Endometrial Receptivity And IVF Success
In vitro fertilization (IVF) is one of the most well-known and successful forms of assisted reproductive technology (ART) that is available to women and couples today. The process occurs over 4-6 weeks and involves a complex series of events that includes boosting ovulation and fertilizing the egg outside the body. Once an embryo is formed, the resulting material is transferred into the uterus in hopes of implantation and ultimately a successful pregnancy that results in a live birth. However, for some women, poor endometrial quality can lead to frustration, such as miscarriage. When that occurs repeatedly, fertility experts might recommend testing and medications.
The endometrium is critical
The endometrium, or uterine lining, is what sheds every month during a woman’s period. Thanks to the rise and fall of specific hormones throughout the menstrual cycle, the lining thickens after ovulation in preparation for pregnancy. The endometrium is where an embryo first embeds into the uterus to grow into a fetus and where the placenta develops. Even during pregnancy, the endometrium serves as the main source for fluids and nutrients to flow between the mother and the fetus after the placenta forms.
Endometrium quality matters
Research shows that to support not just implantation but a full pregnancy, an optimal endometrial thickness is required. According to researchers, 8-14mm is the ideal range, with figures outside of that set resulting in a higher incidence of miscarriage, especially in IVF. The studies found that regardless of whether fresh or frozen eggs were used, people with uterine lining thicknesses beyond the optimal range were more likely to suffer IVF failure. If a woman experiences multiple failed transfer attempts, fertility specialists might recommend an endometrial receptivity analysis.
Benefits of analysis testing
An endometrial receptivity analysis (ERA) is a test that primarily measures the thickness of the uterine lining. However, an added benefit of the test is improving timing for embryo transfer to boost potential outcomes. Likewise, if the test finds that the thickness is outside of the recommended range, fertility specialists may suggest hormone therapy medications to improve thickness before another IVF round.
Potential medications
In most cases, hormone therapy is the most common option to boost uterine thickness. Estrogen, human chorionic gonadotropin (HCG), and growth hormone are three main choices that can help increase endometrial thickness. HCG in particular, can serve as a priming agent for the other hormones. If none of the previous medications yield results, doctors might also recommend granulocyte-colony stimulating factor (G-CSF), which can be an effective alternative. Some people might be prescribed blood flow-stimulating medications or treatments such as platelet-rich plasma (PRP), although PRP is still considered an experimental solution.
Improving outcomes
Typically, endometrial receptivity medications aren’t a first step for IVF patients. Instead, such options are usually reserved for a woman who has experienced multiple miscarriages or failed IVF attempts and undergoes an ERA that points to suboptimal thickness. If the above sounds familiar, consider speaking with a fertility specialist about undergoing an ERA.
