IVF/ IUI & all forms of TTC not working? The benefits of the Yale Endometrial Function Test

The Yale endometrial function test

 

I feel like a broken record. IUI didn’t work for us again. It was our 4th round on top of 4 IVF’s in 4 years and I’m utterly exhausted with this process. Although I prepared for the worst… I was convinced it worked. My symptoms got increasingly stronger (breast tenderness/ cramping). Until we got the negative. So why am I now doing this new Yale Endometrial Function Test?

At my ‘WTF happened?’ meeting my RE said it was strange because everything seemed to go perfectly. The lower dose of stimulation meds produced 4 synchronized follicles and we triggered at the perfect size (around 17mm – not too mature).

The reason it probably didn’t go to plan was either the embryos weren’t genetically viable OR there could be implantation issues (related to the lining including immunology). I did explore the idea that my body was attacking the embryos, mistaking them for little invaders but when I mention this to my RE’s – they usually dismiss it because it’s so complicated. Here’s a good post explaining why.

Yet, I constantly hear stories of women believing that immunology was the reason they couldn’t conceive and carry a healthy pregnancy (after multiple failed rounds of IVF) and only when this was addressed – it worked. My current RE is open to immunology but isn’t convinced I have it because she thinks she found and addressed the causes of our issues (my septate uterus and my husbands DNA fragmentation).

It was a valid point, but I wanted to have immunology testing before our last-ditch IVF attempt. So she suggested I do another test instead called the ‘Yale Endometrial Function’ test which will checks for a variety of lining issues including immunology.

MAIN TEST BENEFITS:

    1. Signs of infection.
    2. Immunology issues.
    3. Endometriosis (you can’t detect this by eye).
    4. If the embryo can implant in my lining and grow in my uterus.
    5. Any signs of tumor/ cancer or hyperplasia.

Implantation abnormalities are believed to be one of the main causes of unexplained infertility in women. The Yale people describe it like the same way plants need perfect soil conditions to grow and flourish. So before doing our final IVF and wasting more money, time and energy this will inform us if the soil (my lining) is healthy enough for the plants (embryo) to grow.

PROCESS:

I was given A LOT of meds which blew my mind. This simple test was more complicated than the meds I took for IVF! I added the full protocol below but in short:

    • Estrogen patches and progesterone inserts to build my lining, then steroids and antibiotics for the biopsy.
    • They took 2 biopsies of my uterus at certain times of the cycle (day 12 and day 21). I had valium both times as it is painful. Like a more intense version of a PAP smear test with at least 20 seconds of a sharper pain.

Although they colour code the bottles to help, the pharmacy did make one potentially huge error….

One night as I was going to bed I began to read the antibiotic bottles in more detail (which the nurse told me to take with food) however, this one said ‘TAKE VAGINALLY’ I nearly choked in panic, oh no I’ve been swallowing vagina pills, how could this happen?! I emailed my nurse straight away and she confirmed it was a mistake. BIG mistake pharmacy!

THE COST (more detail below):

The Yale Endometrial Function Test is not as pricey as the full immunology testing at approx $2,500 compared to the 10’s of thousands of dollars that can add up with immunology testing and treatment. Gulp.

RESULTS:

It will take 2 weeks for answers so i’m back in the 2 week wait hurrah! Although i’m hoping it’s all clear if there is a problem at least we have more answers. And then we can solve the issues before doing any more treatment.

MY DETAILED PROTOCOL:

Day 1 – Call the clinic.
Day 3 – In for ultrasound to check lining.
Day 4 – Start taking estrogen patches (e.g. 1 Vivelle patch).
Day 6 – Remove 1 patch and replace with 2 new patches.
Day 8 – Replace 2 patches for 2 new ones.
Day 9 – Ultrasound to check lining.
Day 10 – 1 patch AND 25g progesterone (insert) at bed time.
Day 11 – 1 Doxycycline antibiotic (100mg), 1 Medrol steroid (16mg) and 2 progesterone inserts (25mg am & pm)
Day 12 – EFT 1 (biopsy)  -1 Doxycycline antibiotic (100mg), 1 Medrol steroid in the morning (16mg) and 2 progesterone inserts (25mg am & pm) and 1 new estrogen patch. I also took 5mg valium for the pain but was told I can take 800mg of Advil. I couldn’t drive home so needed a lift.
Day 13 -1 Doxycycline antibiotic (100mg), 1 Medrol steroid am (16mg) and 2 progesterone inserts (50mg am & pm)
Day 14 -1 Doxycycline antibiotic (100mg), 1 Medrol steroid am (16mg) and 2 progesterone inserts (50mg am & pm) and 1 new estrogen patch.
Day 15 -1 Doxycycline antibiotic (100mg), 1 Medrol steroid am (16mg) and 2 progesterone inserts (100mg am & pm).
Day 16 – 2 progesterone inserts (100mg am & pm) and 1 new estrogen patch.
Day 17 – 2 progesterone inserts (100mg am & pm).
Day 18 – 2 progesterone inserts (100mg am & pm) and 1 new estrogen patch.
Day 19 – 2 progesterone inserts (100mg am & pm).
Day 20- 2 progesterone inserts (200mg am & pm) and 1 new estrogen patch.
Day 21 – EFT Biopsy 2 –  2 progesterone inserts (200mg am & pm) and I took 10mg valium for the pain.

COST BREAKDOWN

E2 P4 CYCLE DAY 2- $222
E2 P4 CYCLE DAY 8 – $222
MID CYCLE SCAN/ LABS – $457
BIOPSY #1 – $210
BIOPSY #2 (7 days later) – $210
ENDOMETRIAL FUNCTION TEST $595 EACH X 2
TOTAL APPROX – $2,511

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