Hi all, hope everyone is keeping well and 2025 brings renewed hope and success for us all. I’m looking at starting a new IVF round with a new clinic soon. Exploring whether to do the EMMA / ALICE and ERA test after 4 implantation failures. Any success stories of this making the difference for others? From what I read online, it looks like depending on the results, the things that might change off the back of it, is the day the transfer takes place, additional progesterone, and probiotics (which I already take). Just trying to weigh up whether it’s worth doing (on top of PGTA which we’re exploring). I know the HFEA isn’t necessarily supportive due to there being a lack of evidence, but after 4 failed attempts, I’m open to trying what I can! Thanks in advance!
EMMA, ALICE & ERA: Hi all, hope... - Fertility Network UK
EMMA, ALICE & ERA
Hi MiniCeeCee
I haven’t done these tests myself but just wanted to check if your embryos are PGT-A tested? Aneuploidy would be other main reason why embryos fail to implant.
Wishing you all the best for your next transfer! 😊
Thanks so much for your reply ChocoMuffin I will be getting any new embryos PGTA tested, so I’m hoping that will help in a big way - just not sure whether to do the EMMA / ALICE / ERA on top of that too. Or whether to save the pennies there xx
I did these tests after 3 failed implantations, along with other tests.
They showed that my lining was receptive so didn’t need additional progesterone etc. however I did have a high count of ‘bad bacteria’ which they said definitely could impact implantation. Both myself and my husband had to go on strong antibiotics for a week + then I took probiotic orally and vaginally.
My 4th transfer has worked + I am now 5+6 weeks pregnant. Not sure if it was the antibiotics that did it, but I say it’s worth doing if you can! Good luck!
Huge congrats on your pregnancy Thierry101 that’s great to hear! Can I ask did you do PGTA testing too on your embryos?
Thank you, yes we did pgta test + this was our first transfer with a tested embryo too! X
Hi lovely,
I had these done and the ERA showed my window of implantation was out by 24 hours.
This alone wasn't enough for us to have success, but I do think with the addition of steroids it helped us get our miracle baby.
I was in the same boat and was ready to try anything xx
It’s a minefield isn’t it Millbanks I’m just not sure whether to do these tests on top of PGTA testing, or whether PGTA testing will be enough. I’ve also asked about steroids which they are willing to look at for me, which I hope could be a game changer 🤞 huge congrats on your little miracle ❤️
It's so hard to know what to do. Since I did the ERA there have been a couple of studies to say that the window of implantation is wider than previously thought - but still not 24 hours - so maybe this helped or maybe not!
I would also say that PGT-A isn't the silver bullet either - as since my massively good luck (6th transfer) we've been trying for a sibling and with the exact same protocol and PGT-A embryos, the first 2 didn't stick and the 3rd ended in MMC.
BUT - I would say that it helps to alleviate stress once you are pregnant as you are more sure that the baby will be healthy - and also, they ARE more likely to stick, just might need extra help.
I would say that the steroids were the most instrumental in getting us our baby - but that's just a gut feeling, as there's really no way of knowing xxx
That’s such helpful insight Millbanks thanks so much for sharing, it’s crazy how it can work sometimes and not others, such a rollercoaster, I really hope you get the sibling miracle you’re after and sending lots of hope and well wishes your way xx
I also had 4 failed implantations. I then did a new collection with PGTA and 4/6 embryos were normal so didn't explain why my previous embryos failed. My clinic didn't recommend Alice, Emma and Era so I did an at home test for vaginal microbiome which showed I was slightly low on good bacteria so I took probiotics just in case. My first transfer with my new batch somehow worked! don't know if it was the new batch, the PGTA testing, the probiotics or just good luck.
Thanks so much for replying Bimsie1310 I’m in two minds whether to do both PGTA and EMMa/ALICE/ERA, or just go for the PGTA. Part of my keeps thinking it must be an endometrial problem that they aren’t implanting, but then it could just be a chromosome problem. Can I ask did you take steroids with your successful transfer too? Thanks again and huge congrats on your pregnancy! ❤️
I was convinced it must be an endometrial issue. The 4 that failed weren't PGTA tested but all very high grade day 5 blastocysts. I kept pushing for additional tests or steroids/aspirin etc but just kept getting told there was no justification for the extra drugs and nothing wrong with me which was very frustrating as I was convinced there was something wrong.
I moved clinic for my new batch and the consultant there had a PhD in embryo implantation and he told me 90% of implantation is down to the embryo and if a women had 3 PGTA tested euploid embryos transferred one at a time there was a 97% chance one would stick. I was therefore convinced I must have a lot of abnormal embryos. When I did the PGTA and 60% came back as normal, I again asked why my previous 4 could have failed as it just didn't add up and he couldn't give me an explanation except that it was a different clinic and maybe the embryos weren't made as well. I again pushed for more tests and drugs and was told the same again, no need. I therefore just did a natural transfer with only progesterone and expected it to fail as it always does. Still have no idea why this one worked but so so happy it did. Only 8 weeks so far so still a long way to go but I have high hopes.
Have high hopes for you also Bimsie1310 and thanks so much for sharing your story, so helpful to hear! X
I’m in the same boat MiniCeeCee . Currently trying to decide whether to ask for further tests. I’ve made an appointment with the clinic to discuss pgta testing so will see what they say about that. My worry is that we’d have to do it on our already frozen embryos so perhaps more of a risk to defrost and refreeze. Also want to ask about the Alice Emma and era, worried they will say I don’t need it like others as there seems to be a reluctance to do anything additional.
Same Bun23 I have a nurses appointment at the new clinic I’m looking at in a couple of weeks, so will find out more then I’m sure. But for now, I’m looking at opting in for PGTA and Emma , Alice and era. Just need to work out when is the best time to do them all. You should definitely as them about the defrost and refreeze risks, as if the risk is low it could def be worth it! Wishing you the best of luck with it all and feel free to reach out direct any time if you need to vent / want to check in on navigating this difficult journey! X
I did all plus pgt-a and got pregnant immediately after 8 failed ETs. The tests showed an infection for which i got antibiotics for and then repeat biopsy that cleared it, took an extra two and a half months in total. By then the pgta were back and ready. Good luck!
That’s great to hear and so happy you got success! I think I might opt for both PGTA and the Emma / Alice / era tests, just to have as much covered as I can 🤞🤞 x
Hi, I’m an advocate for the EMA, Alice and ERA - it’s what worked for me. I had 4 failed transfers then did the EMA, Alice and ERA. The results said I had no good bacteria at all and needed an extra 30 hours of progesterone before transfer - all my other transfers had been too early. So I used LOADS of probiotics x3 a day canesflor and had the later transfer. That transfer worked and she is currently 4 weeks old and nursing happily as I type this.
The doctor who did my transfer said she knew that one was going to work as they’d had lots of success with the EMA, Alice and ERA. They just can’t recommend it I don’t think - because there is not the evidence. I had to ask for it as I was confused why I had repeated failures despite everything always looking good. I’m sure others will have experienced it not working but it worked for me x
That’s really great to hear Tinkertinkerbell thanks so much for sharing your story! And huge congrats. I’m def leaning more towards having the test I think after hearing some of these stories x
My clinic has said they no longer find these tests reliable. However, I have heard stories of women who found the test useful too.
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EMMA and ALICE
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EMMA and ALICE
