EMMA and ALICE

[Cahoots]

Hello

After 3 miscarriages and 1 failed transfer, I have one last embryo left.

In order to give it the best chance I can, the consultant has recommended having EMMA and ALICE tests and a Hysteroscopy to check whether there's anything causing the miscarriages. There's clearly no problem with implantation as I saw the pregnancy on a scan the first 3 times. There was just no heart beat.

Has anyone else had these tests done for recurrent miscarriages? Did they find anything? Were you able to do something to fix whatever they found? I'm just a bit concerned it might be a waste of £800

[Nenad]

hi there, really sorry to hear this. Have you done a thrombophilia screen to check for blood clotting disorders? I had miscarriages and after these blood tests I was diagnosed with APS, which is a leading cause of miscarriage.

I haven’t had a live birth since but at least I know I’m taking the right medication for it (aspirin + Clexane). Xx

[Cahoots in reply to Nenad]

Hey, thanks for your reply.

I had coagulant screening and Lupus anticoagulant screening done on the NHS and they were in normal range. Not sure if the results were passed on to the IVF clinic because I'm private. My consultant said she would consider giving me asprin anyway, and possibly steroids. Not really sure why. I guess if there's no harm in doing so then it just covers that off if there is anything abnormal.

I have a referral to a miscarriage clinic but it's not until July. In the meantime I'm just thinking about having the womb lining checked. Kind of just hoping they find something that's easily remedied so we can just go ahead with the final embryo transfer. I'm 41 this year and just feel like I'm running out of time!

[Nenad in reply to Cahoots]

Best of luck to you, I haven’t tried EMMA/ALICE so can’t comment on those. Has anyone suggested immune tests? Steroids are usually prescribed if you have high natural killer cells. A hysteroscopy would be a good idea too if you haven’t done this already, especially since you miscarried 3 times, there may be scar tissue etc xx

[leo1980]

hello. I had both the Emma and Alice test. - it was a treatment of antibiotics and probiotics I think. - did it about 4 years ago. I also due to age (41 then) had our embryos pgt screened.

Am on the steroids, clexane and aspirin too.

If it’s the last embryo, probably worth throwing the kitchen sink at it. You can still use the findings from Emma/alice for future successful cycles.

Hope that helps.

[Sansan87]

hi Cahoots

I had these tests and really recommend them. Mine back with chronic inflammation which was treated with antibiotics and a lot of the bad type of bacteria so I started prebiotics. My transfer after this worked. Wishing you all the best

[Greyeverything]

I know it’s a lot of money but if it’s the last embryo I’d be inclined to do everything on offer. If it doesn’t work you may end up wondering if you had just done those tests would the outcome have been different, where as if you do it you know that you did everything you could. I’d say do the aspirin as well, we did a ‘throw everything at it’ round and they put me on blood thinners, no indication I had any issues but why not and that was my successful round. No idea if that’s why but it certainly did no harm!

[Tinkertinkerbell]

I had a miscarriage and 4 failed transfers. I was convinced that I had some kind of infection in there that they hadn’t found. I had the EMA, Alice and ERA and they found that I didn’t - which at least gave me peace of mind as I was obsessively thinking there was something there. They also found that I had no good bacteria. So I did Loads of canesflor (about 6 courses x3 a day) to get my good bacteria up. Plus I took oral probiotics x2 daily just in case. They also adjusted for the ERA and my next transfer worked. Good luck to you x

[Cma83]

I agree with the comments above and would encourage you to go ahead with the tests and ask them to add in the Thrombophilia screen (which I did not know about at the time).

I'm glad I had the 'kitchen sink treatment' which was the ERA, EMMA, ALICE and NKCT after my 2nd miscarriage and 4 failed transfers. Through the ERA they found out the optimal time needed for an embryo transfer which turned out to be an extra day on Progesterone. The NKCT identified a high number of white blood cells which meant they put me on Intralipid infusions (according to research, there's no guarantee this works). I was also put on steroids (Prednisone), Aspirin and Inhixa during my last round. Prior to transfer we went through PGT-A testing. All of which worked, but resulted in a miscarriage at 6 weeks. Thereafter my GP referred me to St Mary's Hospital Recurring Miscarriage unit in which they conducted the Thrombophilia screen and identified I suffer from blood clots and require a higher dose of Aspirin.

In conclusion, I know it's not my embryo's, I need to improve my lining and have a higher dose of Aspirin. Just had a Hysteroscopy done last Friday and all looks fine apart from having a deeply retroverted uterus. I'm about to embark on my 8th round so fingers crossed (I started at age 37 and I'm now 40 and I wish I had done all these tests earlier).

Wishing you all the best on your journey x

[Cahoots in reply to Cma83]

Thank you. I have had some blood clotting tests done and all came back normal. I didn't get my embryos tested - they didn't actually offer this at the time, but if this last one doesn't work out and I need to do another egg collection we will definitely get those ones tested. They said its not worth testing this one as it's frozen and could do more harm than good.

I just want to make sure we've done all we can to give this last one a good chance. I don't know if I can cope with another miscarriage 😪

I'm sorry you lost your last pregnancy, despite all the extra tests/meds, that must have been hard!

Good luck with your next round. You're so brave to keep trying so many times xx🤞🍀

[Cma83]

Thank you and I really hope all goes well for you 🤞xx

(What keeps me going is the fact my sister had her little boy at 40 years old after 7 rounds of IVF, he's now 2 years old and brings so much joy to the family)

[Laurapax]

hi Cahoots im really sorry to hear about your miscarriages and failed transfer. I’m in a really similar position, 3 miscarriages (from natural conception over the last 2 years) and a failed ivf transfer with a PGTA Tested embryo. I’ve had EMMA ALICE NK Cells and a hysoscopy. I’m now late 30s and don’t really know what to do next. I’ve not had a live birth so no idea if it’s ever going to happen for me. I hope you are doing ok xx

[Cahoots in reply to Laurapax]

Hey, I'm sorry you're in the same position as me (although I am almost 41 now). I don't have any advice I'm afraid as I still don't have any answers myself, and haven’t had a live birth either 😒 It's so frustrating and upsetting. Especially as my infertility is unexplained!

I'm going for another egg collection next month and plan to get any embryos PGTA tested, but clearly even that doesn't guarantee it will work. I'm also starting to think it's not going to happen for me, so I've just started looking in to adoption as a back-up plan xx

[Laurapax]

I’m sorry it is literally torture and for it to keep happening again and again with no clear reason is just so shit. Have you been to see a recurrent miscarriage specialist? I understand that after three we are entitled to see one through the NHS but I’m pretty confident I’ve had all the tests done as part of me going private for ivf. Have your pregnancies been from natural or ivf conception? Although this pregnancy was natural my clinic put me straight on progesterone and I’ve been having my betas watching them be to low. Agony. My progesterone levels are fine so it’s not that. I honestly just don’t know what to do next. I think I’ll reach out to a miscarriage specialist alongside my ivf clinic - a few names keep popping up.

Wishing you all the luck for your upcoming cycle - I also did PGTA and I am glad I have as at least I know and it might be able to help identify what’s going on, whether it’s an embryo or environment issue. Good for you for exploring other avenues too. It is something I am going to need to consider the longer we are in this position. I just wish it would be our turn like it seems to be so easy for others. Xxx