Not sure if its been mentioned, but why not Ety's custom tips? I've heard mixed reviews on them, but I'm leaning towards getting custom also. Its really hard to get a consistent seal with any of the universal tips without effort or pain.
If keeping the etymotic's flat awesome sound is important to you do NOT get the custom tips through their program. It WILL change the sound. How much someone care's is another story. For me it exaggerates the treble greatly and I lose all the reference quality of the er4s. I'm on my fourth retry and second remold.
Rin has the exact same story with measurements even on his website. This is essentially what happened with mine:
http://rinchoi.blogspot.com/2013/05/etymotic-research-customfit-ear-sleeves.html
However, with the last iteration they managed to get the housing deeper into the mold and therefore closer to my eardrum. But the difference is minimal at best. They are still far from the original sound. Are they more comfortable? I suppose. They don't dig deep into your ears like the ety, but I don't find them amazing either. They just sort of feel like most earphones but bigger. I prefer the pfe112 for comfort over anything I've ever tried. Oh well.
If you absolutely can't stand the ety tips then perhaps this would give you a similar enough sound with better comfort. However, it will be different. So if the sound is critical, and you don't want the comfort issues, I'd switch earphones before I used the customs. I'd rather use my earpods with no eq than my er4s with customs. No joke. They're too bright and peaky. They also don't seal as well as the er4s. And I don't really believe people who say they do. I think they weren't getting a proper fit to begin with. The ety can achieve 30-40db of isolation. I think this is partly due to the depth and the way the tips and housing seal. The silicon customs change this and reduce the isolation. They aren't bad, but not as good.
I would say the only reason to ever get them is comfort, but for me personally the sound is different enough that I'd rather use another earphone. I always talk about the pfe112 if you follow this thread and I'd MUCH rather take the small amount of distortion compared to the ety custom sound. But that's me. I have heard a few success stories, but more failures. And of the success stories how do we know they didn't prefer the bright sound just like some people prefer bassy sound? Who knows.
Just be aware they will sound different. I think etymotic doesn't want to dissuade anyone from using the customs, and that is understandable, so they just say they could change the sound but can't guarantee anything. They don't want to say "yeah, it will definitely change the sound". No one would buy them. But if they say "no they sound exactly the same" a lot of people would be even more mad.
If the money isn't too much, i guess that's your call as to how important the comfort it. But I wouldn't do it again. Maybe from someone like westone or something, as i've seen fuller deeper customs that might help, but that would be it.