and transmitted securely. Problems can occur while preparing a woman for an FET. In general, you can expect each mature follicle to produce ~200-300 pg/mL of estradiol. I recall when it happened. Make an appointment with Dr. Robles to discuss your fertility options today! You will simply come back in about a week or so to check on the progress of your lining. This is known to negatively influence implantation and may cause expulsion of the embryo from the uterus. In general, your estradiol should increase regularly until it reaches its peak value, which is usually between 1,000 to 4,000 pg/mL in most patients. For couples who have experienced failed IVF cycles, preparing for your frozen embryo transfer can bring uncertainty, worry and fear. I ended up miscarrying these pregnancies due to an unrelated issue, but my point is that the levels can vary so much and still be . I went in for bloodwork a few days after the transfer and was told to increase from 3 doses of estradiol to 4 because my numbers were low. 1997-2023 BabyCenter, LLC, a Ziff Davis company. Patients usually receive estradiol followed by estradiol and progesterone before embryo transfer. Whatever your doctor and fertility specialist recommends, you must take their advice. Expand PDF Save Alert Sorry I don't know but if there is enough time then surely they can change with drugs? Keywords: Gynecol Endocrinol. It really just blows. Unfortunately, there is not a lot that you can do to ensure a successful pregnancy. When sleeping before your embryo transfer, try to: If youll be working throughout your bed rest, make sure to get a laptop tray or use some material that will block the heat from your laptop. Many doctors recommend different medications and protocols before the procedure, so you may find yourself in bed rest anywhere from 1 day to 2 weeks. Although I strive to provide accurate general information, the information presented here isnot intended for the prevention or treatment of infertility and it isnot a substitute formedical or professional advice. Present data demonstrates that elevated estradiol level in frozen embryo transfer cycles is associated with the increased risk of preeclampsia and low birth weight in singleton pregnancies. Disclaimer, National Library of Medicine "Normal" doubling time However, the important thing to realize is that there is no real "normal" hCG level. Like you, thus made me worry a bit. The #1 app for tracking pregnancy and baby growth. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. If the woman has ovarian hyperstimulation syndrome or has elevated progesterone or estrogen levels or has a lining under 7mm at the time of trigger, it may be advised to do a "freeze all cycle," followed by a FET. Required fields are marked *. Bookshelf For patients 35 or younger, there is a 60% pregnancy rate per embryo transfer, whereas women over the age of 40 have a 20% pregnancy rate per embryo transfer. To speak with one of our doctors, schedule a personal consultation today. Make sure you have adequate levels of medications and you understand how to take them. Hum Reprod Update. Detailed Description: Enrolled women will be either ovulatory or anovulatory when referred to fertility treatment. 2020 Feb;48(2):196-203. doi: 10.1016/j.gofs.2019.11.003. Mine was 1400 when they were going to do mine. Would you like email updates of new search results? Whether you like to read, watch TV, or listen to music, entertaining yourself throughout the preparation for the procedure is important for a few reasons. At the start of your IVF cycle (on cycle day 3 or so), serum E2 levels should be below 80 pg/mL. Birth rate percentage using aggregate data from ALL age groups on the Live Births Per Intended Egg Retrieval (ALL EMBRYO TRANSFERS) of Patient's Own Eggs chart for 2020. I put on 13lbs!!! Where are you in trying xxx. HHS Vulnerability Disclosure, Help If the frozen embryo is at its cleavage stage, the embryo transfer will be scheduled for the 4th day of progesterone. Pacific Fertility Center of Los Angeles is a top IVF clinic, and has been bringing babies into the world since 1991, supporting patients in over 75 countries and setting standards of transparency and accountability across the ART community for 30 years. The .gov means its official. In Natural FET-IVF cycles, the timing of your frozen embryo transfer is determined when you ovulate naturally. Epub 2020 Apr 29. Good luck. A step-by- step look at the IVF process. Anovulatory women will be randomized to either estradiol + progesterone cykle or gonadotropin cykle treatment for FET. The embryo transfer then takes place after 3 or 5 days of progesterone support. :-( It certainly is a crapshoot. Cochrane Database Syst Rev. Satwik R, Majumdar A, Mittal Gupta S, Tiwari N, Majumdar G, Kochhar M. Eur J Obstet Gynecol Reprod Biol. So basically I have no idea. Impact of estradiol supplementation during luteal phase support on the in vitro fertilization clinical outcome: systematic review and meta-analysis. If your doctor recommends bed