Endometrial Receptivity Array (ERA)?

omarismyhomeboy

Does anyone have experience with an ERA test? After my last failed PGS transfer, my doctor said we could either try 1 more time or skip to this biopsy called ERA (determines your 'correct day' of endometrial receptivity, which may not be on ay 5). Apparently some 25% of women who have implantation failure are transferring on the wrong day. 

My question is..what is the process like? How many cycles did it take you? Are you glad you did it? Or, are you embarking on one now?

I am leaning towards doing the test so we don't lose another embryo but wanting opinions. 

oxinfree

I'd like to follow this. We were wanting to do an ERA but for some stupid reason there was an issue with my clinic doing it in NY at the time. We ended up doing a regular biopsy instead. I'm really curious on it's efficacy in fixing Repeated Implantation Failure...

APM_SLP

So you probably already heard enough from me on this topic lol but I might have new information for you!

i have my biopsy this Thursday.  I'm taking all my meds as I normally would for an FET.  Instead of the actual transfer on transfer day we will do the the biopsy.  The results will show if my lining is optimum, pre-optimim or post-optimum.  If it's optimum then we know we've been doing the transfer at the right time, with 5 nights of progesterone.  If it shows I'm post optimum then next month we will do the same meds meds but with only 4 nights of progesterone and re do the biopsy.  At that point we would assume that test would show optimum.  If my first test shows pre optimum we would do the biopsy the following month with everything the same except 6 night of progesterone, in hopes that that test would show optimum.  Then, the following month we would do however many days of progesterone make me optimum- and do an actual transfer.  

Basically, the process is exactly the same as that of an FET.  I hear the biopsy is an extremely painful 1 minute, but then you are fine afterwards.  Maybe mild cramping.  They told me to take 600 mg of ibuprofen prior to the biopsy.  I'll let you know how awful it is! I've been told results take 2-3 weeks.  Dr said I will stop meds right after the biopsy and then can start my estradiol again when I start my period, preparing for whatever will be next- either another ERA or an actual FET if the results are optimum. 

omarismyhomeboy

Thank you @APM_SLP I'm not tired of hearing from you  Please let me know how the biopsy goes! Looks like I will be doing the same in about a month from now. 

APM_SLP

And they just called and changed my biopsy to Friday.  Always hurry up and wait!

Vic311

Yes, please keep us updated @APM_SLP. I am going in for my baseline ultrasound tomorrow. If all looks quiet, I will begin my cycle for the ERA. I am heading to Hawaii right in the middle of the medications, so I will be on the Lestrogen for an additional week to stall things until I get back home. I will likely have my biopsy on 11/11. I'm praying that this gives us some useful info!

taradise99

Hi, I had this test done as well as the e-tegrity biopsy. I'm on my 4th round of IVF so I figured it couldn't hurt. It wasn't covered by insurance, and I think it was like $600, so it wasn't too bad.

You take PIO as you would for a transfer and the biopsy will tell you if the timing of the progesterone is right. For mine they found that I should have the PIO shot earlier. However, this is only useful for a FET. I found this out as I was preparing for this fresh cycle that the info is not very helpful for a fresh transfer. However, it was worth it for me as during the biopsy they found polyps in my uterus. I had a hysteroscopy to remove the polyps so I hope that that helped in the long run. 

APM_SLP

@taradise99 do you mean they found that you need more than 5 nights of PIO?

taradise99

@APM_SLP, no they said that they found they would need me to take the PIO at an earlier time the night before the transfer...

APM_SLP

@taradise99 wow that's interesting!

Vic311

@APM_SLP so curious to hear what your biopsy says. Evidently it's a couple of weeks before we get results, right? I just did my first Delestrogen injection tonight. Not too bad

omarismyhomeboy

Thanks so much everyone. We have decided to go with ERA this cycle! We have biopsy tentatively scheduled for Nov 7th. Good luck to everyone

APM_SLP

@vic311 I've never heard of delestrogen? My biopsy is at 1:30pm PST tmrw n I'll report back! 

omarismyhomeboy

@APM_SLP good luck!!! I am looking forward to hearing.

Vic311

@APM_SLP My doctor uses a compounding pharmacy so I think it's just a form of estrogen. Good luck tomorrow--I'll be thinking of you! Let us know how it goes 

APM_SLP

Just finished up.  Not going to lie- that sh*t hurt.  Severe cramping/pinching feeling.  He said mine was a little more painful then normal because he had to use some extra tool because my cervix was curving (or something like that lol). The positive thing is that it was over fairly quickly.  Still cramping now but it's tolerable. 

