ERA – Round One


Ok y’all, my Endometrial Receptivity results are in.


So this means the standard 5 days of progesterone pre-transfer is WRONG for this uterus, and I’m part of the 1 in 4 women whose IVF transfers were happening on the wrong day, and I’ll need to do another mock cycle, adding an extra day of progesterone before doing the biopsy, to see if that will put me into the Receptive zone.

But here’s my confusion – and a question I’m waiting to hear back from Igenomix (AKA Ivigen) on, because my doctor, not surprisingly, has no real opinion on. Any of you gals who’ve done ERA, I’d especially love your thoughts:

Here’s the deal:

  • My ERA biopsy was done after five days/five shots of PIO, which is the standard protocol. As we did my daily PIO shots at 8pm, this means on biopsy day I had no PIO shot.
  • HOWEVER… during all of my five cycles of DEIVF, the embryo transfers were all done after five days/SIX shots of PIO. Why? We were doing my daily PIO shots at 6am, so on transfer day I had an injection. For three out of five of the transfers, the progesterone was in my system for 6 or more hours.

So what the hell does this mean?

I wish I had a fucking clue.

You see, I’m the first patient my RE has done this with, so while he intellectually understands my question, he doesn’t know enough about ERA to recommend anything other than the standard Igenomix recommendation of re-doing it an extra 24 hours later. But my question is, if I’m pre-receptive at day 5, and my history is having failed implantation 4 out of 5 transfers at day 5 but with 6 doses of PIO in me, am I wasting my time doing it at 6 days/6 doses and should I jump to 7 days/7 doses?

I know, it made me dizzy just writing that last sentence.

So I emailed Igenomix, in hopes that they’ll connect me to their genetic counselor and not simply give me a rubberstamped answer or tell me to listen to my doctor, which means…?

Who the hell knows, but it does mean that I am back on estrogen, HA! Ahh, the irony after my recent “free at last” post about getting off of it. The sooner I can get this mock cycle over and done with, the better. So the next biopsy should be in mid-February if I canculated that right. I just have to figure out how many PIO days I’m gonna do.

Fuck a doodle doo, I dearly love playing doctor (NOT).

Ultimately, I’m sure I’ll just go forward with doing it at P+6, and stop being so damn impatient, as this is the very last one and I want to get this right (plus if I do it at P+7, I’ll still need to do one at P+6 just to make sure that’s receptivity date fo’ sho’. But I do get 5 minutes to whine…


Well, at least before this happened I had a great visit with my therapist. I hadn’t had a 1:1 with her in a while and it really really was a good thing. With my back all fucked up even more (I re-tweaked it a bit, pushing my progress back a few weeks, as I gauge my recent gains by my ability to put on my own shoes and socks with ease, which I now need help with again. Sonofabitch.), I literally was talking to her lying on her sofa. Yep, a Freud joke did slip out as I did that, heh.

But seriously, it was so good to have this talk with her, and really dig deep in talking about some of the things I’ve broached on this blog – my anxieties, my resentments, my fears towards taking more steps if the final embryo transfer should fail, and my overall acute sense of mortality that’s come up during this process.

If any of you are having these crazytown moments like I have, get thee into a kickass counselor like mine. The more I talked about it with her, the more two things became crystal clear:

  • We want a family and if IVF doesn’t work this 6th and final try with the last of the good quality embryos, we’re going headfirst into domestic adoption. When I look back on my life in 50 years, I don’t want to say I didn’t make an effort.
  • After what happened with my mother abandoning me during my miscarriage this summer, I came to an epiphany while I spoke to my therapist. And it’s a big one y’all, something we all tell ourselves intellectually but don’t always believe emotionally:
    I am not my mother. I will never be like my mother. I am no longer afraid of turning out like her!  I am going to be a GREAT mother!

Fuck yeah!



14 thoughts on “ERA – Round One

  1. Wow. This is somewhat confusing. I mean, good for you for finding out you are pre-receptive! Welcome to the club. We just take a little longer to warm up 😉

    I will say, though, that it is strange that the conditions weren’t 100% recreated for biopsy as they were for transfer. I wasn’t doing PIO- just Crinone and suppositories- but basically during biopsy and transfer they’d have me take my crinone in with me to use later- not to use before transfer. So I really had 5 days for both transfer and biopsy. Which narrows down the chance of a pointless reading a little bit.

    So yeah, basically I suggest you do it after 6 days of PIO now…because skipping around isn’t terribly recommended. Believe me, you remember how impatient I was and how I wanted to skip my second biopsy and just “assume”- and then it came back as POST-receptive which is a total mindfuck. But I was glad to know, because the next embryo wouldn’t have had much of a chance with 6 full days of progesterone. Oy.

    Bad news is you gotta do this whole thing again. Good news is you’re getting ANSWERS.

    Liked by 1 person

    1. Update! I talked to the genetics counselor at Igenomix, and she said she understood my question completely but that everything depends on how long the progesterone is in your system… and my prior transfers were only 12 hours different, and their analysis shows I need to do something a full 24 hours later. So we shall see… I’m actually relieved though at least knowing that perhaps there’s a reason why things have been messed up these first five times. And hopefully I can catch up with you and be in pregnant land later this spring !!!

      Liked by 2 people

      1. That’s a good update!!! And that makes sense So glad you reached out to Igenomix directly. Yes, its such a relief to know you have some sort of an answer to the failures. And I look forward to you joining me in pregnant land in a few short months!


  2. Sorry can’t add as not an ERA but my experience was similar to ‘Upside of IF’s’ i.e. I took suppositories and not PIO therefore it kind of makes things ‘messy’ down there. So if I had the transfer in the morning the doc asked me to hold off and he inserted it at the end of the procedure. If it was an afternoon one, then I think I did my morning one and then he held off on the lunch time one and put it in after the transfer.


    1. Yeah my doc is insistent on PIO until the transfer, then after that he’s okayed the use of the supps. When I got pregnant this summer I was doing daily PIO shots up until the 9th week when I miscarried and every other shot in the last couple of weeks was hell as there were very few non-lumpy areas on my ass to shoot so half the time it was excruciating! During cycle 5 I did suppositories post transfer which were annoying having to do 4X a day (and yeah the mess, but better than an ass you can’t sit on comfortably), but they were partially covered by insurance whereas PIO and Delestrogen aren’t (crazy!).

      Funny I have had my RE up in there for everything else but I would be weird about him inserting a suppository, like someone putting a tampon in for ya, hmm…! 🙂


  3. Ok so some progress on ERA! I’m no help on that front, but hope you now have a plan going forwards with answers from Igenomix.

    I love that quote at the end of your post. You are not alone in your worry. my husband thinks similarly to what you write about your mother. He worries he will be like either of his mother and father. He is nothing like them though, I tell him that, but for him the worry is hard to shake. Of course Our parents influence the way we are, but I bet you know exactly what type of parent characteristics you don’t want to be which will make you a wonderful mother. It’s a very sensitive issue to write about, thanks for sharing. Loving the PMA!!


  4. I wish I could add some insight to this since I had my ERA in Oct. But I’ve noticed my doc doesn’t go by dose as such, more on the state of endometrium. So I’ve sort of given up on figuring out what’s happening and right now running on blind trust.😐


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