Endometrial Function Test- Anyone do it or decide not to?

babydreams13 · February 2014

SO I had a consult with a new RE at SIRM in NYC. I'm We are unexplained so he suggested many tests and things to do. One thing that he strongly suggest is the EFT done through Yale university. Its about $600. There is also an EFT done through somewhere in California. It is looking for abnormalities in the endometrium. If it is abnormal this could lead to implantation issues. I had a regular endo biopsy in November and it came back normal. I had a bad experience with the endo biopsy with pain lasting a couple of months and if I overdue it I get random pain still now. I am scared to do this again.

Has anyone done this? If so, what was your experience?

If your RE suggested it but you declined what was your reason?

I'm just trying to figure out if it is really needed.

Thanks!

indianaalum · February 2014

I never heard of it, so I can' really tell you. HOWEVER, if there is only 2 clinics in the nation that do it, it seems experimental and not a "standard of care" so I guess I would opt out of it.

I guess I would also ask, if you DO IT, how would treatment change with the information? If it wouldn't alter treatment at all, I wouldn't waste my time I suppose??!

babydreams13 · February 2014

indianaalum said:

I never heard of it, so I can' really tell you. HOWEVER, if there is only 2 clinics in the nation that do it, it seems experimental and not a "standard of care" so I guess I would opt out of it.

I guess I would also ask, if you DO IT, how would treatment change with the information? If it wouldn't alter treatment at all, I wouldn't waste my time I suppose??!

Heres the link to info on it: https://familybuilding.resolve.org/site/PageServer?pagename=lrn_wii_implant&JServSessionId_form=login&printer_friendly=1

Resolve wrote about it so its definitely known but newer.

If the endometrium is not receptive the RE said he would put me into a menopausal state with Lurpon and then build the lining back up- something like that. It seems complex. I have found a few women out there that have done it- I been googling a lot. I think the RE thinks my issue is implantation and that this will reveal some answers. I hope some ladies on here post with experiences.

Thanks

babydreams13 · February 2014

BUMP- ANYONE??? I can't stop thinking about this test since the new RE strongly suggested it but I can't find any info on it.

ronniesgirl1981 · February 2014

No experience, but I'm curious. Could he do the Lupron/menopausal thing even without the test? Does it hurt to do it even if you didn't absolutely need it?

Carol77B · February 2014

babydreams13 said:

If the endometrium is not receptive the RE said he would put me into a menopausal state with Lurpon and then build the lining back up- something like that. It seems complex. I have found a few women out there that have done it- I been googling a lot. I think the RE thinks my issue is implantation and that this will reveal some answers. I hope some ladies on here post with experiences.

I also had a regular endometrial biopsy (and an endometrial tube? biopsy) and they were excruciating and based on your side effects I would be really leery- did you tell the RE about your horrible experience and side-effects?

I brought up implantation treatment with my RE at my WTF appointment and he mentioned the test I think you are talking about but I was pretty vehement that I wouldn't want to do it because of how painful my "regular" endometrial biopsy was. He also said it was too early to jump to any conclusions in my situation, but that there were investigational drugs to help with implantation. I would ask your RE if there was any harm in going forward with the protocol you described and save yourself the pain of the test. Or to see if there is a less invasive test he could do to determine if there are implantation issues. I don't think anyone who hasn't had an endometrial biopsy can truly appreciate the pain involved (I think that's the case with a lot of the IVF tests and treatments) and you don't need to be stressing about the test if there are other alternatives.

babydreams13 · February 2014

ronniesgirl1981 said:

No experience, but I'm curious. Could he do the Lupron/menopausal thing even without the test? Does it hurt to do it even if you didn't absolutely need it?

I guess he could just do it but then it puts you out of cycling for 3 months and if you didn't need to do it then its a wasted 3 months. I don't even know what the Lupron/menopausal thing entails. My head was spinning after that appointment. He did suggest a Lupron Protocol when I do cycle. I am off for 10 days in April so I would really like to do an IVF then.

babydreams13 · February 2014

Carol77B said:

babydreams13 said:

If the endometrium is not receptive the RE said he would put me into a menopausal state with Lurpon and then build the lining back up- something like that. It seems complex. I have found a few women out there that have done it- I been googling a lot. I think the RE thinks my issue is implantation and that this will reveal some answers. I hope some ladies on here post with experiences.

