What exactly is the ERA Test for Implant Failure- best infertility specialist in Delhi
RIF (recurrent or repeated implantation failure) can be fatal. Some patients have three or more rounds of IVF, and everything appears to go well: a good number of eggs at retrieval, a good fertilisation rate, the embryos appear to be healthy and of high quality, the uterine lining appears to be healthy and high quality, the transfer goes smoothly, but the pregnancy never “sticks.”Call and book your appointment with Dr. Shweta who is the best infertility specialist in Delhi.
It can also be a difficult and unpleasant condition for reproductive specialists who are attempting to identify a cause. Patients seek answers, and doctors want to assist them. Fortunately, new tests and technology are continuously being developed to assist reproductive professionals in providing some of these answers and assisting patients in finding the correct road to pregnancy. One of these new advancements is the ERA test, which guides nurses dealing with implantation failure with new knowledge and hope.
What factors contribute to implantation failure?
Abnormalities in the genome: Most of the time, the problem is a genetic or chromosomal defect with the embryo, especially in older women who use their own eggs. The rate of chromosomal abnormalities in ageing eggs is substantially higher. This explains why implantation rates decrease with patient age: the typical implantation rate in patients under 35 using their own eggs is around 50%. By the time women are 41-42 years old, that rate has dropped to roughly 12%. There may be a genetic abnormality with the sperm in rare cases. If a patient has RIF, genetic testing, such as Pre-Implantation Genetic Screening (PGS), is usually the first line of treatment. Embryologists can examine the embryos for chromosomal problems before implanting them, which can dramatically boost the implantation rate. Donor eggs are another incredibly effective alternative in this type of situation.
What exactly is the ERA test?
Endometrial Receptivity Analysis (ERA) is an abbreviation for Endometrial Receptivity Analysis (or Array). It is a genetic test that uses a small sample of a woman’s endometrial tissue to determine whether her endometrial lining is ready to accept an implanting embryo.
Each woman has an “implantation window” in her cycle that lasts a few days, usually between the 19th and 23rd day of her menstrual cycle. During the luteal or secretory phase, the ovaries produce progesterone. In order to establish an ideal environment for implantation, progesterone causes several subtle but significant modifications to the uterine lining. Proteins are produced, causing the lining to thicken and become more responsive. For IVF cycles, this could mean that the embryo transfer is taking place on the incorrect day, when the window has not yet opened or has already closed, resulting in implantation failure. Book your appointment with the best IVF hospital in Delhi.
What is the ERA test and how does it work?
When the endometrial lining is responsive, the endometrial cells’ genetic material has a distinct “expression,” which implies that they may produce more or less specific types of RNA. The researchers examined the expression of 236 genes per sample and created a database of over 12,000 endometrial tissue samples to determine the quantities of RNA produced at various stages of the cycle. They then searched for trends using complex computer algorithms until they could consistently categorise a sample as “Receptive” or “Non-Receptive” based on its particular expression profiles. This test is highly repeatable, which implies that the results are the same when samples are examined at the same point of the cycle but months apart. Doctors can use ERA to determine whether a woman’s “implantation window” is occurring as planned or whether the transfer date needs to be moved to achieve the optimum “sync” between the embryo and the uterine lining.
Who are the best ERA candidates?
It is recommended for patients who have had repeated implantation failure with embryos of good morphological quality (at least three failed embryo transfers for young women or two in patients aged 37 years or older) and who have an apparently normal uterus and normal endometrial thickness (>-6 mm) with no obvious problems.
What is the ERA test and how does it work?
When the endometrial lining is responsive, the endometrial cells’ genetic material has a distinct “expression,” which implies that they may produce more or less specific types of RNA ( ribonucleic acids ). The researchers determined and analysed the expression of 236 genes that will engage in endometrial receptivity per sample in the ERA test and generated a database of more than 12,000 samples of endometrial tissue to assess the levels of RNA produced at different phases of the cycle. They then utilised sophisticated computer algorithms to search for trends until they could consistently categorise a sample as “Receptive” or “Non-Receptive” based on its particular expression profiles. As a result, it will be feasible to determine whether the endometrium is suitably receptive for embryo transfer on unusual days or whether the so-called “window of implantation” has altered. Thus, using ERA, doctors can determine whether a woman’s “implantation window” is occurring as expected or whether the transfer date needs to be moved to achieve the optimum “sync” between the embryo and the uterine lining.
How is the ERA test carried out?
Endometrial Receptivity Analysis necessitates the collection of a sample of the uterine lining at a precise point in the cycle.
It is also possible to employ fertility drugs, such as supplementary oestrogen and progesterone, to prepare the uterine lining. The progesterone is started on Day Zero, and the test is performed five days later.
Endometrial biopsy is the process used to get the tissue sample. A thin catheter is introduced through the cervix into the uterine cavity, and a plunger in the catheter creates suction to extract a microscopic sample of the endometrial lining into the catheter. Many women find this phase of the treatment to be rather unpleasant, yet it is a relatively rapid operation. Following that, the sample is delivered to the lab for examination utilising Next Generation Sequencing technology. The results will be available in around three weeks. If the results show that the tissue was “Non-Receptive,” the test should be performed earlier or later until the best time is found.
After determining the patient’s receptive window, tailored embryo transfer (pET) timing can be used.
The disappointment and distress produced by repeated implantation failure is frequently intense after such a significant emotional, physical, and financial investment. If you or someone you care about has battled with inexplicable failed IVF cycles, talk to your fertility specialist about ERA. It provides you with a fresh data point, and knowledge is power. After repeated implantation failures, sometimes a one-day change is all that is required to see results.
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