What is an Endometrial Receptivity Analysis Cycle (ERA)?

At Growing Generations, we do our best to stay up-to-date on IVF innovations that can increase pregnancy success. An Endometrial Receptivity Analysis cycle (ERA) is a newer assessment that has helped fertility physicians determine the optimal day in a surrogate’s cycle for embryo transfer. We recently had the opportunity to discuss the science behind this process with fertility physician Dr. Guy Ringler of California Fertility Partners, who spoke to us about what an ERA cycle is and it’s benefits.

An ERA Cycle is very similar to a “mock cycle,” the purpose of which is to monitor the surrogate’s uterine and hormonal response to the IVF medications they will take prior to embryo transfer. However, as Dr. Ringler explains, an ERA cycle includes one extra step at the end of the mock cycle, the fertility physician takes a sample of the uterine lining on what is believed to be the best day in the cycle for an embryo transfer. This sample is then analyzed by a lab. Because the uterine lining is a significant factor in successful embryo implantation, an ERA is a great way of determining whether conditions are optimal for transfer.

Our conversation with Dr. Ringler references a research study centered around an ERA cycle that focused on monitoring hormone levels and gene expression and their correlation to the uterine lining. Dr. Ringler provides a wonderful explanation during our conversation about what happens to these hormones and genes throughout a woman’s cycle to help bring awareness to the science behind what makes uterine lining optimal for implantation and how an ERA can decrease the odds of a failed transfer attempt.

Amazingly, after an ERA cycle is performed, fertility physicians can present what is called a Personalized Embryo Transfer (PET) window to the surrogate and intended parents. The PET window explains which day during a surrogate’s personal cycle is the most promising for a successful embryo transfer.

While an ERA can be a beneficial tool, it is not always offered or recommended unless one or more failed transfer attempts have occurred, or if there are very few embryos available. If you’re interested in learning more about whether an ERA may be right for your journey, contact your fertility physician directly.

Check out our full conversation with Dr. Ringler in the video below:

YouTube video

Kim Bergman, PhD, a licensed psychologist of 26 years, has specialized in the area of gay and lesbian parenting, parenting by choice and third party assisted reproduction for over two decades. Dr. Bergman has created a comprehensive psychological screening, support and monitoring process for intended parents, surrogates and donors. She is the co-owner of Growing Generations and is a member of the American Society for Reproductive Medicine, the American Psychological Association, the Los Angeles County Psychological Association, the Lesbian and Gay Psychotherapy Association, and the Gay and Lesbian Medical Association. She is on the national Emeritus board of the Family Equality Council. Dr. Bergman writes, teaches and speaks extensively on parenting by choice. Along with co-authors, she published “Gay Men Who Become Fathers via Surrogacy: The Transition to Parenthood” (Journal of GLBT Family Studies, April 2010). Dr. Bergman’s is the author of the book, Your Future Family: The Essential Guide to Assisted Reproduction (Conari Press 2019) as well as the children's book You Began as a Wish (Independent Press 2019). Dr. Bergman created her own family using third party assisted reproduction and she lives with her wife of 35 years. She has two adult daughters.