CYCLE 2 - ERA

During our first transfer, my lining and labs looked great and the embryos were a good quality so there was no real reason for the transfer to fail other than the odds of IFV never really being in your favor. So we decided to ask for a way to increase our success with the next transfer, especially since it is the last embryo.

During our 2nd cycle, instead of doing the transfer on November 14th, we did an endometrial receptivity array (ERA), a this test was developed to evaluate issues with the receptivity of the uterus that may lead to failed implantation.

To achieve successful implantation, an embryo must be at the correct developmental stage when the uterus is prepared to accept it. This precise timing is known as the “window of implantation.”
Traditionally it has been assumed that each woman has the same window, with implantation occurring 8 - 10 days after ovulation in most women. Consequently, embryo transfers have historically been performed on a specified day in all individuals to mimic what occurs in natural cycles. However, more recent evidence suggests that each woman may have a personal window of implantation due to alterations in the receptivity of the uterus. If a woman has a window that is displaced, the embryo and uterus may not be in synchrony and this may prevent implantation from occurring.
The goal with the ERA is to determine the ideal day for embryo transfer thereby decreasing the likelihood of implantation failure. The ERA is performed using a biopsy of the uterine lining and is done in the office without anesthesia. Progesterone is a hormone that helps the endometrium become receptive and during an IVF cycle an embryo transfer is normally performed after progesterone has been administered for five days. The ERA is done during a “mock cycle” on the same day that an embryo transfer would normally occur. Once the biopsy has been obtained, the genes involved in receptivity are analyzed and the ERA predicts the endometrium to be “receptive” or “non-receptive” on the day the transfer would have occurred.

We are waiting on the results from the ERA to determine if we will change when I start the progesterone. At the appointment, I asked the doctor what she has seen with the results of this test in their office, and she said there have been quite a few of her patients who results have shown a different receptive "window".

I am interested in hearing the results from this test and hoping we get good feedback to move forward.