ERA or transfer?

Question

Hi everyone, hoping I can get some opinions on my next steps. I'll try to summarize as best as I can!
I'm 31 (turning 32 next week), husband is 32. I have PCOS and my husband has MFI (low count and morphology).
1st IVF - 5 retrieved, 4 fertilized, 4 morulas on day five (so one day behind). We transferred the best morula, and the others did not make it to freeze.
2nd IVF - cancelled halfway due to low response. The reason my response was low the first two rounds was that my doctor was terrified to overstimulate me due to my extremely high AMH.
3rd IVF - 18 fertilized, 3 blasts (4AB, 3AB, day 6 3CB), did not do PGT-A. 
We transferred the 4AB last month and unfortunately it did not work. I'm at the point in my infertility journey that I've had 2 transfers (I kind of count it as 1.5 since none of the other morulas made it and I'm convinced the one they transferred didn't either). I'm trying to decide if I should try the ERA next cycle or go into another transfer. 
I'm personally leaning a bit more towards doing it, and the thing that puts me off it the most is that my clinic has been extremely conservative in their treatment due to Covid. Meaning that my original ivf cycle was delayed 3 months (similar to many others) and they are really controlling the number of transfers they do a month. They aren't even accepting day 1s for transfer cycles until September/1. I was only able to transfer earlier this month due to my doctor fighting for me. I'm on birth control now so that I can get for in a couple of days and call in my day 1 the first week of September. 
I'm scared of a second wave and them canceling all transfers again and holding my embryos hostage (or that's what it feels like lol). Im from Toronto and it doesn't seem like other clinics are doing this. I hate that this is a consideration for me but I really want to be able to do another transfer this year. My doctor said that she's not concerned about implantation failure quite yet,  however I am so scared of the regret that I will have if I do another transfer that fails, do the ERA anyway, and end up testing not receptive. 
My husband is on the fence, leaning slightly more towards just going for another transfer. I would love to hear your opinion on this, thanks in advance!

Answer

I had a successful FET and then had two more unsuccessful ones after that. I chose to do the ERA because I only had a couple embryos left. I really wanted to do another transfer and not be set back a few months, but on the flip side didn't want to essentially throw away a good embryo if I wasn't receptive. It turns out I was prereceptive and the FET after finding this out and adjusting my meds worked! We all have different journeys and situations, so in the end you need to do what makes sense overall for your situation. For me the ERA was totally worthwhile!

Answer

ERA! Our first fet is 9/8. We only have two embryos and they were donated to us so we wanted to be sure we increased our success as much as we could. I’m SOOOO happy we did the ERA! I found out I need an entire 24 more of progesterone before transfer. I am a huge ERA believer now! We would have most certainly lost our first embaby if we transferred during the standard window.

Answer

Technically uv had only 1 proper transfer (considering the 1st was embryo quality issue) , so i would say do 1 more, then see if u need an ERA.

Answer

Lots of factors here! How many embryos do you have now, 2? Will you be able to go straight into another transfer, or will you have to wait for ERA results? I totally understand wanting to move quickly to the next steps and just be pregnant already. 
I don’t want to speak to what you *should* do, but I’ll share my experience with you. 
I did my ERA after my second failed transfer. My results came back pre-receptive and I wish I’d done it sooner. Luckily we started with 10 PGT tested embryos. If we’d had fewer, I probably would’ve been more insistent on completing more testing up front. 
That said, idk how I would feel if my results returned ‘receptive’. I like to think I would be grateful to have the confirmation that we are on the right track. But I know it’s hard to accept hitting pause on this journey for another month, when we’ve been waiting so long to be pregnant.

Answer

I would do another transfer cycle since it seems like your embryos weren’t good quality to begin with so we can’t blAme it on your lining.. would also save time and with covid, you  ever know! I’m in Montreal Canada and it was the same here!

Answer

Would an ERA put you out just one cycle? I ended up choosing to do an ERA before trying any transfers but I also only have two PGT tested embryos so that was a large determining factor for me. We can’t afford to do another retrieval for a long time so I wanted to do every test I could before transfer to give my embryos their best shot and know as much about my body beforehand.

Answer

I would probably just go ahead and do the transfer. In my opinion the problem was more with the quality of the embryos, rather then the implantation (can’t say from only one transfer). I also have PCOS, and my first transfer didn’t take, it was a pgs tested embryo and the lining was good, so we don’t know why it didn’t stuck 🤷‍♀️ the second month we did another transfer and it did, no changes in the protocol except adding baby aspirin. So I would say if my second transfer would’ve fail, I may have considered ERA, but I think one, was just not enough. But I had a lot of embryos, 16 to be exact, so another retrieval was out of the scene, since you have no many left and you don’t want to risk loosing them, you can try.

Answer

I did an ERA after my second transfer and I was pre-receptive needed 24 hours of progesterone. My 3rd is a success as far as implantation and currently pregnant

Answer

I would do another cycle before considering an ERA.

Answer

If I was put in your position, and had to choose between ERA and FET....I would just try to transfer first due to Covid. Since Covid thrives in the Fall/Winter type of environment we don’t know if things will get shut down again..... it was very painful for me to have my cycle cancelled from Covid and have wait for an unknown reopening date to resume transfer/treatment. Torturous. I would rather have already transfer and hope that I had a chance than to wait to have a chance. 
The obvious ideal scenario is doing an ERA and then your transfer. If you can do this within the timeframe, then by all means go for it!
Just my 2 cents! All the best. Let us know what you’ve decided! Good luck!!!

ERA or transfer?

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