Microbiome, ERA/EMMA/ALICE- Are they REALLY worth it? How accurate are they?

[Katiluna]

After the recent failed fresh transfer with donor eggs, I'm now thinking of exploring the vaginal microbiome and some other issues. I have never had the microbime looked into and have never taken vaginal probiotics before.

I had a GBS infection detected during a routine antenatal check just before my 2nd miscarriage, but I took some antibiotics to get rid of it. Based on some medical studies published online that I've recently come across, miscarriages, and some procedures such as a hysteroscopy and D&C may disrupt the vaginal microbiome. I had three miscarriages, a hysterscopy and two D&Cs. Now I think it's time for me to look into this.

As we all know, the ERA/EMMA/ALICE tests require an endometrial biopsy (which must be painful) and the tests are very expensive. But what's really holding me back is the lack of evidence on the effectiveness of these tests. The use of these tests is rated red by HFEA. According to them, there is no evidence from randomised controlled trials (RCTs) to show that they are effective at improving the chances of having a baby for most fertility patients.

Some studies published online state that the implantation window may change and may not be the same in every cycle.

-Did you find the ERA test accurate and helpful in terms of how much progesterone you actually needed before your embryo transfer? Did it help you to have a successful pregnancy?

- What was your experience with the EMMA/ALICE tests and how did you find them in terms of accuracy?

-Did you manage to optimise/restore your microbiome with just taking probiotics and without actually having to do the EMMA/ALICE tests?

-What probiotics did you take?

Any input would be much appreciated.

Many thanks