What is the value of endometrial receptivity testing (ERT)?
Endometrial receptivity testing (ERT) is a recently introduced fertility test that claims to identify the optimal "window" for embryo transfer, when the the lining of the uterus is ready to welcome the implanting embryo. In an endometrial receptivity test, a small sample of endometrium is taken via an endometrial biopsy, and the sample is analyzed for expressions of certain genes in a laboratory. The claim is that some women's optimal "window" for embryo transfer is earlier or later than normal, and by identifying the "window" through genetic expressions, timing of embryo transfer can be personalized.
CHR currently does not recommend ERT to patients who experience multiple failed IVF cycles or implantation failures--the patient population for which the test is supposed to help. One reason is our center's location.
Sometimes there are advantages to practicing in a highly overregulated state like New York. The advantage in this case is that New York State, in contrast to a good number of other states, has so far not licensed the sale of ERT. Consequently, New York-based patients must go out of state if they want to have this test done, which means not only costs for the test but also travel costs.
For CHR, this offers a convenient explanation why the test is not available at the center. The honest truth, however, is that, even if the test were licensed in New York State, CHR, likely, would not recommend it to patients. The reason is simple: It just appears to be yet another industry-driven test, introduced to the commercial market without appropriate prior validation studies. In addition, the improving understanding of implantation also suggests that the test, likely, makes little biological sense.
This is a part of the September 2018 CHR VOICE.
Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.
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