I also had a regular endometrial biopsy (and an endometrial tube? biopsy) and they were excruciating and based on your side effects I would be really leery- did you tell the RE about your horrible experience and side-effects?

I brought up implantation treatment with my RE at my WTF appointment and he mentioned the test I think you are talking about but I was pretty vehement that I wouldn't want to do it because of how painful my "regular" endometrial biopsy was. He also said it was too early to jump to any conclusions in my situation, but that there were investigational drugs to help with implantation. I would ask your RE if there was any harm in going forward with the protocol you described and save yourself the pain of the test. Or to see if there is a less invasive test he could do to determine if there are implantation issues. I don't think anyone who hasn't had an endometrial biopsy can truly appreciate the pain involved (I think that's the case with a lot of the IVF tests and treatments) and you don't need to be stressing about the test if there are other alternatives.

Yes excruciating is the word to describe it! I had a hysterscopy and an endo biopsy the same day both with no anesthesia. I was in such pain from having both done. Pain for months and now when I shoveled last week I reactivated the soreness in my lower abdomen. I told the new RE about the pain he said it was probably from the bysterscopy...who knows. Either way IDK if I am ready to do the EFT when its not even really a known thing. I haven't seen many posts about it anywhere. I think its about $600 and I can deal with the cost but the pain is another thing. Also you have to do like a mock cycle as if you were doing a FET...so meds for no transfer. I just don't wanna make the wrong decision. I think he thinks since we are unexplained this is one of many tests that MAY reveal answers. Thanks for responding.

babydreams13 · February 2014

IFinTN said:

I agree with Ronniesgirl....I've seen many just do the lupron treatment anyway. Good luck!

You have seen people just do the Lupron treatment to shut down for months or Lupron as a protocol before stimming? I'm so confused and don't wanna make the wrong decision.

SKLH · February 2014

I was with a previous RE who suggested this test. I asked him the same thing about just doing the treatment rather than doing the test and he said there was no way he would induce menopouse on a 27 year old woman without cause to do it. I ended up going to a few second opinion appointments and the RE that I chose totally dislikes those tests. He says it's a huge red flag when the ONLY place performing those tests is collecting $600 per test and no other entity is catching on and offering the test. It's super experimental. I trust his expertise so I'm not even going to bring it up again. Honestly, the financial aspect of it makes a very good point. I also reaserched it online and found a article where Dr. Braverman (Reproductive Immunologist) says it's just another "problem" that someone has created and decided to try to treat at a costly price. I'm not sure how I feel deep inside but if you look it up, it's been around for a few years but has yet to become a "standard of care" at every clinic. That says a lot about the effectiveness of the test as well. GOod luck making your decision!

Sophistikitty · February 2014

I had the E-tegrity biopsy done through my local RE. I think most RE’s consider it to be better than than the EFT. E-tegrity is what C.CRM uses.

There is an even newer test called ERA (Endometrial Receptivity Array) but there are very few RE’s that do it.

Here are the links to the EFT, E-tegrity and ERA...

https://medicine.yale.edu/obgyn/kliman/infertility/eft/index.aspx

https://www.etegritytest.com/

https://www.iviomics.com/en-us/specialists/era.aspx

babydreams13 · February 2014

IFinTN said:

IFinTN said:

I agree with Ronniesgirl....I've seen many just do the lupron treatment anyway. Good luck!

You have seen people just do the Lupron treatment to shut down for months or Lupron as a protocol before stimming? I'm so confused and don't wanna make the wrong decision.
The lupron depot for 3 months. It is used when people fail the Integrin Beta test and the uterus is "out of phase" for implantation. I think that would be along the same lines as the uterine issue he is looking for.

