What is the ERA (Endometrial Receptivity Analysis) test?
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- čas přidán 5. 08. 2024
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The time to talk about "everything I can possibly do to give myself the best chance of pregnancy success" is BEFORE your embryo transfer. Not after. This is why I discuss tests like the ERA test and Receptivadx test with all my patients before transfer. Every embryo is important to me and I want to make sure I'm doing the very best job for every patient I meet.
I also know that there's a virtual alphabet soup of three letter abbreviations that surround the whole fertility journey, so this week on The Egg Whisperer Show, I'm breaking down the steps that I take when doing the ERA (Endometrial Receptivity Analysis) test, and how it could help you. The ERA tells us exactly when to start progesterone before a transfer to give the embryo the highest chance of implantation success. Think of it as an personal evite to your Embryo Transfer Party! In a way, the test tells you exactly when to show up for the party. I will also talk about the Receptivadx test that basically tells you what to wear to the party (the protocol you should use).
If you know me, you know that I love using the latest technology, mixed with personalized care, to set patients up for the best chance of success.
So, how does it work? How do I do it? What's involved? What's the technology behind ERA? Find out all the behind the scenes info in this episode.
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Dr. Aimee Eyvazzadeh is one of America’s most well known fertility doctors. Her success rate at baby-making is what gives future parents hope when all hope is lost. She pioneered the TUSHY Method and BALLS Method to decrease your time to pregnancy. Learn more about the TUSHY Method and find a wealth of fertility resources at www.draimee.org. - Věda a technologie
while on this protocol for an ERA and eventually a transfer, is there anything one can do to promote thickening of the uterine lining?
Gillian Rode there are many different protocols. I prefer a medicated protocol with estradiol. This promotes lining growth.
the ivf dr has meds for that. Or, try traditional medicinals pregnancy tea, L-arginine, and vitamin E. There is a study online about how those 2 thickened lining
You’re absolutely amazing. The way you take your time to explain this process makes me so confident in you.
Thank you so much!
I love the way you speak, I feel very comfortable. You transmit calmness. I wish to have you as my doctor.
Thank you Carmen! I'm doing a live fertility q+a tomorrow on IG at 4PM pst. Do join! instagram.com/eggwhisperer. Also sign up for my eggwhispererschool.com and take one of the courses if you think that would help you.
Thank you SO MUCH for this comprehensive explanation. I was going to do a transfer after a loss without doing the ERA and you just changed my mind. Thank you.
hey did u conceive after era?
@@tasnimshaheen5892 yes!!! But it came back as receptive so we didn’t change the protocol however my embryos were tested and I also got my thyroid checked and needed to go on medication for that because it was slightly high. Those are the changes we made before this transfer.
Hi did you do the era during the egg retrieval? If not when did you do the ERA?
The ERA Test was the answer for me! I had success after two failed transfers doing ERA test.
Congratulations, were you pre or post receptive?
Hi De.Aimee, thank you for your informative shows on CZcams! I have watched a few videos about ERA and some doctors have changed their opinion in the last couple of years and the effectiveness of the test appears less supported. Did your appreciation of the ERA changed in the last 2 years or do you generally recommend it, even for a first transfer? (I have 3 tested embryos- 41 y.o).
Thank you!!
I was diagnose with second infertility and have had 2 failed FET. I asked for the ERA prior to the first but was told that I don’t need it because I had already given birth. I feel like I wasted 2 perfect embryos. Now the doctor is saying maybe we should do an ERA. Thousands of dollar later and many tears shed, I feel like I got the message across. This video was super helpful and supports so much of what I am looking for.
Hi my fertility doctor performed endometrial biopsy the same day with my egg retrieval. His reason was, since I’m going under anesthesia for my egg retrieval May as well doing the endometrial biopsy. Is this ok? I read that there are specific time to do endometrial biopsy. Please advise, thank you!
I love you Dr. Aimee!!! Thank you for giving me something to think about. My egg retrieval is tomorrow, doing PGT-A, and im considering doing ERA. This is our first IVF round. ❤️
ah thank you Denise!!! I hope your cycle is amazing and goes so smoothly!
great sense of humor
Hi Dr. Aimee, I finished my retrievals and because of your video, I asked my dr about ERA and she said that she doesn't recommend it because I was pregnant before even though all of them were miscarriage. I have a few normal embryos and I don't want to take chances. This will be my first transfer. What is the correlation between being pregnant before and ERA? Also because I will do a saline sonogram, she said that I will need to do that first and in my next cycle ERA if I decide to. Her protocol is ERA with birth control pills, does this work? I would appreciate your response.
