Dr Gayatri Satpathy

Endometrial receptivity

Many women undergoing IVF are unable to get pregnant, even after transferring good quality embryos. Although a good quality embryo is an important starting point, it is also important to transfer the embryo into a uterus that is ready to receive the embryo. The timing of embryo transfer also plays an important role.

What is the endometrium?

  • The interior of the uterus is lined with a tissue called endometrium, which is prepared each month for the arrival of an embryo for further growth and progression of pregnancy.
  •  Even the best embryo will fail to implant if conditions aren’t right.

What is Endometrial receptivity?

  • The endometrium is receptive when it is ready for embryo implantation to occur. This period of receptivity is called the window of implantation. 
  • Each woman has a unique window. For some women the window is shorter and/or displaced. By knowing a woman’s personal window of implantation we can optimize her chances of pregnancy through a personalized embryo transfer.

What is ERA test?

  • ERA test evaluates endometrial receptivity, the optimal time for embryo transfer that is specific for each woman.

How does ERA test result help?

  • When performing the embryo transfer in a personalized way, the chances of getting pregnant are increased after the assisted reproduction treatment.
  • Maximize your chances of pregnancy and don’t lose good embryos.


Who can benefit from ERA test?

An ERA test can be beneficial for couples who have had 3 or more unsuccessful IVF cycles. In such cases, the couple has had an otherwise good fertilization rate, the embryos have developed and appear healthy and the uterine lining looks good but the woman had recurrent implantation failure. If the ERA determines that the endometrium is receptive to the embryo and it still fails to implant, the only other reason for the failed pregnancy is a genetic abnormality.

How is the ERA test done?

For the ERA test an endometrial tissue sample is taken through a fine catheter. This procedure does not require anesthesia and may be conducted in the doctor’s office. Before this sample is taken, the patient is given progesterone supplements for 5 days. Progesterone is one of the hormones that play an important role in making the endometrium receptive to an embryo.

Once the tissue has been collected, the genes within it are analyzed. This can then predict whether the uterus would be receptive to an embryo on the day that the embryo would have been transferred.

If the test determines that the uterus is receptive, the embryo may be transferred as planned in the next IVF cycle. However, if the endometrium is detected as non-receptive, the progesterone timing will be altered so as to allow doctors to transfer the embryo only at a point when the uterus is receptive to it.

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