子宫内膜容受性检测 ERA 找到种植窗，实现个体化胚胎移植

生殖医学解决方案 > 子宫内膜容受性检测 ERA 找到种植窗，实现个体化胚胎移植

概述

ERA
适用人群
益处

什么是 ERA 检测?

由 Igenomix 开发并取得唯一专利权的子宫内膜容受性检测 (ERA) 是专为子宫内膜容受性所设计的检测。

这项技术是利用 NGS 分析 248 个与子宫内膜容受性状态有关的基因表现。

已有多项研究证实 ERA 检测在侦测与容受性有关的基因表现图谱，具有高灵敏度和特异性。利用 ERA 检测，可在患者进行人工生殖技前，检测其个人着床窗期。

进行 ERA 时，Igenomix 特有的 AI 算法会先分析取自子宫内膜组织样本的 RNA，依 RNA 表现图谱，再将其分类为容受性或非容受性。若子宫内膜结果是非容受性，ERA 检测能够找出专属每一位患者的个人着床窗期。

ERA RCT 结论

我们随机对照研究表明：相比在标准日进行移植，在容受期进行个体化胚胎移植的受检者有更好的临床结果。

检测流程

谁应该接受 ERA 检测呢?

ERA 检测适用于因子宫内膜因素经历移植失败的辅助生殖患者。
不同阶段的临床研究正在探索 ERA 对于初次就诊的 IVF 患者的适用性。

什么时候会需要二次采样呢?

90% 的个案不需要二次采样。只有在下列情形发生时，才会需要二次采样：

Pre-receptive 2 days 结果的患者。
Post-receptive结果的患者。

检测限制

仍有小于 5% 的机率在第一次进行ERA时，会因为检体量、或检体质量不足而得到无讯息的结果。如果发生这种情况，则需要进行第二次采检。

医师可使用 ERA 的检测结果来进行个人化窗期植入。

不良的胚胎质量、基因异常、或个人病理情况，均可能影响怀孕的可能性。

ERA®检测并不会对任何其他子宫内膜病理提供报告，也不会评估或预测持续妊娠的健康状况。

为什么要进行 ERA 检测?

共有 21 篇发表论文可支持 ERA 检测；其中 13 篇出自 Igenomix 内部论文，另外有 8 篇为独立研究。
在 Igenomix 开发的专用AI算法下，有 90%的个案不需进行二次采样。
随机临床试验（NCT01954758) RCT 案证实，比起第一次即接受新鲜囊胚植入的患者，使用ERA检测后持续怀孕率可上升 25%。

科学证据

*Simón et al., In vitro fertilization with personalized blastocyst transfer versus frozen or fresh blastocyst transfer: a multicenter, randomized clinical trial. Fertility and Sterility, 2019; 112. e56-e57. 10.1016/j.fertnstert.2019.07.273.

**Oral presentation, Clemente-Císcar, ESRHE 2018

The development of the ERA diagnostic tool was published in the paper by Díaz-Gimeno et al, 2011 (Fertil Steril. 2013 Feb; 99(2):508-17).

ERA´s effectiveness and consistency were demonstrated in the paper by Díaz-Gimeno et al, 2013 (Fertil Steril. 2013 Feb; 99 (2): 508-17).

ERA clinical applicability to patients with implantations failure was demonstrated in a publication by Ruiz-Alonso et al, 2013 and 2014.

What a difference two days make: “personalized” embryo transfer (pET) paradigm: a case report and pilot study Ruiz-Alonso M. et al, 2014. (Hum Reprod. 2014 Jun;29(6):1244-7)

A randomized study is currently in progress to assess its applicability to patients without any prior assisted reproduction treatment (ClinicalTrials.gov Identifier: NCT01954758).

The role of the endometrial receptivity array (ERA) in patients who have failed euploid embryo transfers. Tan J, Kan A, Hitkari J, Taylor B, Tallon N, Warraich G, Yuzpe A, Nakhuda G. J Assist Reprod Genet. 2018 Jan 11. doi: 10.1007/s10815-017-1112-2. [Epub ahead of print]

Combinatorial use of Endometrial Receptivity Array (ERA) and PGT-A can improve the clinical outcome in cases with previous ART failures. N. Findikli, M. Gultomruk, K. Boynukalin, M. Kavrut, E. Oral, M. Bahceci. ESHRE Oral communication.

Pregnancy outcomes in patients undergoing embryo transfer in cycle following endometrial receptivity assay. M. Pasternak, G. Schattman, Z. Rosenwaks. ASRM Poster.

The implantation rate of Japanese infertile patients with repeated implantation failure can be improved by endometrial receptivity array (ERA) test: A randomized controlled trial. S. Taguchi, M. Funabiki, T. Hayashi, Y. Tada, Y. Iwaki, M. Karita, T. Ota, K. Maeda, T. Matsubara, P. Zada, N. Sugiyama, Y. Nakamura. ASRM Oral communication.

EndomeTRIO

子宫内膜三合一检测：子宫内膜健康的新维度，可改善患者的预期生殖能力。

Efficacy of the endometrial receptivity array for repeated implantation failure in Japan: A retrospective, two-centers study. Hashimoto T, Koizumi M, Doshida M, Toya M, Sagara E, Oka N, Nakajo Y, Aono N, Igarashi H, Kyono K. Reprod Med Biol. 2017 Jun 27;16(3):290-296. doi: 10.1002/rmb2.12041. eCollection 2017 Jul. PMID:29259480

Assessment of endometrial receptivity by endometrial receptivity array (ERA) in patients with adenomyosis and previous implantation failure in IVF. Kaur S, Mahajan N, Rani K, Naidu P, Kaur J. ESHRE Poster.

Mode of progesterone administration and its effects on endometrial receptivity in programmed frozen embryo transfer cycles. Rosen A, Huang A, Billb Y. PCRS Poster.

Endometrial Receptivity and pregnancy rates are higher after 7 days of progesterone in medicated FET cycles. A.M. Propst, L. Hansard, K. Silverberg, M. Hegtvedt, N.Z. Burger, T.C. Vaughn. ASRM Poster.

Endometrial receptivity array: Clinical application. Mahajan N. J Hum Reprod Sci. 2015 Jul-Sep;8(3):121-9. doi: 10.4103/0974-1208.165153. Review. PMID:26538853.

Live birth after embryo transfer in an unresponsive thin endometrium. F. Cruz, J. Bellver. Gynecol Endocrinol. 2014 Jul;30(7):481-4. doi: 10.3109/09513590.2014.900747. Epub 2014 Mar 20.

Mode of progesterone administration and its effects on endometrial receptivity in programmed frozen embryo transfer cycles. Rosen A, Huang A, Billb Y. PCRS Poster.