Types of Endometrial Analysis


Endometrial Receptivity Analysis (ERA)

For most women the time of endometrial receptivity for an embryo to implant is accurately predicted by the number of days after ovulation, but for some women the ‘window for implantation’ occurs later or earlier. The Endometrial Receptivity Analysis or ERA is a method whereby the endometrium may be checked to determine whether the date of embryo transfer may need to be adjusted to match the woman’s own window for implantation.

Embryo may not implant successfully if not transferred at the optimal time during IVF treatment.

How it works:

  • The woman goes through a mock frozen embryo transfer cycle and on the day of embryo transfer instead of replacing an embryo a Pipelle biopsy is done.
  • This is where a small sample of the lining or endometrium is taken and then couriered to the ERA lab for testing in Japan.
  • The ERA lab then checks the expression of 238 genes in the biopsy sample and sends a report indicating a receptive endometrium or a pre-receptive or post receptive endometrium.
  • The timing of the embryo transfer is then adjusted accordingly.

ERA test resulted in a 73% increase in pregnancy rate in patients with implantation failure.

Who should do ERA?

The current recommendations are that the ERA may be useful in women with recurrent implantation failures. There is debate about what the definition of implantation failure is, It is reasonable to consider ERA if a pregnancy has not resulted after the transfer of 2 to 3 good quality embryos into a normal uterus, in which the expectation of greater than 80% would have become pregnant. 

Blog on ERA can be found here.



Endometrial Microbiome Metagenomic Analysis (EMMA)

Endometrial health is vital for a successful pregnancy. A healthy endometrium is rich in healthy bacteria - the endometrial flora or microbiome.

EMMA analyses the endometrial microbiome for a better reproductive prognosis and recommends the best probiotic treatment to balance your endometrial flora, improving your pregnancy prospects.

The chances of pregnancy may be reduced if the levels of healthy bacteria in the endometrium are low.

Analysis of Infectious Chronic Endometritis (ALICE)

Chronic endometritis is one of the causes of recurrent implantation failure and recurrent pregnancy loss. In most cases, this disease causes endometrial inflammation with no visible symptoms. 

ALICE detects the bacteria causing chronic endometritis to improve the success of your fertility treatment.

About 66% of patients with repeated implantation failures or recurrent pregnancy loss are affected by chronic endometritis.