Endometrial receptivity enhances the chance of successful implantation.
Endometrium is a tissue lining the interior of the uterus where the embryo attaches and grows during pregnancy.
Receptive endometrium means that the uterine lining is ready for the implantation of the embryo. The period of receptivity is usually between days 19-21 of the menstrual cycle. This is called the window of implantation.
In a frozen embryo transfer, the exact timing of the receptive period cannot be determined with accuracy.
Displaced window of implantation
The phase of receptive endometrium will not be the same in all women and may show variation in both natural cycles and also in the endometrium prepared for a frozen embryo transfer.
3 in every 10 patients have a displaced window of implantation.
Endometrial Receptivity Array
This is a genetic test done to assess the expression 238 genes within the endometrium using a novel testing method called Next Generation Sequencing (NGS). The samples are processed in Spain (Igenomics) and the results will tell us when the best time to transfer will be, based on the genetic information
Preparation for ERA
On day 2 of your periods, a scan will be done to ensure that your uterine lining is thin and you will be given estrogen tablets for about 7 – 12 days and once the endometrial thickness is adequate (8mm or more), progesterone levels in your blood will be tested. Your progesterone level must be less than 1ng/ml for us to start progesterone injections. The ERA test will be done on the 6th day of starting the progesterone injections.
An early light breakfast is advisable. This procedure is done without anaesthesia. A full bladder makes the process easier. Using a fine pipelle catheter, a sample of the uterine lining will be taken in the OP room. The same will be sent for evaluation. You may feel slight cramping during the procedure. We usually advise insertion of a suppository for pain relief half an hour prior to the procedure. Occasionally, we may have difficulty obtaining a sample, especially if the uterus is tilted sharply forward and in these cases a short anesthetic (IV sedation) may be required.
It will allow for a personalized embryo transfer. The chances of getting pregnant are increased after personalized embryo transfer. But this test cannot guarantee a positive pregnancy test.
The ERA test resulted in a 73% pregnancy rate in patients with recurrent implantation failure. Your embryo transfer will be timed according to the report.
After ERA, you will be given some tablets for about 2 weeks and the embryo transfer will be planned in your subsequent cycle. Once we receive the report, you will be informed of the same by one of our hospital staff.