IVF is an expensive procedure and requires several sessions to complete the treatment. With all the physical and mental pressure, women look for various additional tests to boost the success rates of pregnancy. Our deeper understanding of the endometrium has led us to a stage where we have learned that it is not just the morphology of the endometrium on ultrasound that is essential for implantation but also its functionality.

What is Endometrial Receptivity Analysis?

Pregnancy is not an easy task, putting all the right elements at the right place and at the right time leads to conceiving naturally. One of the crucial steps of the reproductive arrangement is the relationship between the embryo and the endometrium where the implantation takes place. Time is an important factor when it comes to implantation either naturally or at a lab. The period for implantation is known as the “window of implantation”, or “window of receptivity”. The ERA test helps to check if the uterus is ready for the ” window of implantation” during an IVF cycle.

What is the “Window of Receptivity”?

The endometrial Window of Receptivity is defined as the window of opportunity during which the endometrium becomes receptive to the embryo.

Earlier, doctors believed that the window of receptivity or implantation was somewhere between the eighth or tenth day after ovulation for all women. However, with the help of the ERA test, we know that the period of the window is not universal and varies among women. It varies in women based on progesterone hormone levels and genes.

Do you need an ERA test for determining successful pregnancy?

The ERA test or the Endometrial Receptivity Array is a tool that studies 238 endometrial genes responsible for receptivity in both natural and hormone replacement cycles. The test result for any given patient stays valid for up to 40 months after biopsy.

This test was designed to detect a shifted window of implantation, this may be either advanced or delayed, thus preventing implantation of a transferred embryo due to embryo-endometrial dyssynchronization.

The report is generated as either receptive or nonreceptive. A non-receptive report indicates a shifted window which may be either pre receptive or post receptive and is accompanied by a recommendation for the precise duration of luteal support required for the embryo transfer.

What happens in ERA testing?

The Endometrial Receptivity Analysis (ERA) helps to analyze whether the uterus is in or about to be in the window of implantation. Various fertility clinics offer ERA testing, however, some of them deny it after the recent studies that show no improvement in infertility results in unselected patients.

The ERA test takes place in two stages. Firstly, a biopsy is done by taking a small sample of the endometrium. The second step is testing the sample for gene expression. Based on the genes, the ERA test determines whether the uterine lining is ready to receive embryos or not.

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