Anyone have Endometrial Receptivity Test?

Anyone have Endometrial Receptivity Test?

Violet
Violet

August 17th, 2012, 12:30 pm #1

Hi,
Well, it was a BFN for me.
2 very good quality embryos, immune testing/treatment, scratch biopsy before the cycle...and nothing not even a chemical.
Ugh.

I regrouped with my RE and he is suggesting an Endometrial Receptivity Test. So, we would do all medications like I would use in a cycle and then a biopsy of my endometrium would be taken on a specific day (seems around implantation time) to see what is happening for me.

Has anyone done this? I have never had any lining issues, no polyps, no endometriosis...nothing so this is all new to me.

He said it will help him rule out what is going on.

Also, I have to hear from Dr. Braverman as to my most recent immune testing and what came up with that.

Part of me is ready to throw in the towel and move on to adoption. I am tired of always having to do something with my body and running around to appointments.

Anyone do a Endometrial Receptivity Test?
Thanks!
Violet
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Violet
Violet

August 17th, 2012, 1:02 pm #2

My Dr. has described it a little differently. We talked about it on the phone yesterday and he did not mention 2 biopsies, just one.

I am going to call back today because I don't want to do this on the fly.

Can you describe what you did?

My RE said to start off on Day 1 with the E2 support I was doing for a FET DE. Then they would begin me on P4 support at some point (waiting on calendar for that) and then he said approximately 8 days after the P4 support starts, he would do a biopsy. Does this sound right?

Also, I have been taking intralipids and neupogen for immune issues. Did you take those as well during the testing? My RE is not well-versed in immune areas so he said he did not think I needed to take these. It seems to me like if I were to take these for an FET, then why wouldn't I do it with the EFT? Wouldn't they want to see how intralipids and neupogen affect endometrium?

Thanks, Christine! How are you doing?
Violet
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Dee
Dee

August 18th, 2012, 3:33 am #3

Hi,
Well, it was a BFN for me.
2 very good quality embryos, immune testing/treatment, scratch biopsy before the cycle...and nothing not even a chemical.
Ugh.

I regrouped with my RE and he is suggesting an Endometrial Receptivity Test. So, we would do all medications like I would use in a cycle and then a biopsy of my endometrium would be taken on a specific day (seems around implantation time) to see what is happening for me.

Has anyone done this? I have never had any lining issues, no polyps, no endometriosis...nothing so this is all new to me.

He said it will help him rule out what is going on.

Also, I have to hear from Dr. Braverman as to my most recent immune testing and what came up with that.

Part of me is ready to throw in the towel and move on to adoption. I am tired of always having to do something with my body and running around to appointments.

Anyone do a Endometrial Receptivity Test?
Thanks!
Violet
I have never heard of this type of test before.
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Joined: May 15th, 2009, 12:50 am

August 18th, 2012, 3:53 am #4

My Dr. has described it a little differently. We talked about it on the phone yesterday and he did not mention 2 biopsies, just one.

I am going to call back today because I don't want to do this on the fly.

Can you describe what you did?

My RE said to start off on Day 1 with the E2 support I was doing for a FET DE. Then they would begin me on P4 support at some point (waiting on calendar for that) and then he said approximately 8 days after the P4 support starts, he would do a biopsy. Does this sound right?

Also, I have been taking intralipids and neupogen for immune issues. Did you take those as well during the testing? My RE is not well-versed in immune areas so he said he did not think I needed to take these. It seems to me like if I were to take these for an FET, then why wouldn't I do it with the EFT? Wouldn't they want to see how intralipids and neupogen affect endometrium?

Thanks, Christine! How are you doing?
Violet
Maybe your doctor doesn't intend to do a baseline/natural cycle screen first.

What you described in terms of taking E2 and P4 support prior to the biopsy sounds similar to what I did for my second screen.

Regarding your other question: I used Intralipids prior to embryo transfer, immediately after my embryo transfer and for a few weeks post-transfer. I've been doing that for several failed cycles and also did it for my successful cycle that gave me my current pregnancy. But I was not taking them as part of the Endometrial Function testing protocol. My understanding from reading a bit of information on the Yale web site, is that the objective of the biopsies is to determine the impact of hormonal supplementation on the lining and on the basis of the results, progesterone supplementation might be adjusted for the next transfer attempt (as it was for me). My successful cycle used a gradual P protocol that didn't include any PIO shots.

It looks like there are a couple of ways to approach the medication levels used to prepare for the biopsy:
http://info.med.yale.edu/obgyn/kliman/r ... otocol.pdf
http://info.med.yale.edu/obgyn/kliman/r ... 20mock.pdf

For general information and links about the EFT, check out this site:
http://info.med.yale.edu/obgyn/kliman/i ... lcome.html

Good luck. I hope this biopsy gives you some more information to work with for your next attempt.

