Hyderabad: If you are trying to conceive but have failed an implantation with apparently good looking embryos in a physically normal looking uterine cavity, and haven’t had any luck with getting pregnant yet, chances are you may have an underlying fertility problem.

For some women, their cause of the infertility may be due to the uterus’ inability to hold onto a healthy embryo. Previously it had been believed, that the viability of an embryo is the sole determinant of a successful IVF cycle. However, the latest research findings show that while high quality embryos remain important for a successful IVF cycle, the receptivity of the uterus for the embryo plays quite a significant yet undermined role in deciding the fate of the cycle.

It is now possible to test a woman’s uterus to determine if the uterus is either receptive or not receptive. The new test called the Endometrial Receptivity Array (ERA) tests the receptivity of the uterus and identifies the most ideal time for embryo transfers to ensure a successful pregnancy.

Dr. Chandana Lakkireddi – Infertility Consultant, Nova IVI Fertility, Hyderabad, “While it is true that embryo quality is the strongest predictor of implantation, but for couples who do not conceive even after genetic testing like preimplantation genetic diagnosis (PGD) or preimplantation genetic screening (PGS), there could be endometrial factors involved. The ERA test is the first of its kind to examine endometrial receptivity as a product of gene expression of the endometrial lining at specific times during a woman’s cycle. The test looks at the cyclical pattern of 238 different genes. Being a receptivity endometrial diagnostic method, the ERA determines the personalized window of implantation for each patient before to begin an assisted reproductive treatment. The ERA test has shown high sensitivity and specificity detecting gene expression profiles associated with receptivity. This reduces the number of IVF cycles the couple has to undergo and therefore reduces the cost and trauma of miscarriage”.

She further added, “In fact, some of the latest reproductive findings encourage patients to freeze their embryos and transfer them in a later cycle once the uterine lining has recovered from the effects of harsh fertility drugs. Endometrial biopsy in a cycle before embryo transfer can predict which day implantation may occur in a subsequent cycle”.

Endometrial Receptivity Array (ERA) operates on a similar premise and provides insight into how receptive a woman’s uterus will be at a particular stage in her menstrual cycle. Essentially, this helps doctors to determine the best time to transfer an embryo in hopes that it will implant.

ERA indicates the window of implantation (WOI), increasing chances of successful transfer. Typically, embryo transfers are performed between day 3 and day 5 after retrieval. The time of transfer is determined as a direct result of embryo development. Embryos that stand a strong chance of growing in the lab until day five are transferred as blastocysts. Those that show less progressive growth can be transferred earlier in hopes of achieving implantation.

Previously, doctors had no choice but to repeat in-vitro fertilisation (IVF) cycles till there was a success or otherwise. Now, after ERA, timely implantation is possible which increases the success rate of pregnancy and reduces the time that patients have to wait to achieve a pregnancy.

ERA results are consistent in different cycles of the same patient when hormonal treatment is maintained, company sources said. The cost of the test is relatively inexpensive when considering the overall costs of fertility treatment and potential benefits of understanding endometrial receptivity.