During this event, Dr Laura García de Miguel, Medical Director at Clínica Tambre explored the intricate world of endometrial receptivity tests, focusing on ERA (Endometrial Receptivity Analysis) and ER-map. These tests have gained significant attention and are widely used in assisted reproduction.
The endometrium is the innermost layer of the uterus, where embryo implantation and fetal development occur. It undergoes significant monthly changes driven by hormonal fluctuations, preparing for potential pregnancies.
For successful embryo implantation, the endometrium must be in prime condition, ideally trilaminar and 8-12 millimeters thick. While embryos are essential in reproductive treatments, a less-than-ideal endometrium can hinder implantation and ongoing pregnancy.
At Clinica Tambre, 2D scans are routinely used to evaluate the endometrium and, if necessary, other imaging tests are used such as hysteroscopy or MRI to assess endometrial morphology. However, endometrial receptivity tests become crucial when facing challenges during treatment.
While fertility clinics may offer various receptivity tests, they all aim to identify the optimal timing for embryo transfer in relation to progesterone, known as the ‘window of implantation.’
At Clinica Tambre, they offer the ‘Endometrial Solution,’ comprising two subtests: ‘ES-Time’ assesses the window of implantation, while ‘ES-Meta’ examines the uterine microbiome for potential infections and imbalances.
Both tests require a biopsy, typically performed by gynecologists during consultation. While not always painless, we recommend taking ibuprofen 30 minutes before the procedure. A full bladder is also advisable.
Biopsy results are usually available within 15 days. It’s crucial to wait for these results before proceeding with endometrial preparation for the next transfer.
ES-Time reveals the patient’s window of implantation, a brief period influenced by estrogen and progesterone levels. Around 25-30% of our patients experience issues with this window, making this test invaluable for tailored transfer planning.
ES-Meta identifies the presence of pathogens and assesses the balance of lactobacillus in the endometrium. This information can lead to antibiotic treatments or microbiome adjustments to enhance pregnancy chances.
These tests are recommended when infertility causes are unknown, in cases of implantation failure, recurrent miscarriages, or a history of infections in the uterus.
It’s worth noting that these tests can sometimes yield inconclusive results or require multiple biopsies if the window of implantation isn’t easily identified.
In conclusion, endometrial receptivity tests are essential tools to optimize fertility treatments. Failure to consider them in time can lead to increased costs and disappointment. Choose a trusted clinic that explains all potential strategies, including these tests, and stay well-informed about their necessity and validity periods.- Questions and Answers