Also, take some pain releif beforehand. Collecting the sample hurts!
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Joined: May 15th, 2009, 12:50 am

August 18th, 2012, 3:56 am #5

Hi,
Well, it was a BFN for me.
2 very good quality embryos, immune testing/treatment, scratch biopsy before the cycle...and nothing not even a chemical.
Ugh.

I regrouped with my RE and he is suggesting an Endometrial Receptivity Test. So, we would do all medications like I would use in a cycle and then a biopsy of my endometrium would be taken on a specific day (seems around implantation time) to see what is happening for me.

Has anyone done this? I have never had any lining issues, no polyps, no endometriosis...nothing so this is all new to me.

He said it will help him rule out what is going on.

Also, I have to hear from Dr. Braverman as to my most recent immune testing and what came up with that.

Part of me is ready to throw in the towel and move on to adoption. I am tired of always having to do something with my body and running around to appointments.

Anyone do a Endometrial Receptivity Test?
Thanks!
Violet
I know how hard failures can be as I went through more than my fair share of them. Be kind to yourself during this difficult time.
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E&H
E&H

August 18th, 2012, 11:36 am #6

Hi,
Well, it was a BFN for me.
2 very good quality embryos, immune testing/treatment, scratch biopsy before the cycle...and nothing not even a chemical.
Ugh.

I regrouped with my RE and he is suggesting an Endometrial Receptivity Test. So, we would do all medications like I would use in a cycle and then a biopsy of my endometrium would be taken on a specific day (seems around implantation time) to see what is happening for me.

Has anyone done this? I have never had any lining issues, no polyps, no endometriosis...nothing so this is all new to me.

He said it will help him rule out what is going on.

Also, I have to hear from Dr. Braverman as to my most recent immune testing and what came up with that.

Part of me is ready to throw in the towel and move on to adoption. I am tired of always having to do something with my body and running around to appointments.

Anyone do a Endometrial Receptivity Test?
Thanks!
Violet
I believe it is a little uncomfortable but is quite reliable.
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Violet
Violet

August 19th, 2012, 1:30 pm #7

Maybe your doctor doesn't intend to do a baseline/natural cycle screen first.

What you described in terms of taking E2 and P4 support prior to the biopsy sounds similar to what I did for my second screen.

Regarding your other question: I used Intralipids prior to embryo transfer, immediately after my embryo transfer and for a few weeks post-transfer. I've been doing that for several failed cycles and also did it for my successful cycle that gave me my current pregnancy. But I was not taking them as part of the Endometrial Function testing protocol. My understanding from reading a bit of information on the Yale web site, is that the objective of the biopsies is to determine the impact of hormonal supplementation on the lining and on the basis of the results, progesterone supplementation might be adjusted for the next transfer attempt (as it was for me). My successful cycle used a gradual P protocol that didn't include any PIO shots.

It looks like there are a couple of ways to approach the medication levels used to prepare for the biopsy:
http://info.med.yale.edu/obgyn/kliman/r ... otocol.pdf
http://info.med.yale.edu/obgyn/kliman/r ... 20mock.pdf

For general information and links about the EFT, check out this site:
http://info.med.yale.edu/obgyn/kliman/i ... lcome.html

Good luck. I hope this biopsy gives you some more information to work with for your next attempt.

Also, take some pain releif beforehand. Collecting the sample hurts!
You have been wonderful and I appreciate it.

How many weeks along are you? I have a lot of respect for how you kept trying through all this time. You are amazing! How many donors have you tried?

So, for the actual test, what P4 supplementation did they give you? I know for your successful cycle it was gradual however did you do that for the test as well?

My Dr is saying start with 50mg and then go up to 100mg (which is my normal dose) on the next day and continue with that. He does not have a lot of experience with this test and I am concerned he is just throwing numbers out there.
I have had a hunch that the gradual p4 approach would be good for me as I am sensitive to meds and anything that mimics what my body would do naturally is better for me.

Thanks for your help!
Violet
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Joined: May 15th, 2009, 12:50 am

August 19th, 2012, 3:36 pm #8

I'm 21 weeks with twins. I transfered 2 day-5 blasts and they both took.

This was my fourth donor.

First was an unproven donor. We had lots of embies, did a fresh and several FETs = nothing. We paid full price for this cycle, we were the only recipient.

Second donor attempt, I needed to economize so I used vitrified eggs from a "rock star" donor at my clinic whose previous donations had resulted in live births. One fresh, one FET = nothing. I wanted to test the embies but the clinic advised against it thinking that the embies might be more fragile because they came from thawed eggs.