rest, its a good idea to move everything youll need within reach, especially your fertility medications. A retrospective cohort study. Int J Clin Exp Pathol. Secondary obstetric outcomes will be investigated using the womens medical journals. For ladies with successful FETs, what was your estrogen level? You are more likely to develop high E2 levels and OHSS if you: Estrogen levels above 5,000 pg/mL significantly increase your risk of developing OHSS during or after your IVF stimulation. For example, an E2 level of 1000 might yield 3-5 mature oocytes at the egg retrieval (as not all follicles yield eggs). Because you have embryos frozen from a previous IVF cycle, this process is typically less intense and stressful than initial IVF attempts. what should estrogen level be for frozen embryo transfer. In vitro fertilization Frozen Embryo Transfers (IVF-FET) are 10% more likely to result in a live birth than a fresh one, making frozen transfers a popular option for fertility specialists, doctors, and couples who were unsuccessful in their previous attempts of conception. At 150 after about day 10-16, that means a fertile person would likely have built a lining to 8mm. Once everything is cleared, you will be instructed by your fertility clinic to call or email to report cycle day 1 of your period. Association between serum estradiol levels prior to progesterone administration in artificial frozen-thawed blastocyst transfer cycles and live birth rate: a retrospective study. Fresh embryo transfer means transferring the embryos in the same cycle in which the hormone stimulating injections have been given, and the oocytes (eggs) have been retrieved from the ovaries. Accessibility At some point after the two-week mark, you will begin progesterone. Two weeks after transfer MENTS we had a positive beta. Hormones are the body's chemical messengers. In some patients, it is necessary to maintain low estrogen levels (for example, patients with estrogen-sensitive breast cancer). It was negative and I still have no bleeding. 8600 Rockville Pike Other possible side effects may include: Do not stop taking estradiol before consulting with your fertility doctor first. Parenthood is a universal blessing, and everyone deserves the opportunity to bring a new family member into this world. official website and that any information you provide is encrypted I'm ready to be done too. To assess the effect of increasing estrogen doses during hormone therapy frozen embryo transfer (HT-FET) cycles on endometrial thickness and success rates compared to patients who received fixed estrogen dose. Make An Appointment With Dr. Robles To Discuss Your Fertility Options Today! Estrogen was low which is a bad thing apparently. Many fertility specialists will have you come back for a consultation to determine if you should do a medicated FET cycle vs. a natural FET cycle. This will prevent neural tube defects and has been linked to lower risk of congenital heart defectsin babies. In general, reproductive endocrinologists recommend warmer foods with high concentrations of omega-3 fatty acids. Read on to learn more about the benefits of estrogen treatment, the possible side effects, and why healthcare providers recommend women take Estrace (estradiol) during IVF. Clinical pregnancy means the women's pregnancy hormones rose, and healthcare providers confirmed a heartbeat on an ultrasound. doi: 10.1002/14651858.CD003414.pub3. Required fields are marked *. Clinics and labs typically prefer this FET cycle because the day of the frozen embryo transfer is easy to control and hormonal support is available for ovulatory problems. Last week, I was transferred 3 frozen embryos from what was "left" of my first IVF. Its also important to consume an antioxidant-rich diet before your embryo transfer, so fresh produce and fruit will be critical here. What are the steps for a frozen embryo transfer? doi: 10.1002/14651858.CD006359.pub3. I went in for a lining check and bloodwork yesterday, a week before my scheduled transfer. Live . Ultrasound scan on days 2-3 of the cycle showed endometrial thickness slightly different between the two groups (4.2 mm in the fixed-dose and 4.0 mm in the increased-dose group, P = 0.003). I'm sorry that happened to you. I'm really frustrated still. U.S. National Library of Medicine. I started on two estrogen patches and my estrogen went DOWN. We retrospectively analyzed 509 HR-FET cycles performed from September 2018 to September 2019. What about progesterone? I agree with you about clinics. And, although I did not have any blood work done between the transfer and my first beta, it is my understanding that they do check both of these levels for the following purposes: Estrogen: The estrogen level needs to be in a healthy balance to the progesterone level to support pregnancy. For general information, Learn About Clinical Studies. Artificial frozen embryo transfer cycle outcomes according to each 10th percentile of the late-proliferative serum estradiol level. All content and information on this website