Introducing Myself/ERA Questions (loss mentioned)

beachwifey · June 2017

Hi all. I'm so thankful for this board. I've been reading for a while and wanted to introduce myself and become a more active member. I was married in April 2014, and we've been TTC for 2.5 years now. I had a miscarriage from a natural pregnancy in November 2015, and since then my husband has been diagnosed with a very low sperm count (< 1million). After a year or so of trying various medicines and alternative health type things to get his counts up we had a little luck, but not enough. His urologist said we only have a 1-5% chance of getting pregnant naturally with each cycle. The urologist and our RE suggested we proceed straight with IVF, since our success rates with IUI would be very small (< 10% with each round). I had my first ER in April 2017. We retrieved 21 eggs, 17 matured, 10 fertilized with ICSI. We had to do a freeze all cycle, and our RE recommended PGS testing. Only 3 embryos tested normal. We did our 1st FET on 6/14, and I just got a BFN yesterday. We were devastated, to say the least, especially because I was so sure I was pregnant.

Our Dr is recommending, since we only have 2 embryos left, that we do a mock trial next with an endometrial biopsy for ERA (endometrial receptivity array). I'm on the fence mainly because of the money and time it will take. Our insurance covers nothing, and we've paid for 100% of this process out of pocket, which has not been easy.

My question to those who've been through this are: If you paid out of pocket how much did the ERA cost? How long does it take to get results? Did you feel it was worth it? What was the procedure like?

Thanks to all of you to reading this very long post. I appreciate it so much.

bethann1022 · June 2017

Hello and welcome!

I wanted to respond as I just had my first ERA in June and will have another in July, so I want to share my results and experience. I had my first ER in November 2016 which resulted in 16 eggs, 12 mature, 9 fertilized and 2 blastocyst embryos, we had to do a freeze all as well, and because of my age and our family history, our RE did not feel PGS was necessary. We did two back to back single FET's in January and February, both of which resulted in BFNs. Our RE then recommended the ERA test before another IVF cycle, but because of the cost and time (1-2 month delay), as well as the fact that because of my PCOS, my RE felt that our first two embryos were fair-poor quality, we decided to move onto another cycle first. We completed another cycle with similar results, 15 eggs, 12 mature, 9 fertilized this time 3 blastocyst embryos of much higher quality, again we did not do PGS as our RE did not feel it was necessary. In May we completed another FET, this time with two good quality embryos, and as you, I felt pretty sure I was pregnant, only to have another BFN.

My RE pushed for me to have an ERA before the next transfer, which will be our last frozen embryo. I was going to move forward with the last embryo and then do the ERA before another cycle, but after consulting with another RE, he strongly advised I do the ERA first as it is the highest possible cause of failure for our case. I did the ERA on June 12th after 12 days of estradiol patches and 4 days of Crinone gel (which is the amount my clinic typically uses for FETs). I just received the results on Friday, pre-receptive and by 2+ days. According to my RE, this is the first time she ever saw this result and they have done this test many, many times. She states that it is very accurate, usually resulting in either a receptive result or a pre or post receptive result with a recommended window of either a 12 or 24 hour adjustment. The 2+ days states that I need somewhere between 6-8 days of Crinone, but this is just a guess and she thinks it may be more likely an absorption problem to the actual Crinone. So, we are going to repeat this month, however this time we will do 6 days of PIO injections, which are my least favorite, but I will do what I have to do. Hopefully it will yield a better outcome.

My advice to you, especially seeing as though you have PGS normal embryos, would be to definitely do the ERA before your next transfer. There has been quite a bit of research demonstrating that each woman only has a 12 hour implantation window and while the clinics use P+5 and this is acceptable for many women, there are also many of us who need more or less progesterone to have receptive linings.

Regarding the cost, it is typically 700-900 dollars per round (most people only need one) for the actual diagnostic test, but I am not sure whether there are additional clinic charges for the biopsy procedure itself, mine was covered by insurance as it is a medical endometrial biopsy.

Anyway, good luck with whatever decision you make and with your next FET!

beachwifey · June 2017

Thank you so much for your reply! I find it so much easier to make these often impossible decisions when I have as much information as possible. I hope you get the answers you are looking for with the repeat ERA. This whole process feels like such a numbers game, and I know how frustrating and disappointing it can be.

I totally empathize with you about the PIO injections, my clinic uses them for the FET protocols and they are not fun. I found a lot of massage and a little heat after the injections helped a lot in eliminating the nasty lumps that sometimes form and hurt so bad.

Good luck with the rest of your journey!

shauna43 · June 2017

@beachwifey hello there. I had started a ERA thread that's is currently on the page I can tag you in.

But to answer your questions:
I had to pay $600 oop.My Dr billed the biopsy part to insurance. It took 1 week and 5 days for my result. Yes was worth it. Found out I'm pre receptive by 12 hours. I have had 5 ivf fails. The actual biopsy is painful. Pretty bad cramping.

I would def do the rest. You may get answers to your fails. I have gone thru pgs normal embryos. I regret not doing the ERA sooner.

I will tag u in my previous ERA post

beachwifey · June 2017

Hi @shauna43 thanks for the info. I'll be sure to check out your thread.

Introducing Myself/ERA Questions (loss mentioned)

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