Third attempt we were the second receipient from a proven donor. Tested these embies, of 5 only one was normal (which was the same results as I had from my last OE cycle, of 5 embies we tested only 1 was normal). This really pissed me off because I was thinking, if I wanted crappy odds, I could have saved all these donor costs and tried again with my eggs.

I honestly can't remember when we added Lovenox and intralipids to my protocols -- if it was for my second or third donor. It has been a long journey.

This time we were the only receipients from a proven donor. I had to ask my mom to give me $10K to help me afford this cycle. I wanted to test the embies but I couldn't afford the extra $5K. So, because they were not tested, I transfered 2 and here I am! I also have 3 frosties. I may have transfered only 1 if I knew it was chromosomally normal. But, as my preganancy is progressing, I'm getting less and less fearful of complications from twins and getting more excited about having an instant family of four! I hope I can carry them for a long time to reduce any developmental risk that come from premature birth.

Can you ask your doctor who will actually be performing the test? Is he sending the biopsy out to another doctor or a lab? Were you given an authorization form to sign that comes from another medical practice or were you asked to pay fees to someone else for the test? I had to sign Yale's HIPAA form and give a credit card number to my doctor that they passed on to Yale to bill me the $459 for the test. If he is using someone else to perform the test, that practice would be guiding him on the P4 dosages and timing.

I found my old protocol and here are the dosages I was on, all were adminstered vaginally:

It started with 2 days of 25 mg twice a day - first biopsy was taken on the second day. For me, this biopsy was normal. It sounds like your doctor might be skipping this part.
then 2 days of 50 mg twice a day
then 5 days of 100 mg twice a day
then 2 days of 200 mg twice a day - the last day of this was when the biopsy sample was retreived. This sample turned out to have some abnormalities that were seen on a cellular level.


I'm certainly not an expert on endometrial testing. There may be more than one protocol that is utilized successfully. If yours differs from mine, it may not be an issue.

Either way - best of luck to you for this test and for your ongoing efforts to become a mom!
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Violet
Violet

August 21st, 2012, 2:36 am #9

Wow...I am amazed at what you have endured to have a child. You are incredible. I knew you were trying with DE for awhile however I did not realize this was your 4th donor. How did you keep going?

I am feeling like I am struggling and I am still doing my FETs from 1st donor. Maybe due to the 3 years of OE treatment that I left almost no stone unturned.

Kudos to you.

Thank you for all of the information. Your help has been integral in me making the decision to do this. I will look through the Yale test compared to this test from Spain that we are doing. So, yes my Dr. is sending the test to Spain...and I am paying the company from Spain directly. They test 238 genes involved in endometrial receptivity.

I will let you know how it goes.

Who was your immunologist?
Thanks and so happy your pregnancy is going well. I am so glad you are embracing the twin pregnancy and I look forward to hearing all good things. You worked hard for it
Violet
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Joined: January 15th, 2010, 4:50 am

August 22nd, 2012, 5:54 am #10

Hi,
Well, it was a BFN for me.
2 very good quality embryos, immune testing/treatment, scratch biopsy before the cycle...and nothing not even a chemical.
Ugh.

I regrouped with my RE and he is suggesting an Endometrial Receptivity Test. So, we would do all medications like I would use in a cycle and then a biopsy of my endometrium would be taken on a specific day (seems around implantation time) to see what is happening for me.

Has anyone done this? I have never had any lining issues, no polyps, no endometriosis...nothing so this is all new to me.

He said it will help him rule out what is going on.

Also, I have to hear from Dr. Braverman as to my most recent immune testing and what came up with that.

Part of me is ready to throw in the towel and move on to adoption. I am tired of always having to do something with my body and running around to appointments.

Anyone do a Endometrial Receptivity Test?
Thanks!
Violet
FIRST, I AM SO SORRY FOR THE BFP. PG MENTIONED

TO ANSWER YOUR QUESTION:

I HAD AN ENDOMETRIAL BIOPSY AND A MOCK CYCLE DONE WITH RE #3 (DR. RICHARD MARRS AT CFP). HOWEVER, FOR MY DE IVF CYCLE I MOVED ON TO A DIFFERENT CLINIC, DR. RICK BUYALOS AT FSAC WHO DID NOT REQUIRE A MOCK CYCLE. I TOOK THE MOCK CYCLE SHEET WITH ME SO THAT DR. B. WOULD HAVE ALL THE INFO. HE DID DO ANOTHER MOCK TRANSFER TO MAKE SURE THAT HE COULD THREAD THE CATHETER EASILY.

WE TRANSFERRED ONE HATCHING BLASTOCYST AND SHE TOOK AND BECAME MY DD.

GOOD LUCK TO YOU!

LISA
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