Endometrial Receptivity Array (ERA) test opens up a new window for personalised embryo transfer

Umesh (38 years) and Rashi (35 years) were married for 6 years. They were trying to conceive for the last 3 years of their marriage but were unsuccessful. Fertility test results had shown that Umesh’s semen analysis reports were normal but Rashi’s menstrual cycle was irregular.

Rashi had undergone 2 laparoscopy procedures in 2014 and 2015 to find out the cause of her infertility. Both the procedures showed that her left fallopian tube was normal but the right one had a tubal block. After undergoing multiple tests the couple was diagnosed with primary infertility with unilateral tubal block and polycystic ovaries.

Over the years, the couple consulted few infertility specialists across different hospitals and underwent fertility treatment as advised by these doctors. However, these treatments didn’t work for them.

Despite the initial treatment setbacks, the couple did not give up hope and decided to consult at the Nova IVF Fertility centre in Mumbai.

Consultation at Nova IVF Fertility, Mumbai

Before coming to Nova, the couple had undergone multiple ovulation inductions and 6 IUI cycles, with negative results each time. The next best procedure IVF/ ICSI (Intracytoplasmic Sperm Injection), an Assisted Reproductive Technique, was advised by the doctors at Nova. ICSI is a micromanipulation technique used in IVF treatments. Instead of allowing the sperm to fertilise the egg in a dish naturally, ICSI involves injecting a healthy sperm into the cytoplasm of an egg, using a fine glass needle in a laboratory.

In Umesh and Rashi’s case, the ICSI procedure was followed by cryopreservation of all embryos. During the 1^stattempt, 2 day 3 (cleavage stage) embryos were transferred, however, the result was negative. In the 2^nd attempt, 2 blastocysts were transferred, in order to increase the chances of pregnancy, but this too turned out to be negative.

When pregnancy does not take place, even with good quality embryos, evaluation of the uterine cavity is necessary. The fertility experts at Nova advised the couple to undergo two additional tests – Hysteroscopy and Endometrial Receptivity Array (ERA).

The couple had already undergone hysteroscopy, along with laparoscopy in 2015 in another clinic. This test had shown normal findings which made them reluctant to take the test again. So, the couple decided to give IVF one more try. When the 3^rd embryo transfer also turned out to be negative, the couple agreed to undergo the 2 tests.

Hysteroscopy and Endometrial Receptivity Array (ERA)

• Hysteroscopy is a procedure to check if the uterus is healthy enough for conception and pregnancy. As per the process, a tube (endoscope) is inserted into the cervix through the vagina to check for any fibroids, polyps or other abnormalities. Rashi underwent the test and her results came normal.
• ERA test determines whether the endometrium is receptive for the embryo when the transfer is being planned. A sample of endometrial tissue is taken, and molecular level analysis is done. Usually, day 3 embryos are transferred on the 3^rdday of progesterone intake and similarly, day 5 embryos (blastocysts) are transferred on the 5^th day of progesterone intake. In Rashi’s case, the ERA test results showed a noticeable change. The time for embryo transfer was detected to be one and a half days earlier than the usual day of embryo transfer. The reports showed that the embryo transfer should be done on day 3.5 of progesterone intake.

The last 3 frozen embryos were thawed and then cultured to blastocysts. Two blastocysts were subsequently transferred as per the ERA results. The transfer was successful and resulted in a single, live pregnancy at 6 weeks. Umesh and Rashi were blessed with a baby in 2017.

According to statistics, ERA tests claims more than 70% successful pregnancy rate. It is advised for women who have been diagnosed with repeated implantation failure. As suggested by Nova team, Umesh and Rashi gave ERA test a try at the right time and they were able to conceive successfully.

Thus, at Nova IVF Fertility our team leaves no stones unturned, ensuring you are able to fulfil your wish of having your child.