Oh got it, I didn't know it was called Lupron Depot. I never even heard of Integrin Beta. Is this BW? Thanks

babydreams13 · February 2014

SKLH said:

I was with a previous RE who suggested this test. I asked him the same thing about just doing the treatment rather than doing the test and he said there was no way he would induce menopouse on a 27 year old woman without cause to do it. I ended up going to a few second opinion appointments and the RE that I chose totally dislikes those tests. He says it's a huge red flag when the ONLY place performing those tests is collecting $600 per test and no other entity is catching on and offering the test. It's super experimental. I trust his expertise so I'm not even going to bring it up again. Honestly, the financial aspect of it makes a very good point. I also reaserched it online and found a article where Dr. Braverman (Reproductive Immunologist) says it's just another "problem" that someone has created and decided to try to treat at a costly price. I'm not sure how I feel deep inside but if you look it up, it's been around for a few years but has yet to become a "standard of care" at every clinic. That says a lot about the effectiveness of the test as well. GOod luck making your decision!

Hmm Interesting. I don't wanna go into a menopausal state if I don't have to. I had 2 chemicals but Dr. T says he isn't convinced that I don't have an implantation issue. I do agree that this test is experimental and thats why I'm on the fence about it. Paying 600 is not the issue, the issue is going through the pain and having to deal with it all over again. Then going into a menopausal state that also may or may not help. Always maybe this will work. UHH. Interesting about Braverman bc he use to work with Dr. T at SIRM until he branched off on his own. He was the other Dr. I was looking into but he doesn't take my insurance and is way more expensive in general. I tried looking up info on it and found some info but not much. I just don't wanna get a BFN and think what if...this may be our last chance. Thanks!

babydreams13 · February 2014

Sophistikitty said:

I had the E-tegrity biopsy done through my local RE. I think most RE’s consider it to be better than than the EFT. E-tegrity is what C.CRM uses.

There is an even newer test called ERA (Endometrial Receptivity Array) but there are very few RE’s that do it.

Here are the links to the EFT, E-tegrity and ERA...

https://medicine.yale.edu/obgyn/kliman/infertility/eft/index.aspx

https://www.etegritytest.com/

https://www.iviomics.com/en-us/specialists/era.aspx

Thank you! Would you mind sharing if anything showed up from this test? After what IVF did you have it done? Does your RE think implantation is your issue? We are unexplained so after many failed cycles and 2 chemicals I guess he is just trying to cover his bases.

Sophistikitty · February 2014

I had it done after my first failed donor cycle. My RE just wanted to rule out all the uterine issues he could before transferring my last two frosties (as obviously my eggs were no longer the issue). My results came back, “Beta-3 Integrin absent and endometrium out of phase” which is indicative of a luteal phase defect. I was not prescribed Depot Lupron as that is generally prescribed when Beta-3 Integrin is absent and the endometrium is “in phase” (some RE's treat with Lupron Depot anyway though). Luteal phase defect is just treated with progesterone which of course I have been on for all my cycles and my levels were always good.

I know it’s hard when you can’t figure out what is wrong. Has DH had his DNA fragmentation tested? Have you both had karyotyping done?

babydreams13 · February 2014

Sophistikitty said:

I had it done after my first failed donor cycle. My RE just wanted to rule out all the uterine issues he could before transferring my last two frosties (as obviously my eggs were no longer the issue). My results came back, “Beta-3 Integrin absent and endometrium out of phase” which is indicative of a luteal phase defect. I was not prescribed Depot Lupron as that is generally prescribed when Beta-3 Integrin is absent and the endometrium is “in phase” (some RE's treat with Lupron Depot anyway though). Luteal phase defect is just treated with progesterone which of course I have been on for all my cycles and my levels were always good.

I know it’s hard when you can’t figure out what is wrong. Has DH had his DNA fragmentation tested? Have you both had karyotyping done?

Thanks for the info. Uhh I just don't wanna go through another biopsy and then again everything comes back normal.

DH and I both did the Karyotyping (normal) and I did the RLP (normal). The new RE said based on our previous IVFs and DHs SA, we could do the DNA fragmentation test, but he doesn't think the problem lies with DH. He said its most likely my eggs....great. We are doing immune testing next week. If nothing shows up from the immune testing maybe I'll get the EFT..uhh idk.

With the EFT did you have to do a mock cycle? Were you in pain? How long before you could do an IVF again?

Thanks

Sophistikitty · February 2014

I had the biopsy two months before transfer. The E-tegrity biopsy is usually done on a natural cycle which is how mine was done. There is no down time and some RE’s actually feel it can help with implantation much in the same way as an endometrial scratch can (which many RE’s do the cycle before transfer).

