Ray of hope for IVF tests

Why did my In Vitro Fertilisation (IVF) fail? After over eight years of trying to conceive and two failed attempts of IVF cycles this is what 31 year old, Vidya kept wondering over and over again. Despite taking every possible care, the cause of failure remained a mystery. But, thanks to a revolutionary test, she has new hope.

More than 50,000 IVF cycles occur in India and the success rate of IVF varies from 30-50 per cent. Experts at the Nova IVI fertility clinic believe that the new test Endometrial Receptivity Array (ERA) could transform IVF by analysing the receptivity of the uterus and pinpointing the exact time for embryo transfers to ensure a successful pregnancy.

Recent studies show that 15-25 pe cent of cases of implantation failure often happen because an embryo is implanted at the wrong time in the uterus, missing a woman's crucial window of fertility. Dr Chandana Lakkireddi, fertility consultant, Nova IVI Fertility, Hyderabad, says “Quality of embryo is not the only predictor of a good implantation.

The receptivity of the uterus is also a crucial factor. The ERA test operates on a similar premise and provides insight into how receptive a woman’s uterus will be at a particular stage in her menstrual cycle. Essentially, this helps doctors to determine the best time to transfer an embryo in hopes that it will implant.

This test helps both doctors and couples understand why IVF can be unsuccessful and reduce the frustration of unanswered questions. The test involves collecting a sample of uterine tissue with a soft catheter, with local anaesthesia and send to the genetic lab for detailed analysis. This reduces the number of IVF cycles the couple has to undergo and therefore reduces the emotional and financial loss incurred.”

Currently doctors are evaluating the uterine lining by its appearance in ultrasound and demonstrated blood flow by Doppler. It has been believed that for most women, there is a two to four day time period when the lining gives out the key chemical signals that allow the embryo to attach, leading to a pregnancy.

“In fact, some of the latest reproductive findings encourage patients to freeze their good quality embryos and transfer them once the uterus is ready to accept it. Endometrial biopsy in a cycle before embryo transfer can predict which day implantation may occur in a subsequent cycle,” she added.

In case of Vidya, basis her medical history and ERA report, her healthy good quality frozen embryos were transferred at the right time to result in a successful implantation. Vidya was asked to do a blood test after 2 weeks from then to check for pregnancy and the result was positive. She was followed up with scans and found to be having a single healthy pregnancy.

Typically, embryo transfers are performed between day three and day five after retrieval. The time of transfer is determined as a direct result of embryo development. Embryos that stand a strong chance of growing in the lab until day five are transferred as blastocysts.

ERA will be useful guide at this point of treatment to determine personalised implantation window for better success. Previously, medical experts were dependent on a hit and trial method till there was a success or otherwise. Now, ERA allows timely implantation which increases the success rate of pregnancy and reduces the time that patients have to wait to achieve a pregnancy. Moreover, the cost of the test is economical, especially when considering the overall costs of fertility treatment and potential benefits of understanding endometrial receptivity.