3 out of 10 patients have a displaced window of implantation
Performing the ERA test in a patient’s first IVF cycle significantly improves their chances of having a baby without losing valuable embryos
The cumulative rate shows 71% of women using ERA gave birth within one year, up from 55% without ERA
On a worldwide level, IVF is still relatively inefficient in humans, with birth rates of only 25% to 30% per cycle started, while other mammals show an implantation rate of greater than 95%. The main difference between species with a menstrual cycle, such as humans and other mammals, lies in the endometrial control of embryo implantation.
Igenomix has been working in the field of assisted reproduction for many years; optimizing embryo selection and transferring the best embryo, thereby increasing the effectiveness of IVF treatment. On the basis that the endometrial factor is a possible cause of infertility, a team led by Dr Valbuena, Medical Director of Igenomix, has carried out a study with the aim of improving clinical implantation by diagnosing, personalizing and synchronizing the endometrial factor.
The study, published in the scientific journal Reproductive BioMedicine Online and titled ‘A 5-year Multicenter Randomized Controlled Trial of In Vitro Fertilization with Personalized Blastocyst Transfer versus Frozen or Fresh Transfer’ concludes that personalized embryo transfer, guided by the endometrial receptivity analysis (ERA) test, which determines when the endometrium is receptive, increases the possibility of having a child in the first IVF cycle, increasing the live birth rate from 42.4% achieved when using standard transfer of frozen embryos to 56.2% when using personalized embryo transfer guided by ERA.
The study, a prospective, randomized, international multicentre clinical trial involving 16 clinics in 7 countries, evaluated 569 women with fertility problems during their first consultation at an IVF centre, to assess whether personalized embryo transfer guided by ERA increased the chance of live birth in infertile patients compared to standard transfers of frozen or fresh embryos. For most patients, standard transfers are performed, with no knowledge of the optimal implantation time.
The results were positive. Following personalized embryo transfer, 56% of women had a baby after the first embryo transfer and 71% achieved success after 1 year, compared to 42% and 55%, respectively, who underwent conventional transfer of frozen embryos.
These results support the value of well-designed prospective and randomized studies with a sound scientific basis.
Personalized transfer guided by the ERA test vs standard transfer (non-personalized)
A personalized embryo transfer is one that is performed at the optimal time when the endometrium is receptive, which is usually 120 hours after the first dose of progesterone. However, the window of implantation (time of receptivity) in 3 out of 10 women occurs at a different time than expected.
“Since we developed the ERA test to solve the cases in which the patient’s window of implantation was displaced, one of our goals as endometrial experts was always to discover when this event occurred. This was because, over the last few years, we have observed that the endometrial factor has been the main cause behind implantation failure in many women who, even with the best quality embryos, have not achieved pregnancy”,, explains Carlos Simón, Head of the Scientific Board of the Igenomix Foundation.
Patients frequently suffer multiple implantation failures before finally becoming pregnant and giving birth. This study shows that performing a personalized embryo transfer guided by the ERA test in the first IVF cycle significantly improves the chances of having a baby.
The results obtained from this research on personalized embryo transfer serve to validate the importance of endometrial preparation and highlight the need to personalize assisted reproduction treatments including IVF.
This study is supported by a further 21 publications that support the ERA test, 8 of which have been performed by independent study groups.
The ERA test, a new ally on the road towards maternity
Precision medicine is centred on personalized treatment, and this is exemplified by the ERA test, which provides personalized consideration of the endometrial factor in IVF treatment.
Personalized embryo transfer provides superior results to the ‘blind’ transfer of frozen or fresh blastocysts (embryos at day 5 of development), as shown by this study.
This type of transfer has not only led to more births, but has also resulted in an increase in pregnancy rates from the first transfer. This is because of the fundamental principles behind the ERA test.
The ERA test works by analyzing the expression of 248 genes in the endometrium, providing insight into its receptivity or lack thereof at the time when embryo transfer normally take place. This test, patented by Igenomix in 2009, determines the optimal time for embryo transfer on a case-by-case basis, fully incorporating personalized treatment into the fertility clinic.
The ERA test is currently the only available diagnostic tool to evaluate the status of endometrial activity. In addition to significantly improving the pregnancy rate, in the last years it has offered a solution to thousands of patients who struggled to conceive despite regular attempts.