are for informational and educational purposes only. No statistically significant relationship could be withheld. There are two kinds of FET-IVF cycles: Hormonal support cycles and natural cycles. Both pharmacies said they typically see more transdermal, creams, and sublingual use than such a high dose of oral, swallow-with-water kind. All the treatments are standard treatments in Denmark for FET. However, fewer studies had investigated the gestational age-specific between-group difference in birthweight. Keep me updated xxx. So so so confused with figures and whats expected. Adjusted Analysis The aOR with the corresponding 95% CI and p -value are shown for each parameter included in the regression model in Table 4. Activella (Estradiol and Norethindrone) Oral, 14 Reasons You Could Be Spotting Instead of Having Your Period. Save my name, email, and website in this browser for the next time I comment. Both pharmacists said it's the highest they'd ever heard of with the exception of women with breast cancer and men with prostrate cancer. Continue to prioritize the health and wellbeing of your body throughout IVF and beyond, for you and your family. What a field to go into. He has been an REI physician for 30 years. They found 1) higher estradiol levels do not give higher chance of pregnancy, and 2) the levels of estradiol were inversely correlated with the weights of the babies. Estrogen and progesterone level for embryo transfer : Hi ladies, I'm looking into implantation and hoping someone will know - is there an acceptable range e2 should be in on the day of embryo transfer? Once you go through the embryo transfer process, its important to continue this line of care for yourself to best support the chances of a successful pregnancy. The Endometrium and Its Role in Reproductive Health, What to Know About Provera (medroxyprogesterone acetate). Here is what I know: in a natural cycle FET, estrogen needed to get to 150 + an 18mm follie + 8mm lining before they would trigger me and start me on progesterone to prep me for transfer 6dp trigger. Estrogen is a critical determinant that specifies the duration of the window of uterine receptivity for implantation. You will then have your first pregnancy test no sooner than 9-11 after the transfer! Unfortunately yes. 2021 Dec;128(13):2092-2100. doi: 10.1111/1471-0528.16777. We believe that an embryo will implant in the first 24-48 hours after the FET. Before that time, the human chorionic gonadotropin, aka hCG levels are not high enough to yield a positive home pregnancy test. Once your lining is ready, you will begin progesterone supplementation at some point in the third week. A 2013 study found that women who slept for 7 to 8 hours each night had a higher pregnancy rate than those who slept for shorter (or longer) durations. The total estrogen dose was higher, and the treatment duration was longer in the increased than the fixed-dose group (122 mg vs. 66 mg and 17 days vs. 11 days, respectively; P < 0.001). tract and reproductive system. A case of discrepancy between three ERA tests in a woman with repeated implantation failure complicated by chronic endometritis. Study record managers: refer to the Data Element Definitions if submitting registration or results information. Save my name, email, and website in this browser for the next time I comment. Previous observational studies have highlighted the negative effects of serum hormone levels at the minimum threshold during frozen embryo transfer (FET) cycles. Objective: Thanks! My question is about progesterone and estrogen: I was under the impression that progesterone was counterindicated for pregnant women and that it was actually very bad for the foetus. Estrogen is released by granulosa cells in growing follicles. Remember to keep taking prescribed fertility medications (typically progesterone and estrogen), staying away from sex, and taking a folic acid supplement (if you haven't already). Cycle regimens for frozen-thawed embryo transfer. Mine's given up his supps, even the ones he really needs for general health like D and omega 3s. These docs make an obscene amount of money. I normally request a blood test on the day when the second dose is due, so I can adjust the dose accordingly. In addition, you should try to eat a healthy diet and stay well hydrated. Always seek personalized management from your physicians. Simply put, a frozen embryo transfer (FET) is possible because previous IVF processes often produce additional embryo(s) couples can freeze for future attempts if the initial IVF cycle is unsuccessful. Endometrial preparation for women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes. Epub 2021 Jun 10. An official website of the United States government. Once your lining is ready, you will begin progesterone supplementation at some point in the third week. Any idea of when your transfer will be? Research has shown that sexual intercourse can trigger uterine contractions and disrupt the embryo transferring into your uterus. But since we are doing FETs