To determine if Endometrial Receptivity Analysis (ERA) testing will improve implantation and pregnancy rates in patients undergoing medicated frozen embryo transfer (FET) cycles.
Retrospective study in a large private practice fertility clinic.
MATERIALS AND METHODS:
We included all patients who had one or more ERA tests (Igenomix) in our clinic from 1/2016 to 5/2017. Patients were treated with oral and/or vaginal estradiol and begun on vaginal or intramuscular progesterone when the endometrial thickness was 7 mm or more and the serum progesterone level was less than 1 ng/ml. The first endometrial biopsy ERA test was done on the sixth day of progesterone. Patients who had a receptive ERA on day 6 of progesterone had a medicated FET with the transfer on day 6 of progesterone. Patients who had a pre-receptive ERA on the sixth day of progesterone were offered a repeat ERA or FET on day 7 of progesterone. A serum quantitative hCG was drawn 9 days after a blastocyst FET and repeated 48 to 72 hours later. A transvaginal ultrasound was performed by 7.5 weeks estimated gestational age. Statistical calculations were performed with a Chi-Squared test.
A total of 85 women, ages 27-51, had an ERA test on the 6th day of progesterone. The majority of patients had a prior failed FET (70%). Only 24% of the ERA tests on day 6 of progesterone were receptive (Table 1). Repeat ERA testing on day 7 of progesterone was performed on 38 patients. The majority of day 7 progesterone patients had an ERA test that was receptive (79%). Ninety percent of patients had a single embryo transfer and 10% a double embryo transfer. The pregnancy rates were significantly higher in our patients having an embryo transfer on the seventh day of progesterone.
Women undergoing a medicated FET cycle were significantly more likely to have a receptive endometrium, by ERA testing, on the 7th day of progesterone. There were also higher pregnancy rates in women having a transfer on the 7th day of progesterone in medicated FET cycles.
Day 6 or Day 7 of Progesterone
|Days of Progesterone||Pre-Receptive ERA||Receptive ERA||Post-Receptive ERA||PGS Embryos||Pregnacy Rate per FET||Ongoing Rate Per FET|