Hello , I would like to know if we can have the HCG injection and 5 days of progesterone for the era test at the same time ? What is the best preparation before performing the biopsie ? Because my doctor has prescribed only the HCG injection.. Should I start progesterone after HCG as when I did my first embryo transfer ? Thank you for your information.
Hi! Does this test work? I heard there were 5 studies done that show this test doesn’t work and 1 with a 20 participants that showed it does work. But, some actually show that doing it makes you less successful. These tests have come out very recently. What are your thoughts on this test given the studies conducted now?
Can you please tell me when is the best cycle to do the ERA test? Does it need to be during the cycle immediately before the FET cycle? My Dr has told me that we can do it any time and wants me to do it next month even though we will then be doing 3 months of estrogen therapy to try and improve my lining before an FET. I would love to hear your opinion. Also - you mentioned in the video about sending the sample to 2 different labs for two different types of infomation. But I don’t think you discussed this. what is the other lab that you send it to? Is this looking for BCL6? Thank you
Alison Crawford if you haven’t read this be sure to: draimee.org/what-is-the-era-test. There’s no rush to transfer after the ERA. The results are reproducible for almost 3 years. I repeat it in patients who come back for their next pregnancy if they want to but I don’t find it to be that helpful if you’ve already done it once. Receptivadx.com is for the bcl6 test. You’re right
I have history of one ectopic pregnancy, so RN trying for IVF. We have 12 excellent quality embryos. So pl tell me, do I really need to do ERA test? Plz answer my question.
Hi my fertility doctor performed endometrial biopsy the same day with my egg retrieval. His reason was, since I’m going under anesthesia for my egg retrieval May as well doing the endometrial biopsy. Is this ok? I read that there are specific time to do endometrial biopsy. Please advise, thank you!
Thanks so much for the information. We just received our genetic test results back and we have 3 normal embryos. Yay! We have decided to do the ERA test. This was very helpful 😊
Beautiful! So glad you have 3 :) You're definitely doing all the right things!
Did u conceive after era?
With a era test how long is the result valid for?
Hi Dr Aimee. Thank you so much for this video. Do you offer the EMMA & ALICE test when doing an ERA and if so, do you find it worth while?
EMMA and ALICE just became available in the US. Finally doing my first test!
@@EggWhisperer When would you recommend that? Is a single failed transfer an indication? Thank you. Blessings and love
@@joannaiv I discuss ERA + Receptivadx for anyone even before a transfer that doesn't work. I haven't started adding on EMMA + ALICE yet
Hi Dr. Aimee.. is an ERA the same as an endometrial scratch or endometrial activation? I am having an EA done cycle before FET. Thanks!
Yes! The way the test is done = endometrial scratch
My first failed transfer was a good quality embryo with a thick uterine line. I don't know what happened? I had 1 embryo, now I have 4 and I was checking out the Era and 80% say NOT to recommend it, doctor, do you think I should do it?
Hi Dr Aimee - what about the endometrial scratching procedure ? Do you recommend that at all?
The biopsy you do for the ERA is the scratch. I don’t do a scratch Ie a biopsy just to do the biopsy without trying to learn as much as possible about the uterus
One ivf resulted in 1 fresh day 3 embryo transfer (it didn't take); 2nd ivf canceled (nothing growing); low AMH; almost 42 yo. Just banked a day 3 embryo and will try another retrieval. I suppose ERA could improve my chances as well as transferring 2 embryos? Thoughts, Dr Aimee? Thank you
yes, I think it could help. When you're ready to transfer, doing a mock cycle can only give you more information about yourself. It won't hurt.
doctor, do u trust ERA test ?
Hi Dr.Aimee my era test showed post receptive , does that mean I take my progesterone in the morning instead of taking it at night? My doctor doesn’t believe in it but I insisted to have my era done since it was my last pgs embryo
pet-calculator.igenomix.com/ you use this calculator to take your ERA# and then it tells you based on the transfer day and time, what time to start your progesterone ahead of time. I do believe in the test :)
Hi Dr. Amy. What are your thoughts on endomterial scratch and aspirin after 2 failed transfers?
