Endometrium Receptivity Assay (ERA) Test: Booking, Price, and Results
About Endometrium Receptivity Assay (ERA) Test: Booking, Price, and Results
| Field | Value |
|---|---|
| Also Known As | Endometrial Receptivity Analysis, Endometrial Receptivity Array, ERA Fertility Test |
| Sample Type | Endometrial tissue biopsy (uterine lining sample) |
| Fasting Required | Not required in most cases; fasting is necessary only if general anaesthesia is used |
| Report Time | 35 days |
| Recommended For | Women undergoing IVF, particularly those with recurrent implantation failure |
| Price | Starting at ₹45,000 |
What Is an Endometrium Receptivity Assay (ERA) Test?
The endometrium receptivity assay (ERA) test is a specialised molecular diagnostic test that examines the uterine lining to determine the best time for embryo transfer during IVF. It uses next-generation sequencing (NGS) to analyse gene activity in a small tissue sample taken from the endometrium, which is the inner lining of the uterus. Doctors typically recommend this test for women who have experienced repeated IVF failures despite having good-quality embryos. It is also referred to as the ERA fertility test, endometrial receptivity analysis or endometrial receptivity array.
What Does an Endometrium Receptivity Assay (ERA) Test Measure?
The ERA test examines a tissue sample from the uterine lining using NGS technology. Here is what this test analyses:
| Component | What It Tells Us |
|---|---|
| Gene expression profile | Activity levels of 238 genes linked to the different stages of the endometrial cycle |
Why Is an Endometrium Receptivity Assay (ERA) Test Done?
The ERA test is used when standard IVF approaches have not resulted in successful implantation, despite the presence of good-quality embryos.
Common Symptoms That May Require This Test
The following situations commonly lead to a referral for this test:
- Repeated failure of embryo implantation across multiple IVF cycles
- Unexplained infertility despite good embryo quality
- Multiple failed frozen embryo transfers (FET)
- Suspected displacement of the window of implantation
- Prior to a planned frozen embryo transfer in women with a history of IVF failure
- Inconclusive results from previous fertility investigations
Conditions This Test Can Help Detect
The ERA test helps identify the following:
- Displaced or non-standard window of implantation
- Pre-receptive endometrium (uterine lining not yet ready at the standard transfer time)
- Post-receptive endometrium (optimal window has already passed)
- Recurrent implantation failure (RIF), where embryos do not attach after multiple IVF attempts
How to Prepare and What to Expect
Before undergoing the ERA test procedure, some specific preparation steps are required. Your fertility specialist will guide you through a hormone protocol in advance.
Do You Need to Fast?
Fasting is not required for the standard in-clinic biopsy procedure. However, if your doctor plans to use general anaesthesia (intravenous sedation), fasting will be necessary beforehand. Confirm this with your doctor in advance.
Practical Tips Before Your Test
The following tips will help you prepare:
- Bring a detailed clinical history including your symptoms, previous test results, and fertility treatment history, as this is required for the test.
- Your doctor will likely prescribe a course of oestrogen and progesterone in the weeks before the biopsy; follow this hormone protocol precisely.
- Inform your doctor about all medications and supplements you are currently taking.
- Avoid tampons and vaginal douching for at least 24 hours before the procedure.
- Arrange for someone to accompany you if your doctor has prescribed a relaxant medication.
Step-by-Step Procedure
- Your fertility specialist will guide you through a preparatory hormone cycle, including oestrogen and progesterone, to prime the uterine lining.
- The biopsy is timed precisely, usually seven days after the LH surge or after five full days of progesterone, to capture the relevant endometrial stage.
- In the clinic, a thin instrument called a pipelle is gently inserted through the vagina to collect a small tissue sample from the uterine lining.
- The procedure takes approximately two minutes. Most women experience brief cramping, which passes quickly.
- The tissue sample is placed in a sterile container and stored refrigerated (at 2 to 8°C) until it is dispatched to the laboratory for NGS-based analysis.
- Results are returned to your fertility specialist within 35 days, who will then advise on the ideal timing for your embryo transfer.
