What ERA testing measures

We want to give patients who visit our Virginia fertility center the best chance of having a successful pregnancy. Endometrial receptivity array testing, also called ERA testing, can help us do this by indicating the best time to transfer an embryo to the uterus.

The timing of embryo transfer is important because the embryo must implant in the uterine lining (endometrium) as the first step in a successful pregnancy. Implantation is a complicated process and timing is critical. When our fertility specialist transfers an embryo to a patient’s uterus, the embryo is at a stage of development when it is prepared to release the chemicals necessary for implantation.

Ideally, when the embryo is transferred to the uterus, the endometrium is also physically and chemically ready for implantation. Recent research has indicated that, for some women, the endometrium is not at peak receptivity when doctors expect it to be. If the endometrium is not receptive, the embryo may not implant at all. The embryo could also implant weakly, resulting in early pregnancy loss. For most women, the endometrium is receptive 6 days after starting progesterone in a programmed frozen embryo cycle, but some women need 5 days while others need 7 days before the embryo is transferred.

How Igenomix ERA testing works

Doctors refer to the condition where the embryo is ready to implant but the endometrium is not receptive as dyssynchrony, i.e a mismatch between the embryo and the endometrial lining. Our Virginia fertility center uses Igenomix ERA testing to avoid dyssynchrony. The steps of this test are as follows:

• Endometrial biopsy. During a natural or hormone-induced cycle, our fertility specialist will administer hormones to stimulate the uterus to prepare for pregnancy. They will biopsy a small amount of endometrial tissue when the endometrium should be receptive.
• Laboratory analysis. Lab technicians will extract genetic material from the biopsy and analyze the 248-gene sequence involved in endometrium receptivity for signs that the patient’s endometrium is receptive.
• Report. If the genetic analysis indicates receptivity, the day of the patient’s cycle that the biopsy was taken will be reported as her window of implantation. If not, our specialist may repeat the test cycle, taking the patient’s biopsy on a different cycle day in the hopes of pinpointing her receptivity.

If the ERA testing indicates potential dyssynchrony, our fertility specialist can attempt a personalized embryo transfer based on the patient’s window of implantation. He will transfer an embryo to take advantage of the time the patient’s endometrium is receptive, rather than timing the transfer based on when the average woman is receptive.

ERA testing promotes pregnancy success

Recent research demonstrated that a significant number of women who have had at least one failed implantation after IVF were experiencing dyssynchrony. In small group studies, personalized embryo transfer based on the window of implantation resulted in higher rates of implantation and pregnancy success.

To learn more about whether ERA testing could work for you, contact our Virginia fertility center.