What is ERA testing in IVF?

What is ERA testing in IVF?

Despite its many advancements and successes, reproductive medicine has long ignored the endometrial component. In reality, the oocyte/embryo has remained the primary focus of this area ever since it began. The maternal endometrium, on the other hand, was considered to be a passive component of the fertilization process; all that was needed was a “good embryo” (or four or five). 

Nevertheless, despite considerable advancements in embryology and embryo transfer techniques over the past 30 years, IVF is still not very effective globally, with live birth rates currently averaging 25 to 30 percent every cycle. Ignoring the endometrium may be the cause of at least some of this gap; after all, it’s reasonable to assume that any collaborative activity involving partners necessitates the operation and coordination of both. (1)

Many IVF patients are unable to conceive even after transferring healthy embryos. While a good embryo is a good place to start, it is equally crucial to transfer the embryo to a uterus that is prepared to receive it.

What is the endometrium?

The endometrium, a tissue that lines the inside of the uterus and serves as the embryo’s nest throughout gestation, prepares the uterus each month for the arrival of an embryo. If the circumstances aren’t ideal, even the best embryo won’t successfully implant. 

When the endometrium is prepared for embryo implantation, it is receptive. The window of implantation refers to this window of receptivity. 

Every woman has her own window. By doing a customized embryo transfer, you can increase your chances of becoming pregnant by being aware of your unique window of implantation. (2)

What is ERA test?

The ERA® diagnostic test is the first to pinpoint each woman’s particular tailored window of implantation, allowing for synchronization of the embryo transfer with that window.

It is indicated for all patients starting assisted reproductive treatments. The ERA test provides the greatest benefit for those experiencing recurrent implantation failures.

Why use and what are the benefits of the ERA test?

The chances of becoming pregnant after assisted reproduction are boosted when the embryo transfer is done in a tailored manner. Pregnancy rates with an ERA in the first IVF cycle for any patient are 72.5%. 

ERA test increases your chances of becoming pregnant and avoids losing healthy embryos. 

After a year, 7 in 10 women gave birth. A tailored embryo transfer is preferable to a traditional frozen embryo transfer, as shown by our recent randomized study.

What do the ERA test results say?

  • A receptive result

The window of implantation is located on the day the sample was taken, according to a receptive result. The advice is to carry out the embryo transfer under identical circumstances as the biopsy. 

  • A non-receptive result

The window of implantation is moved when the test is non-receptive. In this instance, we will estimate your window of implantation using the ERA computational predictor to show you when, in 90% of cases, your personalized embryo transfer is most successful. Only 10% of cases will require a second biopsy.

It should be noted that while there were no appreciable differences in the two groups’ loss rates, the ERA group had higher pregnancy and implantation rates than the FET group . The female fertility assessment does not include an ERA endometrial biopsy, and first-time IVF patients are often not advised to undergo one. However, discussing your specific case with your doctor is always more beneficial for women.

Who is a good candidate for ERA testing?

Identifying suitable candidates for Endometrial Receptivity Analysis (ERA) testing within In Vitro Fertilization (IVF) processes is paramount. This specific diagnostic tool proves invaluable primarily for distinct demographics, warranting a closer examination.

  • Firstly, individuals grappling with recurrent implantation failure, characterized by numerous unsuccessful embryo transfers, find ERA pivotal. This scenario often encompasses those encountering two or more disappointments in this arena.
  • Additionally, ERA offers crucial insights for those facing the perplexities of unexplained infertility. When other infertility causatives stand excluded, ERA emerges as a beacon, shedding light on concealed impediments.
  • Moreover, advancing maternal age plays a significant role. The aging process inevitably alters endometrial receptivity, thereby influencing implantation success rates. ERA adeptly pinpoints the most propitious transfer window, enhancing the likelihood of successful implantation.
  • Lastly, patients with irregular menstrual cycles benefit immensely. Given the cycle’s variability, accurately determining the optimal implantation timeframe poses a challenge. ERA tailors its approach, relying on an individual’s unique endometrial gene expression, thus offering a bespoke solution.

Thus, ERA testing stands out as a crucial tool, meticulously tailored to support specific groups navigating the complex journey of IVF.


1- Ruiz-Alonso, M., Valbuena, D., Gomez, C., Cuzzi, J., & Simon, C. (2021). Endometrial Receptivity Analysis (ERA): data versus opinions. Human Reproduction Open, 2021(2), hoab011.

2 and the rest- https://www.igenomix.net/our-services/era-patients/

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