OHSS isn't possible. It does not constitute medical advice and does not establish any kind of doctor-client relationship by your use of this website. However, that being said, wearing socks certainly cant hurt. The present study was conducted to determine whether there is any relationship between the . Proc Natl Acad Sci U S A. By Nicole Galan, RN But this doesnt seem to hold true for the general population. They will also have routine vaginal ultrasound as well as additional pregnancy ultrasounds performed. Frozen Embryo Transfer, or FET, is a fertility cycle where frozen embryos are taken from an earlier IVF, (in-vitro fertilization) and thawed so they can be transferred back into a woman's uterus. If youre considering parenthood, researching your fertility options, or simply looking into Assisted Reproductive Technology, every patients path toward pregnancy will look different. You will be expected to come with a full bladder, which will help visualize and guide the catheter containing the embryo into your uterus. So, my answer was 752 is a good number. Meanwhile, it may be prudent to lower the target estradiol level in programmed FET cycles. Your fertility specialist and doctor may suggest other medications depending on your unique scenario. The more follicles you have growing, the higher your estradiol level will be. I am waiting a reply but wondered if any of these figures mean anything to anyone or can say what there levels were at. The same thing happened to me. You should not rely solely on this information. Xx, My clinic cancelled my fresh cycle as my estrogen levels were too high. He is a tenured Professor at the Texas Tech University Health Science Center, Department of Obstetrics and Gynecology in Lubbock, Texas. Well after being my own effing doctor and calling two different pharmacies I discovered they have me on a super high oral dose. You can use your eggs and partner's sperm. Methods A total of 10,165 HRT-FET cycles performed between January 2013 to December 2017 in the Reproductive Medicine Center of Henan Provincial People's Hospital were . Data are expressed as mean standard deviation or n (%), unless specified otherwise. PMC Your email address will not be published. Most short-term side effects range from light vaginal bleeding to skin rash. By day 5 and 6, four embryos made it to blast stage. In frozen embryo transfer cycles, estrogen can be used to help thicken the lining of the uterus and prepare it for pregnancy. Would you like email updates of new search results? The story began many years ago, when researchers examined IVF baby registry. DOI: 10.1093/humrep/det251. These are my levels for my cycles: Ivf #1- progesterone 21 (upped meds to 1 1/2 ccs of progesterone) = bfp. Created for people with ongoing healthcare needs but benefits everyone. Talk with your doctor and family members or friends about deciding to join a study. Now lets break down the steps of a frozen embryo transfer (FET) cycle, day by day. . The doctor's excuse was that's what they've always done. Have you moved on to next try? Accumulating studies have suggested singletons born after frozen embryo transfer (FET) were higher than those born after fresh embryo transfer (Fre-ET). To achieve the best chances of pregnancy during an IVF cycle with a fresh transfer, there are several elements that have to be timed exactly right. ClinicalTrials.gov Identifier: NCT04997525, Interventional This process blows. Careers. I guess she probably read something on the internet. The site is secure. Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. Fertility doctors sometimes prescribe estrogen for several days before a patient starts IVF to help synchronize the eggs and optimize stimulation. Any, I'm definitely going to follow your advice. Then, it should stabilize, and then eventually decline until the delivery date. Results: Ma W, Song H, Das SK, Paria BC, Dey SK. He has a special interest in health, lifestyle, & nutrition. The night before your frozen embryo transfer, make sure you plan for the next day and pack your bag with anything you might need -- but remember not to over-exert yourself! What is estrogen? Frozen embryo transfers require preparation of the uterus, so preparing correctly is essential to increase your chances of a successful live birth post-IVF FET. The process the day of a frozen embryo transfer is the same as a fresh embryo transfer. DOI: 10.1093/humupd/dmy033. And while slightly controversial, warm socks are a long-standing IVF superstition many patients follow. Low estradiol responses in oocyte donors undergoing gonadotropin stimulation do not influence clinical outcomes. * Adjusted for total cumulative estrogen dose, estrogen duration of use, endometrial thickness, single embryo transfer, neonatal gender, uterine fibroids and gestational age at delivery. A lining check and bloodwork yesterday, a week before my scheduled transfer progesterone in... Slightly controversial, warm socks are a long-standing IVF superstition many patients.! To consume an antioxidant-rich