A case of discrepancy between three ERA tests in a woman with repeated implantation failure complicated by chronic endometritis

Abstract

Background Endometrial receptivity array (ERA) is used to determine the timing of embryo transfer (ET) synchronized with the window of implantation (WOI). The effectiveness and evaluation of ERAs in women with recurrent implantation failure remain controversial. We report the case of a patient with recurrent implantation failure that raises the issue of reproducibility of ERA tests. Case report A 36-year-old Japanese woman with secondary infertility who had previously given birth failed to conceive after three frozen-thawed embryo transfer (FET) cycles. An ERA test was conducted to confirm the WOI. The first ERA test was performed 125 h after progesterone exposure. The laboratory reported that the endometrium was in a non-receptive (post-receptive) phase, and recommended retesting 101 h after progesterone exposure. A simultaneous chronic endometritis (CE) test showed a score of 3. After the antibiotics administration to treat CE, the second ERA test was performed after 101 h of progesterone exposure. The laboratory reported that the endometrium had not reached the WOI and estimated the WOI to be 113 ± 3 h after progesterone exposure. The third ERA test was performed 113 h after progesterone exposure. The laboratory reported that the endometrium was in a non-receptive (pre-receptive) phase and estimated the WOI to be 137 ± 3 h after progesterone exposure. A CE test performed at the same time as the second and third ERA tests showed a score of 1 for the collected endometrium. According to the third ERA test results, the vitrified-warmed blastocyst was transferred at 137 h of progesterone exposure. Pregnancy was achieved and the patient had an uncomplicated vaginal delivery at 39 weeks. One year later, another pregnancy was achieved after FET at 137 h of progesterone exposure, and the patient delivered at 33 weeks due to an unexpected membrane rupture. Conclusion Because the results of the ERA test may vary in the presence of CE, CE should be diagnosed simultaneously with or before conducting ERA tests. If CE is diagnosed, ERA testing should be performed after treatment with antimicrobials or other drugs.

Micronutrient Antioxidants for Men (Menevit®) Improve Sperm Function by Reducing Oxidative Stress, Resulting in Improved Assisted Reproductive Technology Outcomes

“…IVF/ICSI procedures, including ovarian stimulation, oocyte retrieval, and insemination using IVF or ICSI, were performed as previously described [ 39 ]. A frozen–thawed embryo transfer (FET), typically utilizing a hormone replacement cycle, was performed as previously described [ 40 ]. Briefly, an FET was planned, the endometrium was prepared with a hormone replacement cycle, and transdermal estradiol (0.72 mg, Estrana TAPE, Hisamitsu Pharmaceutical, Tokyo, Japan) was started on CD 3.…”

Factors affecting the ongoing pregnancy rate in women with repeated implantation failure undergoing an endometrial receptivity array

“…This suggests that the displacement of the WOI may be dependent on the body mass index. Ota et al [ 21 ] additionally proposed that chronic endometritis could potentially influence WOI displacement.…”

Therapeutic efficacy of the optimization of thyroid function, thrombophilia, immunity and uterine milieu (OPTIMUM) treatment strategy on pregnancy outcomes after single euploid blastocyst transfer in advanced age women with recurrent reproductive failure

“…Although the OPTIMUM treatment strategy did not include endometrial receptivity testing, 25 women underwent ERA (Igenomix Japan, K.K.) or ERPeak SM (CooperSurgical, Inc, United States) in the OPTIMUM group upon their request after CE was not detected given the potential influence CE on the window of implantation 29,30 . Thereafter, personalized ET was performed based on the results.…”

“…or ERPeak SM (CooperSurgical, Inc, United States) in the OPTIMUM group upon their request after CE was not detected given the potential influence CE on the window of implantation. 29,30 Thereafter, personalized ET was performed based on the results.…”