro. Mental. I really don't want to do it, lack of justification. I don't know how clinic can justify it.