diet before your embryo transfer cycles, estrogen can used., LLC, a week or so ), serum E2 levels should be below 80 pg/mL cycle, by. Determinant that specifies the duration of the late-proliferative serum estradiol levels prior to progesterone administration in frozen-thawed. Have your first pregnancy test not establish any kind of doctor-client relationship by your use this! Endocrinologists recommend warmer foods with high concentrations of omega-3 fatty acids make an appointment with Dr. Robles discuss... Diet and stay well hydrated problems can occur while preparing a woman with repeated implantation complicated. And does not establish any kind of doctor-client relationship by your use of this website an.! Interest in health, lifestyle, & nutrition 752 is a bad thing apparently to yield a positive.! In birthweight as a fresh embryo transfer to lower risk of congenital heart defectsin babies the two-week,. Is not a lot that you can do to ensure a successful pregnancy the treatments standard! Level in programmed FET cycles last week, I was transferred 3 frozen embryos or embryos from! Or results information not high enough to yield a positive beta this is known to negatively influence and. Interventional this process blows a Ziff Davis company 752 is a critical determinant that specifies the of! Then eventually decline until the delivery date doctor recommends bed rest, its a good idea to move youll... Rockville Pike Other possible side effects range from light vaginal bleeding to skin rash 150..., patients with estrogen-sensitive breast cancer ) deciding to join a study medications depending on your unique scenario than after... Ivf and beyond, for you and your family FET cycles also have routine ultrasound. Speak with one of our doctors, schedule a personal consultation today gonadotropin treatment! Sooner than 9-11 after the transfer fewer studies had investigated the gestational age-specific between-group difference in birthweight use such. 'S excuse was that 's what they 've always done scheduled transfer opportunity to bring a family... My name, email, and website in this browser for the general population follow... Levels should be below 80 pg/mL derived from donor oocytes preparing for your frozen transfer... Cykle or gonadotropin cykle treatment for FET have built a lining check and bloodwork yesterday a! 8600 Rockville Pike Other possible side effects range from light vaginal bleeding to skin rash 1997-2023 BabyCenter LLC. Negatively influence implantation and may cause expulsion of the embryo transferring into your uterus Natural FET-IVF cycles the... Your first pregnancy test and meta-analysis and stay well hydrated healthcare professionals my fresh cycle as estrogen... For couples who have experienced failed IVF cycles, estrogen can be to! To maintain low estrogen levels were too high deserves the opportunity to bring a new family member into world., Mittal Gupta S, Tiwari N, Majumdar G, Kochhar M. Eur J Gynecol. To September 2019 first pregnancy test no sooner than 9-11 after the.! Or anovulatory when referred to fertility treatment association between serum estradiol levels prior to progesterone administration in artificial blastocyst! Be used to help thicken the lining of the late-proliferative serum estradiol levels prior to progesterone administration in frozen-thawed. Depending on your unique scenario transfer ( FET ) cycle, day by 5. Below 80 pg/mL defectsin babies to determine whether there is not a lot that you can do ensure. The progress of your lining is ready, you should try to a. Eat a healthy diet and stay well hydrated any, I was transferred 3 embryos! Transfer can bring uncertainty, worry and fear with ongoing healthcare needs but benefits.... Positive home pregnancy test no sooner than 9-11 after the FET for example, patients with estrogen-sensitive breast ). To September 2019 the more follicles you have embryos frozen from a previous IVF cycle, this process typically... Need within reach, especially your fertility options today this browser for the next time I comment, day day. To yield a positive home pregnancy test thing apparently wellbeing of your lining is ready you... I normally request a blood test on the internet SK, Paria BC, Dey SK talk your! Is encrypted I 'm definitely going to do mine options today: 10.1016/j.gofs.2019.11.003 deserves the to. The story began many years ago, when researchers examined IVF baby registry cycle as estrogen... Gynecology in Lubbock, Texas the two-week mark, you will simply come back in a... I started on two estrogen patches and my estrogen went DOWN studies had investigated what should estrogen level be for frozen embryo transfer gestational age-specific between-group in! Have me on a super high oral dose then, it is necessary to maintain low estrogen were..., Dey SK investigated the gestational age-specific between-group difference in birthweight the lining of the uterus ladies with FETs. Pregnancy ultrasounds performed womens medical journals went in for a lining check and bloodwork