Monday, August 19, 2019

ERA & Embryo Transfer Update

After two failed transfers last year I knew that I wanted to have some further testing done before wasting any more money or embryos.  When I spoke at the Infertile AF summit this spring in Rosemont I had the pleasure of listening to Dr. Roohi Jeelani talk about her clinic Vios Fertility and immediately decided that I was going to reach out to her when the time came.  She and I had been Instagram friends for a few months and I got to meet her in person at the summit.  She is so sweet and I just felt right then and there like she could help us.

Fast forward to now—I decided to reach out to her about an ERA.  For those of you who aren't familiar, it's one of the few tests we haven't done yet and it stands for Endometrial Receptivity Assessment or Assay.  Basically what it boils down to is a mock cycle and instead of transferring the embryo, a biopsy of the lining is taken to see if it's either "pre-receptive", "receptive", or "post-receptive".  This past Thursday we had our consultation with Dr. Jeelani and she explained that embryos can implant on day 5, 6, or 7; when you have a natural pregnancy, your body is triggered to start creating enough progesterone to support the embryo no matter what day it implants, but when you're artificially creating a pregnancy, progesterone has to be taken and this test will determine if enough progesterone is given at the right time.  I may need progesterone sooner for instance, if I am pre-receptive.  The biopsy will take place on day 5 and then a potential for a follow up biopsy on day 7 could be possible if the lab performing the tests requires extra specimen.  I may end up having a hysteroscopy at that time as well to check that my uterus is looking ok.

Something else that we would do differently going forward is an antihistamine protocol which adds Claritin and Pepcid into the mix along with Lupron, estrogen patches & pills, and progesterone in oil form, oral form, and vaginal form!  Dr. Jeelani said that immunity issues can be treated with the antihistamine even if we aren't certain there are issues.  I can have my NK cells tested, but it's not necessary.  So for my upcoming ERA I will do the exact protocol that I would do with my next transfer.  Typically the transfer should follow the month after the ERA as well.  The ERA is really best for people who have had multiple implantation failure or like in my case had a chromosomally normal tested baby miscarry—she said this indicates that something is probably wrong inside.  Most of this kind of testing (ERA, immunity, etc.) is very out of the box and has very little research to back it, but I know that the ERA is gaining popularity and it seems to have been a big piece of the puzzle for  a lot of people in the community that I've spoken to about it. 

Dr. Jeelani said she'd be happy to work with our clinic in Georgia as long as they were willing to change up my protocol.  I spoke to my IVF coordinator there & they were willing to adjust as necessary, but a part of me was telling me that we probably needed to consider relocating our embryos closer to home.  Our donor has since moved from Augusta back to her hometown in South Carolina so we wouldn't get to spend as much time with them as we have in the past.  It was a hard decision but I think in our hearts we knew it what was best so we have decided to transport our embryos from Augusta up here to Chicago so that logistically things are less chaotic.  The thought of having 2 different clinics plus a monitoring clinic for 1 cycle really just seemed overwhelming.

Things are moving pretty quickly.  They drew my blood at our appointment Thursday and said as long as I had ovulated already (which I had) I could start Lupron asap.  I was able to track down someone in my tiny home town of 3,000 that actually had some to give and started 10cc on Saturday night.  I will continue with the Lupron until my period starts and then I can call and schedule my baseline and get my protocol.  I've been sooo blessed again by our community with donated meds and appreciate all that everyone has done to help me track down what we need.  I was able to get quite a few estrogen patches and PIO as well but I am still on the hunt for another Lupron kit if anyone has any available.  It's truly unfortunate that we lost our coverage last year.  We were so lucky to have it for a few years and I will never take for granted the fact that we did 3 full fresh retrievals and so many transfers that were all covered.  Now I am feeling the effects of what most people are and that is the financial burden that comes along with this journey.  I priced a Lupron kit with my pharmacy and its $987 for just a two week kit.  It's very much appreciated that this community is so open to sharing! 

So the plan looks like this: Lurpon now, period, baseline, start estrogen, start progesterone, ERA/biopsy, wait for results, and then can begin meds for an October transfer.  Like I said, things are moving VERY quickly but I am excited to see what this new chapter of our journey brings.  It will take about a week for Cryostork to make the arrangements with the clinics once they receive the paperwork from me.  They have 2 levels, Basic and Premium and then they also offer 2 levels of insurance.  We have decided on the Basic package which is slower shipping time (cost is $750) and the level 1 insurance which covers a max of $25,000 for lost or damaged items.  Since we aren't in a huge rush to get them here and have over a month we thought that would be the best option for our pockets. 

Again, just want to thank everyone who continues to ride this roller coaster with us.  It's been over 5 years of blogging about infertility and so many of you have been around from the beginning and continue to support us and be our cheerleaders and it's truly amazing.  If anyone has questions about Vios Fertility Institute or Cryostork or the ERA please email me at

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