When an IVF cycle isn’t successful, it’s very common to review the treatment protocol, the patient’s history, and previous cycles to look for ways in which future cycles might be improved. When you’re undergoing infertility treatment, sometimes your response to the treatment itself can provide insight into the difficulty you are experiencing.
When you and your partner go through an initial fertility work-up, the obvious pieces are looked at first: hormone levels, sperm analysis, ovarian function, etc. Then, once you start undergoing assisted reproductive treatment such as IVF, the morphology of your embryos can also be assessed. If you employ tests like PGT-A (formerly known as PGS), you will learn whether or not your embryos are viable based on their chromosomal content.
When a patient has high quality, chromosomally normal embryos and is still struggling to become pregnant, they and their doctor may consider the ERA Test. It stands for Endometrial Receptivity Analysis and it’s a genetic test that evaluates a woman’s endometrial lining with a biopsy. This endometrial biopsy may provide new insight into why some may not be having the outcome they have been dreaming of.
What Does an Endometrial Biopsy Entail?
An endometrial biopsy would be taken by your physician. The biopsy is an outpatient procedure and may cause slight discomfort or possibly mild cramping. Over-the-counter medication can be used but you should also feel free to discuss any pain management directly with your doctor.
The endometrial biopsy would then be sent to a lab to be analyzed to find your specific window of implantation. This window describes the span of a few hours or days in which your endometrium lining is at its most receptive to the implantation of an embryo. According to Dr. Carlos Simon, Scientific Director of Igenomix, clinical researcher and gynecologist who participated in the research that helped develop the ERA, taking into consideration the timing between the development of an embryo and the status of the endometrial lining can be key in achieving a pregnancy.
The endometrial biopsy bases your receptivity on several factors that includes the evaluation of 248 genes. Your window of implantation could be unique, so, discovering your most optimal time can greatly assist your doctor. This means your reproductive endocrinologist can personalize your care and schedule your next IVF cycle around when your endometrial lining will be at its most optimal for implantation.
Should I Consider Getting an Endometrial Biopsy?
We always advise you to speak to your doctor before undergoing any test to see if it’s something that would fit your fertility history and if it’s right for you. Overall, if you’ve had experience with any of the following, you might speak to your doctor about an endometrial biopsy:
- Patients who have had two or more unsuccessful IVF cycles
- Patients who have historically had concerns with endometrial lining (i.e. thin endometrial lining)
- Patients who have experienced implantation failure with known high quality embryos
How can an Endometrial Biopsy Help?
According to studies, having an endometrial biopsy done improved pregnancy rates, up to 73% in when personalized transfers were made according to the test results (Fertility and Sterility, September 2013). This research suggests that if you’ve had unsuccessful IVF outcomes and you have quality embryos, it may be worth a conversation with your doctor to see if the ERA test is worth exploring.
No one likes things to be unsuccessful. Hopefully though, when we look back on what we’ve tried and what we haven’t tried yet, we can find new opportunities and pursue new options that will bring us different results. Look to your physician and work with your medical team in researching all of the options that may support your family building efforts.