He actually is sending off 2 biopsies. One to the ERA lab and one to pathology. He said he just came from a conference where he Learned about how some sort of endometrial infection (or inflammation?) can often cause lack of implantation or chemical pregnancies. So, he wanted a full pathology report as well.  Glad he got it over in one swoop! A week for pathology results and 2-4 weeks for ERA results.  In the meantime- getting off my meds and enjoying my wine!

omarismyhomeboy

@APM_SLP drink up, girl! You deserve it. I am so curious about this inflammation thing! Can you send any info on it?

APM_SLP

@omarismyhomeboy when he calls with my pathology results I will ask him specifics! Cheers!

Vic311

@APM_SLP Yes, enjoy that wine tonight. I am glad you have the biopsy behind you. @omarismyhomeboy, you're up next! 

My RE did say at my visit this week that they will also be sending a second sample for pathology. I have an appt with him next week for my lining check so I will ask him exactly what they will be testing for. 

Have a great weekend, ladies!

APM_SLP

Pathology biopsy is back and results are normal.  They were looking for endometritis (NOT endometriosis), which is an inflammation/infection. 

They said 1 1/2 to 2 more weeks for ERA results.  I'm praying those don't come back optimal! I want a reason for these failures.  

Vic311

Amen, sister. I hope you get some useful info from this test. And yay, no endometritis! Today I had my last lining check before going on vacation. And a little gold star for me--I had the thickest lining ever since starting my IF treatments over a year ago (8.1 mm!) I'll have my biopsy when I get back on the 11th. 

omarismyhomeboy

@APM_SLP I hear you! Keep us posted about ERA results. Looks like my biopsy will be next Thursday, Nov 3. 

APM_SLP

Good luck tomorrow @omarismyhomeboy!!

Vic311

Yes, good luck today @omarismyhomeboy!

omarismyhomeboy

@Vic311 @APM_SLP y'all are so sweet to think of me! IT hurt LIKE A MOTHER but I'm feeling better now:)

APM_SLP

Yay! Yay that's it's done and you're feeling better! My results will be back Monday!! I'm nervous!!

APM_SLP

My intuition is that it will come back receptive, we will transfer two next time and I'll be pregnant with twins.

shauna43

@APM_SLP kup. if my ivf fails again my RE brought up  doing this. how long for results?

omarismyhomeboy

@shauna43 My doc says approx 2 weeks.

APM_SLP

@shauna43 my results come back Monday so that's just a little over 2 weeks

shauna43

Also how much?

APM_SLP

It was about $1600 after paying both the testing place and my clinic. 

APM_SLP

Results came back "optimal."  Dang it.  Not what I wanted to hear. Now I have to decide if I want to take a break until January (house renovations, holidays etc) or just jump into another transfer right away.  Bigger decision will be 1 vs 2 embryos.  Ugh- I was just really hoping that this was it. 

omarismyhomeboy

Wow! I understand the confusing feelings about that. Well, here's hoping things will be in perfect working order for FET #1!!!! xox @APM_SLP

mtpbadger

Looks like I'll be having this done on Monday. FET #3 canceled as my RE didn't like my lining. Since I've had lining issues every cycle, she's hoping this will shed some light on what's going on in my uterus. My doctor said the cost would be around $800 but my nurse will let me know for sure tomorrow. 

omarismyhomeboy

@mtpbadger good luck and I hope it provides necessary answers! It hurts, but the knowledge is worth it. Yeah, mine I think is around $1000. 

mtpbadger

I'm glad this thread was started so I knew what the heck my RE was talking about when it was brought up! I had thought about asking for one anyway if this cycle hadn't worked. My RE isn't that optimistic that it will tell us what's wrong but it's worth a shot at this point to see if we can even get a little bit more information to rule anything out. 

mtpbadger

For those of you that had this done (@apm_slp and @omarismyhomeboy) were you all able to go back into work afterward? Or was it too painful/crampy? I'll be having mine Monday morning and don't want to waste an entire sick day if I don't have to

Vic311

I have my biopsy tomorrow morning so I will let you know!

omarismyhomeboy

@mtpbadger It hurt like HELL when it was going on, but cramps did not last after the procedure. I took like an extra 30 min to myself but worked just fine. 

omarismyhomeboy

@Vic311 Good luck!!!! xoxo