ENDOMETRIAL RECEPTIVITY ANALYSIS
Endometrial receptivity is the most crucial parameter for successful implantation in IVF procedures. Understanding a person’s individualized receptive endometrial window is very difficult to work but at the same time, it is most important to catch the window of implantation to give a successful pregnancy in an IVF cycle. The window of implantation is not the same for all women rather it is individualized and is displaced in one in four patients and it is the reason for most of the recurrent implantation failures.
Endometrial receptivity array testing is a diagnostic molecular tool that is based on the endometrial gene expression to find a woman’s individualized window of implantation. It gives the assessment of
the gene expression of particular endometrial samples and compare the different 236 genes
expressed in a receptive endometrium and it gives the result as receptive or non-receptive
endometrium.
Indication of ERA testing
- Reeurrent implantation failure where there is failure more than 3 to 4 IVF cycles despite giving morphologically good quality embryo.
- Before transferring the PGS embryo
The implantation window of a human embryo occurs 6 to 10 days post ovulation it lasts approximately four days from 20 To 24 of a regular menstrual cycle and clinical pregnancy rates when compared with slow freezing.
Endometrial preparation and biopsy timing
It can be performed natural cycle modified natural cycle for a hormone replacement therapy protocol.
In a natural cycle, the endometrial biopsy is performed at LH surge+ seven days.
Inner modified natural cycle it is administered root 3 when the follicle size becomes more than 17 mm
and the biopsy takes class seven days.
In an HRT protocol, the endometrial preparation is done by serial administration of estrogen tablets
and when the endometrium reaches more than 6to 7 mm, progesterone administration started and the
biopsy is performed 6 th day of progesterone support.
Interpretation of results
The result can be receptive or non-receptive.
Receptive means that the gene expression is similar to a normal receptive endometrium and the actual embryo transfer is performed in a similar way the ERA has been done.
Non-receptive can be very receptive or post receptive. Then the actual embryo transfer should be performed at the given time according to the result.
Clinical outcome after ERA
Era the best time to transfer embryos hence the implantation rates increases it allows analysed embryo
transfer and clinical outcome improves it also helps to improve the ongoing pregnancy rates compared
with fresh embryo transfer.