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Endometrial Analysis

Endometrial analysis is a method where the endometrium is checked to determine the optimal time for embryo transfer

Helpful tools
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Types of endometrial analysis

Endometrial Receptivity Analysis (ERA)

Endometrial Microbiome Metagenomic Analysis (EMMA)

Analysis of Infectious Chronic Endometritis (ALICE)

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Endometrial Receptivity Analysis (ERA)

For most women the time of endometrial receptivity for an embryo to implant is accurately predicted by the number of days after ovulation, but for some women the ‘window for implantation’ occurs later or earlier. The Endometrial Receptivity Analysis or ERA is a method whereby the endometrium may be checked to determine whether the date of embryo transfer may need to be adjusted to match the woman’s own window for implantation.

An embryo may not implant successfully if not transferred at the optimal time during IVF treatment.

How it works:

  • The woman goes through a mock frozen embryo transfer cycle and on the day of embryo transfer instead of replacing an embryo a Pipelle biopsy is done.

  • This is where a small sample of the lining or endometrium is taken and then couriered to the ERA lab for testing in Japan.

  • The ERA lab then checks the expression of 238 genes in the biopsy sample and sends a report indicating a receptive endometrium or a pre-receptive or post receptive endometrium.

  • The timing of the embryo transfer is then adjusted accordingly.

ERA test resulted in a 73% increase in pregnancy rate in patients with implantation failure.

Who should do ERA?

The current recommendations are that the ERA may be useful in women with recurrent implantation failures. There is debate about what the definition of implantation failure is, It is reasonable to consider ERA if a pregnancy has not resulted after the transfer of 2 to 3 good quality embryos into a normal uterus, in which the expectation of greater than 80% would have become pregnant.

Blog on ERA can be found here.

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Endometrial Microbiome Metagenomic Analysis (EMMA)

Endometrial health is vital for a successful pregnancy. A healthy endometrium is rich in healthy bacteria - the endometrial flora or microbiome.

EMMA analyses the endometrial microbiome for a better reproductive prognosis and recommends the best probiotic treatment to balance your endometrial flora, improving your pregnancy prospects.

The chances of pregnancy may be reduced if the levels of healthy bacteria in the endometrium are low.

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Analysis of Infectious Chronic Endometritis (ALICE)

Chronic endometritis is one of the causes of recurrent implantation failure and recurrent pregnancy loss. In most cases, this disease causes endometrial inflammation with no visible symptoms.

ALICE detects the bacteria causing chronic endometritis to improve the success of your fertility treatment.

About 66% of patients with repeated implantation failures or recurrent pregnancy loss are affected by chronic endometritis.

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The Biological Clock

This tool indicates:

  • Natural conception per month if you have no fertility issues
  • IVF success rate at the same age
  • When to seek help after months of unsuccessful attempts

If you are concerned at any stage – we recommend booking a doctor appointment or a free nurse consultation. The sooner you make a plan the better your chances in the long term.

When to seek advice early

  • If you have polycystic ovaries, endometriosis, or have been through a cancer diagnosis; we recommend you get in touch quickly so we can talk you through all your options and give you the greatest possible chance of success.
  • If you’re a single woman considering motherhood in the future; it’s best to approach us early and consider egg freezing as this can be an option for you while you have a higher ovarian reserve and healthier eggs.
Set your age and the months you’ve been trying to conceive
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Your chance of having a baby per month for fertile couples
Your chance of having a baby per IVF cycle (if experiencing infertility)

Body Mass Index calculator

Being overweight or underweight can reduce fertility, so it is important to keep your body weight within the normal healthy range.

Body Mass Index (BMI) is an indication of your body weight and can be calculated by dividing weight by height. You should aim for a BMI of between 20 and 25, as this will optimise your chances of conception.

Woman’s BMI below 19

Even in these modern times, nature knows best. If a woman's BMI falls below 19, the body senses famine and ovulation is switched off to prevent the risk of having a baby with malnutrition. Excessive exercise can reduce body fat and increase muscle mass to a point where periods cease for the same reason. Risk of miscarriage is also increased in women with a low BMI.

Being underweight

If a woman's BMI falls below 19, the body senses famine and ovulation is switched off to prevent the risk of having a baby with malnutrition. Excessive exercise can reduce body fat and increase muscle mass to a point where periods cease for the same reason. Risk of miscarriage is also increased in women with a low BMI.

BMI’s greater than 30

This can reduce fertility by 50%. Pregnancy for women with a 30+ BMI is often associated with problems such as maternal diabetes, high blood pressure, big babies and increased risk of caesarean section.

Add your height and weight to calculate your BMI