Hi hi yes DOC when to stop taking aspirin 🤔
Hi, I had my 1st transfer (Day 3 embryo) with Donar egg on Feb 2020. It was a failed transfer. Last month I had era test after 5 days of progesterone intake and the result says I'm receptive. They report says if we are transferring day 3 embryo's the transfer should be done 2 day's before. My first transfer was done after 3 days of progesterone intake. As per the era result I'm receptive for 3rd day embryo after 3 days of progesterone intake. Then why my transfer was failed? Awaiting for your valuable response.
pet-calculator.igenomix.com/pet-calculator-type/
you can use this link to make sure you're transferring at the right time. Embryo quality+genetics+your uterine cavity all play a role in implantation. Sperm genetics is part of embryo quality + genetics too. If sperm quality wasn't good at time of embryo creation, that could be an issue as well. You're doing all the right things. Keep trying and perhaps talk to your doc about the things I mention to make sure you haven't missed a single thing: cavity evaluation, preconception labs, healthy eating and body size are all essential.
I had my era on cycle day 24 with 8 days of progesterone and it came back as receptive. My following cycle my doctor did my transfer on cycle day 26 with only 4 days of progesterone and he dropped .5 ml of PIO for my daily dose after the results showed I was receptive. Could this be the reason my transfer failed? Also my embryo was thawed 24 hours prior to transfer. I’m so confused. Any input?
I would ask your doctor why they made those changes so you can have clarity about this. I'm glad you noticed the difference.
Would you recommend the ERA test for someone who has done 2 IVF transfers with donor eggs, and both ended with losses? First transfer the loss was at 8 week's, baby stopped growing at 6+2. Was tested and baby was normal. Second transfer lost baby at 6 weeks, stopped growing at 5+3. Still waiting on test results, but think it's leaning towards abnormal.
sigh. I'm so so sorry. Go through my draimee.org/five-steps-to-take-after-a-miscarriage and hopefully you'll find something you can do to prevent this from happening again. Truly heartbreaking and I've lived through outcomes like this with my patients too. Literally some of the hardest stuff we can deal with as a woman and also as a fertility doc.
@@EggWhisperer, thank you so much for your kind word's and info. Yeah, I had all that miscarriage testing done after my first miscarriage. Nothing has come back as abnormal. I do have endometriosis(stage 2/have had 2 lap surgeries), Ulcerative Colitis(under control with meds), MTHFR(take Methlyfolate) low AMH, and diminished ovarian disease, and I'm 38. This is why we went the donor egg route. Nothing wrong with my uterus and I've had a handful of hysterocopy's over the year's! I am having issue's with getting my lining thick. This last transfer I only got it to 7mm with the 3 line look. Husbands sperm are great. Just had a Endometrial Biopsy to rule out endometritis/infection and that came back negative. We always have a saline ultrasound before each transfer. I'm thinking about asking my Dr if we can check my Prolactin level's, Natural Killer Cells, and do ERA. That's all I can find that we haven't already done. Do you think ERA would be beneficial in my case?
Hi Dr. Aimee.
Thank you so much for this video.
I have one question about the window of implantation, and I hope that you could get me an answer.
Basically, I have tested my WOI and I know that I have pre-receptive endometrial (embryo transfer is recommended 12h earlier than the biopsy is taken). Then I had a successful transfer but it leads to missed abortion in 9 weeks and I had to make dilation and curettage. My question is - could this procedure affect the window of implantation and ERA is need to be done again?
And how soon after curettage you would recommend the next embryo transfer?
Hope to hear from you soon!
I m post receptive 13 hours
So instead of starting first endometrin in the morning, on transfer cycle it started at night for transfer in day time.
Did you do the same too?
I wonder when was your second pill inserted because originally it was, e.g 8am, 2pm, 8pm
So if it started 11pm, I wonder if I should do second dose 6 hours after like the mock. However I did 11am the next morning as second insert. You know what my transfer failed.
So I wonder if you mind sharing your experience and time for medication. Thanks
How are the results examined
Hey Dr Aimee - I assume the vaginal progesterone is designed to absorb through cervical mucus? Sorry for the TMI question but you do get a lot of it because of the estrogen pills. I’m hoping my first lot absorbed properly and I therefore did the ERA test correctly.
