Conflicting advice - tests, no test, extended HRT or not? Anyone else in the same boat with adenomyosis (double donation)?

[Dogbiscuits28]

I am about to turn 44yrs, so after three previous IVF attempts in 2023 ( with 2 x 3-day 3BC embryos that didn't stick), a huge mental breakdown and losing my job, I am trying to get my life and IVF journey back on track.

It has been hard, but I think I have wrapped my head around double donation as the most sensible way forward. I know the embryo does 75% of the work in whether pregnancy happens or not, but I would like to make sure the 25% uterus does not cause any issues.

I was diagnosed with adenomyosis in 2023 and had a fibroid removed. In March 2025 I had a hysteroscopy which showed everything looked healthy and the biopsy showed no abnormal cells.

Talking to several different clinics however they have given conflicting info, so if anyone has been through a similar experience with adenomyosis I would really appreciate thoughts.

Some say I need to be on HRT for 3 months before embryo transfer, some say just the usual amount (12 days?) to prepare the endometrium. Some are advocating for endometrial biome testing, some say the tests make no difference. Lots have said the ERA is not worth it.

Two of the doctors have said I would also not be classed as someone having implantation failure issues because the previous eggs were low quality.

Since it will be double donation and hopefully a very good quality embryo, I hope my chances of success are high. But I also don't want to waste my chance because I didn't do something I should, but I also don't want to do unnecessary testing.

Help!!!

[Tinkertinkerbell]

Hi, I don’t have experience of adenomyosis sorry. But I wanted to reply in double donor 44 year old solidarity! I had my double donor daughter 4 months ago when I was still 43. I had 4 failed transfers (2 of them DE) and my 5th worked. For me it was my timing that needed to be adjusted. I did the EMA, Alice and ERA. Good luck to you x

[Dogbiscuits28 in reply to Tinkertinkerbell]

Thank you. Feeling a little despondent today, so very much appreciate you reaching out. Did you do the EMA, Alice and ERA straight away, or once you had a couple of transfers?

[Tinkertinkerbell in reply to Dogbiscuits28]

I had 4 failed transfers - 2 my own eggs, then 2 DE. Then the EMA, Alice and ERA - adjusted timing for that and used probiotics as it also found I had no good bacteria in my lining at all. Then 5th transfer worked ☺️ x

[Dogbiscuits28 in reply to Tinkertinkerbell]

I have started using probiotics as after a lifetime of IBS and medication I am pretty sure my biome is awful! The Dr's also said since my last eggs were 3BC they wouldn't view me as having implantation issues, so I should wait to start with. Trusting them is so hard!

[Tinkertinkerbell in reply to Dogbiscuits28]

It is hard. It was assumed it was my egg quality that was the problem until I moved to donor eggs. My clinic don’t give grades like that - I was just told that the 3 DE embryos I had were ‘outstanding’. When I pushed for a grading, the consultant said two of them were 10/10 and one was 9/10. So you can imagine how excited I was! Then the first two failed so I knew there was something else going on. Then with the adjustments- probiotics and an extra 30 hours of progesterone- the last embryo and the 9/10 is the one that stuck! x

I will also say that you have to use LOADS of probiotics to build it up. First I followed the one a day instructions but had the biopsy after finishing the course and was so surprised to have 0% good bacteria! So I then bought lots of packets and used x3 a day for the 3 weeks leading up to my transfer x

[Dogbiscuits28 in reply to Tinkertinkerbell]

That is really helpful to know! I will up my dose. I also know fermented foods are meant to help a lot. It is a minefield navigating all of this!

[Tinkertinkerbell in reply to Dogbiscuits28]

It is! I never thought I would get my daughter but I did in the end ☺️ Good luck xx