Is the ERA test painful?

It may cause mild discomfort similar to a period cramp during the biopsy, but it is usually quick and manageable.

Can ERA testing improve live birth rates?

Research shows no clear improvement in live birth rates for the average IVF patient.

Should I do ERA during my first IVF cycle?

Most people don’t need it in their first cycle unless there are specific medical concerns.

Does ERA test help with fresh embryo transfers?

No. ERA is used only with frozen embryo transfers.

ERA and PGT-A in IVF: Do These Tests Really Improve Success?

The ERA test (Endometrial Receptivity Analysis) helps doctors figure out when the tummy is just right to put in a baby seed so it can grow. It checks how ready your uterine lining is for implantation during a frozen embryo transfer.

How Does The ERA Test Work?

Your doctor prepares your body just like a regular frozen embryo transfer cycle.

Rather than transferring an embryo, a small biopsy of your womb’s lining is taken to analyse how it’s functioning.
This sample is analysed in a lab to check for hormone activity and gene expression.
Based on this, they suggest a specific “window” when your uterus may be most ready to accept an embryo.

Why Was It Introduced?

For these situations, the standard embryo transfer timing might not work as expected. The ERA test hopes to improve success by tailoring the timing. The ERA test is mostly recommended for:

People who’ve had recurrent implantation failure
Individuals with early pregnancy losses
Patients with suspected issues in the uterine lining
Some cases of endometriosis or immune disorders

What Does Research Say?

Key findings from recent studies:

One major study showed that live birth rates were nearly the same in two groups: those who had the ERA test and those who didn’t. These studies suggest that for most people, the ERA test does not offer a major benefit.○ ERA group: 58.5%○ Standard timing group: 61.9%
Another study warned that the ERA test might even reduce success in some cases by giving misleading timing.

Reasons To Reconsider The ERA Test

It’s costly: The test is expensive, which can be a burden, especially during an already costly IVF journey. It may also delay your transfer by a few weeks or more
It doesn’t improve outcomes for everyone: If your embryo is genetically healthy and your uterine lining looks fine, a standard embryo transfer is often enough. You might not gain anything extra from doing this test
It may add stress: Waiting for results can feel frustrating. Any delay in transfer might feel like yet another hurdle

When The ERA Test May Be Helpful

Even in these cases, the decision should be made after a detailed conversation with your fertility expert. You should consider talking to your doctor about ERA testing if any of the following apply:

You’ve already had two or more failed embryo transfers with good-quality embryos
You’ve had repeated miscarriages
You have a known endometrial issue or suspected inflammation
You’re working with donor eggs or frozen embryos, and past cycles didn’t work

What Fertility Experts Are Saying Now

Many clinics that once routinely recommended ERA testing are now stepping back. This shift is based on growing evidence that the test might not be as useful for the majority of IVF patients.
There’s also concern that the test could lead to unnecessary treatment changes or false hope if the results are misinterpreted.

Still, the test remains an option for people in more complex or repeated failure cases.

Things To Ask Your Doctor Before Getting An ERA Test

Have my previous embryo transfers failed, and if so, why?
Do I have any known conditions (like endometriosis) that could affect my uterine lining?
Will the test meaningfully change my treatment plan?
How much will it cost, and is it covered by insurance?
Can my treatment continue during the wait for test results?

What To Know About The ERA Test

Details

What it does: Finds the best time for embryo transfer
Who it helps: Mainly people with recurrent implantation failure
Costs involved: High, and adds time to the IVF process
What studies say: Little to no difference in success rates
Should everyone do it?: No, not needed for most IVF patients

The ERA and PGT-A tests are used in IVF to help improve the chances of having a baby. The ERA test checks when the best time is to transfer an embryo, but it doesn’t always help everyone and can be expensive. The PGT-A test looks for problems in embryos to increase the chance of a healthy pregnancy. These tests can be useful for some people, but not for everyone. Always talk to a doctor to see what’s best for you.
Disclaimer: This article is intended for general education and shouldn’t be taken as personal medical guidance. Always speak with a qualified fertility specialist to understand whether the ERA test is appropriate for your specific condition and treatment plan.
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FAQs on Extra Tests in IVF: Do They Really Boost Your Chances?

Is the ERA test painful?
It may cause mild discomfort similar to a period cramp during the biopsy, but it is usually quick and manageable.
Can ERA testing improve live birth rates?
Research shows no clear improvement in live birth rates for the average IVF patient.
Should I do ERA during my first IVF cycle?
Most people don’t need it in their first cycle unless there are specific medical concerns.
Does ERA test help with fresh embryo transfers?
No. ERA is used only with frozen embryo transfers.