In this piece Dr Chris Venter, a fertility specialist at Vitalab Fertility Clinic, will discuss the ERA test.

The ERA test, as we call it, the Endometrial Receptivity Analysis, and the question is: can this test help us to improve our clinical pregnancy rate here at Vitalab?

What I always tell my patients when we embark on the IVF journey is that we need two things:

  1. We need a good quality embryo, and
  2. we need a well-prepared receptive uterus.

The ERA test – Endometrial Receptivity Analysis has been designed exactly for this purpose to test uterine receptivity.

What the ERA tests does is it goes and looks for the genetic expression of the uterus meaning is this uterus receptive on a specific day.

So, by testing the genetic expression or the receptivity of the uterus we can then improve the synchronicity between the embryo and the uterus making sure that the embryo has its best chance of implanting at the right time.

Just as a reminder that the endometrium is the lining of the uterus, and this lining needs to be well receptive well prepared prior to the embryo that’s been placed.

So what do we know about the ERA test?

We know thanks to many publications on this topic, we do know that some women, especially women with recurrent implantation failure, that 30 % percent of them are due to a displaced window of implantation.

Also, we know is that certain conditions, conditions in the uterus, also can displace this window so it’s very important when we look at the uterus to make sure; are these conditions present? If they are then we know these patients might be prone to a displaced window of implantation.

The real question we had five years back when we have been introduced to the ERA technology is can this improve clinical pregnancy rates in our fertility unit?

We specifically looked at a group of patients and this number is now well over 100 of these patients that were diagnosed with recurrent implantation failure and we went to look at how the ERA test contributed to success in these cases. In this group of patients on average they had three failed previous attempts; some of them had up to eight previous failed attempts. In some of these cases the patients have been suggested that they should even consider surrogacy- so this was a real desperate group of patients that we were dealing with.

So, we looked at these cases and in this group of patients after performing the ERA test we found that more than half of these patients had a displaced window of implantation. We then went to look at these women and then started to prepare the uteruses treating other conditions that can affect implantation and then we performed a mock cycle. During this mock cycle we did the ERA test.

What we found in this group of patients was that more than half of them had a displaced window of implantation which was encouraging to say well maybe we found a reason for the implantation failure. The real question was: what was our clinical pregnancy rate in this group of patients with recurrent implantation failure? In this study we had a 48% ongoing pregnancy rate.

If you go back and look at what was the chance of these women conceiving after the previous failed attempts- it was less than 10% so we could safely say that after employing the ERA test that we had a five-fold increase in the chances to conceive.

We can safely say that the ERA is a very important tool in helping some of our patients to conceive and the ERA test has changed many lives in our practice, and I think it will continue to change many lives.

It is very important that if you have a patient with recurring implantation failure to strongly consider making the ERA test part of your treatment and I also think that if you have a patient that only has one embryo- one very precious inventory transfer- that the ERA test has the potential to assist that embryo to have a higher chance of implantation.

Watch the video on this topic here: link