I B yes! I call it “vagi-seltzer” for a reason 😂 it definitely causes a gross slimy watery vaginal discharges because that’s how it gets absorbs: by being exposed to moisture in the vagina. I’ve had patients think that seeing discharge means they are absorbing too much or not enough. I tell patients if they see a tablet come out, place another, if you have sex, place another, if you feel like you may have forgotten a tablet, place another. There’s no such thing as too much. I like to also make sure the progesterone level is at ten with endometrin. If it isn’t it doesn’t mean a patient has to use progesterone injections. I will then go up to endometrin four times a day: 8 am 12 noon 4pm and 8pm. And then I even add one oral progesterone highly too! So many ways to still avoid the injections if a patient wants to.
Hi thanks for your very quick reply. I’m in Australia and for some reason they prefer vaginal progesterone instead of progesterone in oil here. I was on 400mg Utrogestan 3 times a day. It made me quite sedated which was a actually a good side effect. As you can tell I’m quite anxious :)
I B I think you also have a pessary option too that we don’t have in the US. Fingers toes and eyes crossed for you!!
Do you recommend era test for first IVF? I only have 2 embryos (no pgs) so want to ensure success as much as possible
hi Allison. I talk to everyone about implantation testing. And in a case like yours, I would say that most of my patients would do it. It could increase your pregnancy chances by 5-10%.
Allison G. Please don’t listen to people on the internet who are NOT Reproductive endocrinologist. I do believe you need to have two failed implantations cycles before it’s offered. Please speak to your doctor and don’t get listen to bad information. Good luck! 🍀
@@lilithssilvermoon3208 I am a Reproductive Endocrinologist. Harvard Obgyn Residency, University of Michigan REI fellowship. Everyone should know about this testing, especially if you only have the # of embryos for the family size that you want. If you have 2 embryos, you don't have to experience the pain of 2 failed transfers before someone guides you with extra tests. You can certainly decline them, but it wouldn't be fair to offer them after failed transfers if someone doesn't have any embryos left. I hope this answer helps you.
@@lilithssilvermoon3208 Thank you for being so sweet. I really appreciate your message and support. Thank you from the bottom of my heart. Being a fertility patient is one of the hardest experiences a person can have in their life. I'm so sorry for what you've been through so far. I am sending you as much positive energy as I can right now toward you.
Egg Whisperer Show thank you so much! I guess the really frustrating part of all of this is the fact I’ve had every single test under the IVF sun. I have gone through a year of nothing but transfers and testings. From blood tests, biopsy’s, HSG‘s, immunity, hysteroscopy‘s, ultrasounds, sonograms an x-ray, two months on letrozole and Norethindrone, scratches, Neupogen, panel tests, including thyroid. I’ve done it all. This is my last resort. The doctors have found nothing wrong with me. Lucky for me I have 13 more PGS tested embryos. And they are wonderful. I think the ERA test, is what I was missing. As soon as I started learning about this. It dawned on me, I should’ve done this at my last transfer instead of the actual transfer. But my doctor did not seem Very positive about it. So today I insisted. I’m going to have this test done. I am a very healthy person, and there is no reason why I can’t do this everything is in my favor. I think we’re missing the window. I’ve been pregnant before. I have five grown children. I won’t tell my age (50) ha ha 😂🤣😂🤣😂 But I don’t have any problems with my uterus, I’m just too old to get eggs so I use donor eggs. Like I said, there’s nothing wrong with me. This receptivity test I think is my answer
I wish I had you as my doctor, we have had 4 early miscarriages and 1-second trimester loss with donor eggs. We have now been advised the next test to do is ERA, just feel like we have lost so much time x
Victoria Ray I’m incredibly sorry. I would say if you were my patient I would be looking closely at your uterus and asking: have I made sure there isn’t a polyp or fibroid getting in the way or even a septum. I would ask; is it possible the sperm dna could be contributing to this? I would look at alllll the things in my ANGEL method: autoimmune issues, nutrition, genetics, endocrine and lifestyle. Sending you so much love. I’m doing an IG live 4 pm pst this Tuesday. Do join if you’d like. instagram.com/eggwhisperer
Sorry dear I wish all the best for you guys may all come together
Hi, I have had 2 chemical pregnancies with 3 good quality pgd tested embryos. The pregnancies were ‚barely‘ chemical, hcg never rose above 20. But the rise and fall were extremely similar. My Dr. Doesn’t agree with the ERA as technically the embryos implanted (i would say yes but barely) I really want the test but it is very expensive. Would you recommend it in my case? Thank you!
Yes. I definitely do. I would also recommend the receptivadx.com test. I will have the doctor who invented the test on a show in the next couple of weeks so do look out for it!
Egg Whisperer Show Thank you so much for replying! Yes i am going to do the ERA, i would regret it if I didn’t. I will look into receeptivadx too!