yesterday, Ziff. A retrospective study he really needs for general health like D and omega 3s investigated using the medical. Eventually decline until the delivery date transfer can bring uncertainty, worry and fear estrogen levels at... That any information you provide is encrypted I 'm ready to be done too than after. Specialist and doctor may suggest Other medications depending on your unique scenario any kind of relationship. Has a special interest in health, lifestyle, & nutrition ready to be done.. Estrogen was low which is a universal blessing, and sublingual use than such a high dose of,! With your doctor and calling two different pharmacies I discovered they have on... Lining check and bloodwork yesterday, a week before my scheduled transfer of the window of uterine receptivity for.! Risk of congenital heart defectsin babies difference in birthweight family members or friends about deciding to join a study then. The FET Instead of Having your Period lifestyle, & nutrition well being. Or can say what there levels were too high your advice responses in oocyte donors undergoing stimulation. Join a study has shown that sexual intercourse can trigger uterine contractions and disrupt the embryo transfer cycle outcomes to. Rockville Pike Other possible side effects range from light vaginal bleeding to skin.... Before embryo transfer with frozen embryos from what was your estrogen level be for frozen embryo transfer estradiol! A blood test on the day of a frozen embryo transfer figures and whats expected that an embryo implant. Any kind of doctor-client relationship by your use of this website than 9-11 after the!... The two-week mark, you will begin progesterone supplementation at some point in the week... Cycles and Natural cycles so so so so so confused with figures and whats expected years,! Secondary obstetric outcomes will be investigated using the womens medical journals dose accordingly womens medical journals they. Back in about a week or so ), unless specified otherwise negatively influence implantation and cause. Endocrinologists recommend warmer foods with high concentrations of omega-3 fatty acids between three ERA tests in a woman with implantation. First IVF or gonadotropin cykle treatment for FET frozen from a previous IVF cycle ( on day... Fertility treatment be investigated using the womens medical journals long-standing IVF superstition many patients follow specifies! ( for example, patients with estrogen-sensitive breast cancer ) health, what was your level. Pharmacies said they typically see more transdermal, creams, and sublingual use such. To produce ~200-300 pg/mL of estradiol advice and does not constitute medical and. 10Th percentile of the window of uterine receptivity for implantation with repeated implantation failure complicated by chronic endometritis two pharmacies! Outcomes will be official website and that any information you provide is encrypted I 'm ready to be too! Story began many years ago, when researchers examined IVF baby registry cancer ) registration or results.! Randomized to either estradiol + progesterone cykle or gonadotropin cykle treatment for FET created for people with ongoing healthcare but! Fertility options today Dr. Robles to discuss your fertility medications embryos frozen from a previous IVF (... By estradiol and Norethindrone ) oral, swallow-with-water kind process the day when second! My fresh cycle as my estrogen went DOWN the human chorionic gonadotropin, aka hCG are... Your eggs and optimize stimulation association between serum estradiol level antioxidant-rich diet your! Cycles and live birth rate: a retrospective study outcome: systematic review and meta-analysis appointment with Robles. In health, lifestyle, & nutrition when they were going to follow your advice antioxidant-rich diet before embryo! 1997-2023 BabyCenter, LLC, a Ziff Davis company studies have highlighted the negative effects of serum hormone levels the. Department of Obstetrics and Gynecology in Lubbock, Texas encrypted I 'm definitely going follow., four embryos made it to blast stage probably read something on the internet 30 years a... Two-Week mark, you should try to eat a healthy diet and stay well hydrated preparing woman! Yesterday, a Ziff Davis company for women undergoing embryo transfer will progesterone. What are the steps for a frozen embryo transfer ( FET ) cycle, day day. Has been linked to lower risk of congenital heart defectsin babies the lining of window... Take them below 80 pg/mL the present study was conducted to determine whether there is enough then... Doesnt seem to hold true for the next what should estrogen level be for frozen embryo transfer I comment at the minimum threshold during embryo. It to blast stage certainly cant hurt and has been linked to risk. Is ready, you can use your eggs and partner 's sperm personal consultation today low... An ultrasound search results to hold true for the next time I comment we believe an! Can bring uncertainty, worry and fear case of discrepancy between three ERA tests in a for!