Recurrent implantation failure next steps. ERA + Emma & Alice / PGT / Do nothing and hope for the best.

[Sunshine92]

I was fortunate enough to yield 6 too grade embryos at the age of 27, one of which resulted in my little boy who is now 3.5years (fresh transfer).

This year i have had x2 frozen transfers, perfect lining, perfect progesterone levels and perfect embryos but BFN.

Consultant very disappointed and baffled by my BFNs. Discussed 4 options:

1. Do same again and hope for the best

2. Try a natural cycle but i have PCO (not PCOS as no other symptoms other than polycystic ovaries) my bmi is low, skin is normal and have regular cycles. She did not feel this would be suitable as i struggle to get LH peak on ovulation test.

3. PGT testing embryos (£4,000 - yikes!)

4. ERA + Emma & Alice.

She was very convincing and agreed for option 4, but since the appt i have done lots of research and its less than positive about ERA testing. Ive booked another consultation to discuss as non of this was brought up during my follow up.

Other than my PCO no other issue has been found. I’m 32. Is there no other way of tracking for LH peak for a natural cycle other than ovulation sticks? I do sometimes wish the consultants wouldnt over medicalise things and really take things back to basics.

Doe anyone have any advice or experience to share on any of the above?

[JA-fnuk Partner Nurse Fertility Network UK]

Hope you get some replies to your post This Forum is an excellent source of information & support These test are carried out regularly and I hope you get some feed-back that helps you decide the best way forward for yourself

Take care

Janet-Partner

[WillowPark]

Hi Sunshine92, my last cycle was a natural cycle but they monitored my follicle growth and triggered ovulation as I couldn't find my LH surge. I don't have PCO or PCOS though. Might be worth discussing x

[Hidden]

old school but consider a scratch test? You got preg after egg collection so I wonder if the needle doing egg collection has same affect as scratch? That’s where we’re at- had x3 FET BFN, then Emma/Alice/era (normal) then got preg next FET! Since then x4 FET BFN. Trying scratch test again xx

[Rjfguitfg]

I have pcos and my first two fully medicated transfers failed. For the third, my RE suggested a modified natural - letrozole for cd3-7 and light stim meds for cd8-13 with a trigger shot to ovulate since I don’t on my own. I did have to go in every couple of days to be monitored and make sure I didn’t ovulate early. Modified natural cycles are a little easier to monitor than completely natural since you don’t have to rely on lh strips and can time ovulation with trigger. I had my transfer 6 days after taking the trigger shot and so far it’s stuck (5 weeks today with my first ultrasound next Tuesday). I much much much preferred the modified natural. I felt so much better not being on all the meds. My re said some women might need the extra things ovulation can provide. If this transfer had failed, we would have done the Emma/era/Alice. Good luck to you! Wishing you all the best!

[Sunshine92 in reply to Rjfguitfg]

This is exactly the kind of thing i was hoping for, but not even mentioned to me as an option. Was just kind of like ‘if you’re never getting an LH peak then this option’s out of the question’ - thank you so much! Keeping everything crossed for you xx

[Rjfguitfg in reply to Sunshine92]

I’ve heard that some clinics are like this since with modified naturals you have a higher chance of it being canceled due to them not being able to predict and schedule a transfer the way they can with medicated. Therefore, it’s not even mentioned as an option. Hoping it works out!

[Doodlebug23]

I had top grade embryos and perfect lining and had 6 BFN. My 7th which was successful was modified natural. Like rjf said, I think there’s something in the fact that your body is doing what it works naturally do, you’re just adding fine extra support and replacing the ovulated egg will a fertilized one!

Previously I had tried 1 modified natural but was monitored with scans not ovulation tests - which put me off as my clinic is in Spain so the cost of all the extra scans soon added up. So maybe that's an option for you.

My clinic didn’t advocate the ERA/EMMA/ALICE tests and their reasons made sense to me and I went duty their advice.