@@cliodhna2548 you're welcome! instagram.com/eggwhisperer/ do follow me on instagram too where I do live Q+As if you ever want to join. Next one will be next Friday at 4PM PST
@@cliodhna2548 Have you finally done it? How's the result?
Yuan Chen yes i did it. It came back receptive. I did a third transfer but unfortunately that was another chemical ☹️
My progesterone shots weren’t that bad actually. I was super scared beforehand but they’re fine, you’re just sore for a while. Menopur is worse!
Omg yh soon as I injected menopur it felt like a stab wound!
ERA result did not give me any different data, ultrasounds fixed the same, just I suffered from a biopsy
Scrupulous Review I’m sorry it was such a bad experience. I believe in not causing women pain. I either do it under anesthesia or with a Valium and a Vicodin. I also do the receptivadx test at the same time. I accomplish several things : 1. Allows me to make sure a patient can tolerate the meds 2. Makes sure lining thickness is where we want it to be before the real thing 3. Mock transfer 4. Both tests 5. And if a patient hasn’t had a saline sonogram, hysteroscopy or hsg I make sure it’s also done as well during this mock or rehearsal and lastly 6. The endometrial scratch may help some people
@@EggWhisperer I remember that doctor was stabbing me inside of uterus until I scream STOP. I also have painful ER under estradiol 5500 which was mild ovarian hyper stimulation. Pain after pain. Is too much, as a result now I am anti Era woman.
Scrupulous Review I don’t blame you. What you describe sounds barbaric. Again I’m sorry you had such a terrible experience. That is inhumane, doesn’t just sound inhumane.
The ERA test was not bad and it does work!
yeah but it's butt expensive, plus you have to pay monitoring (850+) and medicine(1800+), and waste a full cycle to take the the test- Plus another full cycle for the results. Results have to be in prior to your cd 1, and they take around 3 weeks, so you will have already started and wasted the cycle they arrive in. Sure hope my dr doesn't push this era test on me bc I want my fet in my next cycle. If it doesn't stick, then I'll just start another retrieval cycle and do the era then
Studies are showing it doesn't improve pregnancy rate in people who don't have repeat failures and no difference when used. Can you address those as i believe some came after this video and if you still think it is actually showing valuable information?
Hi, does the lining grow after progesterone is started? I just did an ERA test and started progesterone when my lining was 8mm, but would ideally like it more like 9mm during my real transfer cycle. You also say that most of your patients need 134 hours of progesterone. Does that mean most of your patients are pre-receptive? Mine came back as pre-receptive at 137 hours needed.
I B great questions. If yours was pre receptive it means that you likely did around 125 hours of progesterone in your mock cycle. The info is there on your report. You will find out how many hours you took for the mock and how many hours are recommended for you now. I always recommend double checking everything so that you are doing things right. Also, yes. The lining does continue to grow after the lining check from being on estrogen longer. 8 mm is great!
I B most of my patients come back receptive. 9 out of 10 do and the one that doesn’t is so happy we did the test
Just failed my 1st FET, the embryo was PSG tested. What we know so far is it was implemented but failed to grown. Dr Aimee, what do you suggest me to do for my next try?
@@Li-sx1tq First of all, I'm so sorry. Here are the things that I talk about when this happens to one of my patients: 1. what was the egg quality? 2. What was the sperm like on the day of the retrieval? 3. How many embryos do you have left and how many kids do you want? 4. Have you done implantation testing? 5. What is your body size? aka BMI? 6. have you had a cavity evaluation? 7. What was the transfer day like? If it didn't go well, why? Reviewing the answers to these questions with your doctor will guide you re: best next steps
Thank you Dr Aimee, I will make sure to discuss those questions during my Monday review with my doctor. Your video always give me peace and hope in this journey, I can’t express how grateful I’m for your positivity and selfless sharing of your knowledge!
No ERA, I do not recommend, I have done it was womb scraping of pain, postponed embryo transfer, it is a nightmare especially for 1 st time IVF patient, it is study test only.
Scrupulous Review NOT true- you should never give medical advice to someone else unless you are a medical professional (which you are not) it’s different for everyone and you should encourage people to speak to their doctor. Wow! Just Woooow!
My doctor only does two PIO vaginal a day not three. Is this ok or good?
Smile More yes and ask for a progesterone level check to make sure its enough for you
Smurfgina 🤣🤣🤣