Factors That Can Affect Accuracy
- Incorrect timing of the biopsy relative to progesterone exposure
- An insufficient quantity of tissue collected during the procedure
- Not following the prescribed hormone preparation protocol
- Presence of chronic endometritis (a uterine lining infection); this should be diagnosed and treated before the ERA test is performed
- Underlying conditions such as adenomyosis, which may affect the gene expression profile of the endometrium
Understanding Your Endometrium Receptivity Assay (ERA) Test Results
Results from the ERA test are interpreted by your fertility specialist in the context of your overall IVF plan. The table below outlines the possible outcomes and their general meaning:
| Result | Interpretation |
|---|---|
| Receptive | The uterine lining was in the optimal state for embryo transfer at the time of the biopsy |
| Pre-receptive | The optimal window had not yet been reached; a longer progesterone exposure may be needed before the next transfer |
| Post-receptive | The optimal window had already passed; progesterone should be started earlier in the next cycle |
These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
Certain conditions may influence how results are interpreted:
- Chronic endometritis is an infection of the uterine lining that can affect endometrial receptivity. The ERA test should be performed only after this condition has been treated with the appropriate medication.
- Adenomyosis, a condition where uterine tissue grows into the muscle wall, has been shown to alter gene expression patterns in the endometrial lining, which may affect how results are read.
How to Maintain Healthy Levels
The following general wellness tips may support uterine health during IVF preparation.
- Follow your fertility specialist's hormone protocol precisely, as timing is critical for an accurate result.
- Eat a balanced diet rich in whole grains, leafy vegetables, and lean protein to support overall reproductive health.
- Attend all scheduled follow-up appointments and discuss your full results with your doctor before proceeding to the next IVF step.
Lupin Diagnostics Endometrium Receptivity Assay (ERA) Test Price
The ERA test cost at Lupin Diagnostics starts at ₹45,000. Home collection is not available for this test, as it requires a visit to a hospital as directed by your doctor. The table below shows indicative prices:
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 45000 |
| CHENNAI | 45000 |
| HYDERABAD | 45000 |
| KOLKATA | 45000 |
| NAVI MUMBAI | 45000 |
| PUNE | 45000 |
Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
Follow these steps for ERA test online booking:
- Select the ERA test on the Lupin Diagnostics website.
- Choose your city and preferred centre location.
- Visit the centre at your scheduled time for the biopsy procedure.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Frequently Asked Questions
The endometrium receptivity assay (ERA) test is used during IVF to find the ideal time for embryo transfer by analysing gene activity in the uterine lining. It helps identify each patient's unique window of implantation, which can differ from one person to another.
The ERA test is generally recommended for women who have had two or more failed IVF cycles despite transferring good-quality embryos. It is not typically advised for first-time IVF patients. Your fertility specialist will decide whether it is appropriate for your situation.
The biopsy involves a brief cramping sensation, usually lasting around 10 to 30 seconds. The procedure itself takes about two minutes and does not require sedation in most cases. Taking a pain-relieving tablet an hour beforehand, as advised by your doctor, can help reduce discomfort.
At Lupin Diagnostics, results are delivered within 35 days of the biopsy. This accounts for the time required for NGS-based laboratory analysis. Your doctor will schedule a follow-up consultation to discuss your results once they are available.
A pre-receptive result means the uterine lining had not yet reached the optimal stage at the time of the biopsy, and progesterone may need to be given for longer before the next transfer. A post-receptive result means the window had already passed, suggesting the transfer should be scheduled earlier in the cycle.
The procedure is considered safe, and serious complications are rare. Some women experience light spotting or mild cramping for a few days after the biopsy. Less common side effects can include a minor risk of infection. Your doctor will advise you on what to watch for after the procedure.
No. The ERA test helps optimise the timing of embryo transfer but does not guarantee a successful pregnancy. Current evidence has not consistently shown an improvement in live birth rates with ERA-guided transfers. Discuss the expected benefits and limitations openly with your fertility specialist before proceeding.
Endometrium Receptivity Assay (ERA) Test: Booking, Price, and Results
