In the case of euploid embryo transfer, the frequency of pregnancy increases to 70%.
Why does pregnancy not occur in other cases? Most likely, it is not the readiness of the endometrium to accept the embryo.
The endometrium is the tissue lining the inside of the uterus to which the embryo is attached, and where it is located during pregnancy. Each month, the endometrium prepares for embryo implantation. If this does not happen, then menstruation begins. Implantation window is period during which the embryo gets attached to the endometrium. 75% of women have a standard implant window, but 25% have an implant window offset. Such women will have a history of repeated unsuccessful transfer of good quality embryos. In these cases, an ERA test should be performed to elucidate the implantation window during transfer planning to avoid repeated failure.
What is the ERA test?
ERA assesses endometrial susceptibility and the optimal time for embryo transfer characteristic of each woman.
Why go through an ERA study?
- With personalized embryo transfer as part of the BRT program, the chances of becoming pregnant increase.
- The effectiveness of implantation in primary transfer according to the ERA test results is 72.5%.
- 3 out of 10 women have an implantation window shifted.
Results of the ERA study
- Receptive endometrial
The receptive result shows that the implantation window corresponds to the day the biopsy was taken. It is recommended to carry out embryo transfer under the same conditions as in biopsy.
- Nonreceptive endometrial
A nonreceptive result indicates a shift in the implantation window. In this case, using the computational predictor ERA, we calculate your implantation window for optimal embryo transfer.
In addition to studying the implantation window, the diagnosis of endometrial microflora is important.
What is endometrial flora?
An endometrial flora or microbiome is a collection of microorganisms present in an endometrial. The balance of beneficial bacteria is a key factor for successful implantation. Dysbiosis of the endometrial microflora reduces the chance of pregnancy. It is possible to investigate endometrial microflora using EMMA and ALICE tests
EMMA - metogenomic analysis of endometrial microflora
EMMA allows investigation of endometrial microflora to determine reproductive prognosis
Why undergo an EMMA study?
- EMMA will determine whether uterine microflora is optimal for embryo transfer.
- EMMA determines the percentage of healthy Lactobacillus bacteria in your endometrium. If the percentage is low, the conclusion suggests adequate treatment with probiotics or antibiotics.
- This test also reports the most common bacteria in an endometrial tissue sample, including bacterial pathogens that can cause chronic endometritis or other infections.
ALICE - definition of pathogenic endometrial microflora
ALICE identifies bacteria that cause chronic endometritis to improve the patient's reproductive prognosis. Based on the results of the study, recommendations for treatment are given.
Chronic endometritis is a persistent inflammation of the endometrial mucosa caused by infection of the uterine cavity, mainly by pathogenic bacteria that cannot be identified using conventional methods.
Why go through an ALICE study?
- The ALICE test provides accurate information about the state of the endometrial microflora, which helps prescribe the correct endometritis, increasing the chances of pregnancy. If ALICE gives a positive result, the conclusion will focus on detecting specific bacteria that cause endometritis.
- The list of recommended antibiotics and probiotics will be provided depending on the results of the ALICE study.
ERA, ALICE, and EMMA tests can be performed with one biopsy. Such a test is called EndomeTRIO.