I did not have any pain from it other than minimal discomfort during the procedure. I believe the key to having it go smoothly is having a full bladder.

I would definitely have DH’s DNA fragmentation tested. You can have a perfect SA and still have high DNA fragmentation and there is absolutely no way to predict the result without doing the test. Conversely, you can also have a terrible SA and low DNA fragmentation (like my husband).

Good luck with your decisions.

babydreams13 · February 2014

Sophistikitty said:

I had the biopsy two months before transfer. The E-tegrity biopsy is usually done on a natural cycle which is how mine was done. There is no down time and some RE’s actually feel it can help with implantation much in the same way as an endometrial scratch can (which many RE’s do the cycle before transfer).

I did not have any pain from it other than minimal discomfort during the procedure. I believe the key to having it go smoothly is having a full bladder.

I would definitely have DH’s DNA fragmentation tested. You can have a perfect SA and still have high DNA fragmentation and there is absolutely no way to predict the result without doing the test. Conversely, you can also have a terrible SA and low DNA fragmentation (like my husband).

Good luck with your decisions.

Thanks for all of the info! I had an endo biopsy before my FET but that ended in a chemical. I'm gonna speak to the nurse next week and ask for more info about it. I think the EFT has to be done on a medicated cycle like a FET.

So as for the DNA sperm fragmentation if it didn't turn out good is that when PICSI is used? My new RE mentioned that some people don't do the DNA Frag test and go straight to PICSI which is different than ICSI.

Thanks

SKLH · February 2014

@sophistikitty So you basically had the test done but didn't "treat" it with anyting afterwards? That was also something my RE brought up to me, he said "what's the point of doing and paying $600 for a test if I don't feel comfortable treating it/there is not set "treatment" for? I kinda have ot agree...For me that would be time wasted...

Sophistikitty · February 2014

babydreams13 said:

Sophistikitty said:

I had the biopsy two months before transfer. The E-tegrity biopsy is usually done on a natural cycle which is how mine was done. There is no down time and some RE’s actually feel it can help with implantation much in the same way as an endometrial scratch can (which many RE’s do the cycle before transfer).

I did not have any pain from it other than minimal discomfort during the procedure. I believe the key to having it go smoothly is having a full bladder.

I would definitely have DH’s DNA fragmentation tested. You can have a perfect SA and still have high DNA fragmentation and there is absolutely no way to predict the result without doing the test. Conversely, you can also have a terrible SA and low DNA fragmentation (like my husband).

Good luck with your decisions.

Thanks for all of the info! I had an endo biopsy before my FET but that ended in a chemical. I'm gonna speak to the nurse next week and ask for more info about it. I think the EFT has to be done on a medicated cycle like a FET.

So as for the DNA sperm fragmentation if it didn't turn out good is that when PICSI is used? My new RE mentioned that some people don't do the DNA Frag test and go straight to PICSI which is different than ICSI.

Thanks

PISCI tests sperm binding. The process is similar to the SPA (sperm binding assay). PISCI is generally something that is recommended after a male factor is confirmed. Personally, I would just have the DNA fragmentation done and go from there.

Sophistikitty · February 2014

SKLH said:

@sophistikitty So you basically had the test done but didn't "treat" it with anyting afterwards? That was also something my RE brought up to me, he said "what's the point of doing and paying $600 for a test if I don't feel comfortable treating it/there is not set "treatment" for? I kinda have ot agree...For me that would be time wasted...

My local RE felt there was nothing to treat in relation to my result. This was further confirmed at C.CRM. Dr. S. said that if the endometrium is out of phase you wouldn’t expect Beta-3 Integrin to be present. Dr. S. wanted me to repeat the test prior to cycling as he wanted to find out when and/or if it was present. He was suspicious that the test had been done too early. While the physician’s instructions state that the sample must be taken 7-11 days after urinary LH surge, C.CRM’s instructions explicitly say 9-11 days after. My biopsy came back two days out of phase and was done on Day 7. I did not end up having the biopsy redone as we made the decision to move to another clinic (very long story). In any event, if I had stayed at C.CRM my choices were to redo the biopsy or do two months of Depot Lupron. My new RE will be doing the ERA test.

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