Is ERA testing painful?

ERA testing is not usually painful, except for some discomfort that you may experience during the biopsy. It may cause you to cramp that feels similar to menstrual pain.

Can ERA testing guarantee pregnancy?

Although ERA testing improves your chances of conceiving, it does not mean a successful pregnancy. It helps in transferring the embryo at the best time based on your cycle pattern.

Failed IVF? How ERA Testing Can Improve Implantation Success

Good quality embryos usually lead to successful implantation when you are trying to conceive through IVF. However, in some cases, even the embryo’s quality is not enough to get you pregnant. ERA is suggested in such a situation, which plays a crucial role in your fertility journey.

ERA is short for Endometrial Receptivity Analysis, a test that identifies the best time to transfer an embryo to your uterus. This test helps your doctor understand when your uterus is ready to receive the embryo for successful implantation. This improves your chances of achieving a successful pregnancy.

You can prepare yourself better if you know how the ERA test works and what to expect during the whole procedure.

What Is ERA Testing?

ERA testing is a lab test that is done to study a sample of your endometrial tissue, which is the lining of your uterus. It helps to find out if your uterus is receptive at a particular time in your menstrual cycle.

You may be aware that embryos are usually transferred to your uterus a few days after ovulation or hormone treatment in IVF treatment. This is called the implantation window, starting from days 19 to 21 in the menstrual cycle for most women.

In some cases, the uterus may be ready earlier or later, as the timing is not the same for everyone. A healthy embryo may not implant properly if it is transferred at the wrong time.

The ERA test identifies the most favourable time of implantation by looking at gene activity in your endometrial cells. Your doctor can plan the embryo transfer more accurately with this information.

How Does ERA Testing Work?

The ERA test involves several steps, and you can expect the following steps.

Step 1: Prepare Your Endometrium

You have to go through a natural cycle or a hormone replacement cycle to prepare your endometrium. This process is similar to the one your doctor performs before an actual embryo transfer.

You are given progesterone for five days, and a small biopsy of the endometrial lining is done on the sixth day.

Step 2: Endometrial Biopsy

The biopsy is a fairly quick procedure in which a thin, flexible tube is inserted into your uterus to collect a small tissue sample. You may feel some cramping or discomfort during this procedure, which feels similar to period pain.

Step 3: Laboratory Testing

The tissue sample is sent to a lab, where experts examine the activity of over 200 genes linked to endometrial receptivity. This helps them determine if your uterus was receptive at the time of the biopsy.

Step 4: Get Your Results

The results will show one of the following:

Receptive: Your endometrium was ready to receive the embryo at the time of the biopsy.
Non-receptive: Your endometrium was not prepared. It may be either pre-receptive (too early) or post-receptive (too late).

Your doctor can adjust the timing of your next embryo transfer with the help of this result to match your implantation window.

Who Needs ERA Testing?

The ERA test is not necessary for everyone going through IVF treatment. It is usually recommended for people who have had:

Two or more failed embryo transfers.
High-quality embryos that did not implant.
No clear reason was found for implantation failure.

Benefits of ERA Testing

The main advantage of ERA testing is that it allows for a more personalised IVF approach. It helps to modify the process according to your needs rather than using typical embryo transfer timing for everyone.

Here are some benefits:

Increases the chance of successful implantation.
Reduces repeated IVF failures.
Saves emotional and financial stress by guiding better-timed transfers.
Helps uncover hidden causes of infertility.

Are There Any Risks or Limitations?

The ERA test is generally safe, but like any medical procedure, it can have some minor side effects such as:

Mild cramping or pain during biopsy.
Light spotting for a day or two.

The test may not be necessary for first-time IVF patients or those with clear infertility reasons, like low egg reserve or poor embryo quality. Close monitoring is crucial, as timing errors during the preparation phase can impact your results.

What Happens After ERA Testing?

Your doctor will plan your embryo transfer after reviewing your ERA test results. Your doctor may use the same timeline for embryo transfer in future cycles if the test shows a receptive lining.

However, in the case of a non-receptive lining, the number of days of progesterone can be adjusted to match your ideal implantation window. The adjustments in timing increase the chances of success.

ERA testing may offer new insights when you have been struggling with failed IVF cycles and everything is normal. It focuses on identifying the brief and most ideal time for embryo transfer. You can improve the chances of a successful implantation and a healthy pregnancy by finding out when your uterus is most receptive. Discuss with your doctor whether ERA testing is right for you, as every fertility journey is unique.

FAQs on What To Do When IVF Fails: All About ERA

Is ERA testing painful?
ERA testing is not usually painful, except for some discomfort that you may experience during the biopsy. It may cause you to cramp that feels similar to menstrual pain.
Can ERA testing guarantee pregnancy?
Although ERA testing improves your chances of conceiving, it does not mean a successful pregnancy. It helps in transferring the embryo at the best time based on your cycle pattern.