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What is an Endometrial Receptivity Array (ERA)?

Problems with the endometrial lining are one of the leading causes of infertility in women. The uterus is the organ in which pregnancy takes place. The interior is lined with a tissue called endometrium, which is prepared each month for the arrival on an embryo and is the place where the embryo implants and resides during gestation. Sometimes embryo implantation in the endometrium does not develop successfully. This failure can occur for different reasons. A particularly important factor is endometrial receptivity. Endometrium is receptive when it is ready for embryo implantation to occur, which usually takes place between days 19-21 of the menstrual cycle (5-7 days post-ovulation). This period of receptivity is called the “Window of Implantation”.
An Endometrial Receptivity Array (ERA) is a novel diagnostic technique that allows us to evaluate the endometrial receptivity status of a woman, from a molecular point of view. A biopsy of endometrial tissue is performed on a specific day of a woman’s cycle.  This biopsy is performed by an ICRM physician here in the office, and is an easy and quick procedure. The biopsy is sent to the testing facility and the expression of 238 genes involved in endometrial receptivity is analyzed. An ERA predictor analyzes the data collected and classifies the endometrium as “receptive” or “non-receptive”.
The results of the analysis determine whether or not the patient will be responsive to embryo implantation at the time of sampling. If “receptive”, then the window of implantation is defined as the day on which the biopsy was taken, meaning the embryo is capable of implanting in the uterus during this period. A state of “non-receptivity” means that the window of implantation is displaced. In this case, the process will be repeated according to data from the ERA predictor, which will give a new estimation of your window of implantation.
At ICRM, we typically recommend an ERA to patients that meet certain criteria. If you are 37 years of age or older, with at least 2 failed implantations (not biochemical pregnancies), we highly recommend ERA testing to provide more information and to hopefully increase the chance of success of a future embryo transfer. However, if you do not meet this criteria but would like to learn more about an ERA and
 how it may be a useful tool for you, please feel free to speak with a nurse or physician at ICRM. Also, more information is available from IGENOMIX.  (Information courtesy of IGENOMIX.)