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A new test detects the best period for in vitro conception. Dr Daniela Savova, obstetrician and gynaecologist in Dr Shterev Hospital, elaborates

One of the biggest challenges of in vitro fertilisation procedures is to have a successful implantation of the embryo, and to achieve pregnancy. Are there new ways to improve the embryo implantation?

One of the leading causes of implantation failures are problems with the endometrial lining. The uterus is the organ in which pregnancy takes place. The interior is lined with a tissue called endometrium, which is prepared each month for the acceptance of an embryo and is the place where the embryo implants and stays during pregnancy. Sometimes, embryo implantation in the endometrium does not develop successfully. When this does not occur, menstruation begins. This failure can occur for a number of reasons. A particularly important factor is the so called endometrial receptivity. Endometrium is receptive when it is ready for embryo implantation, which usually takes place between days 19-21 of the menstrual cycle (5-7 days post-ovulation). This period of receptivity is called "window of implantation". There is a new technique called ERA®, helping us to identify this window of implantation - a novel diagnostic method developed by the Spanish company IVIOMICS. This technique allows for the assessment of the endometrial receptivity status of a woman, from a molecular point of view. For the purpose, a biopsy of endometrial tissue is performed and sent out for additional testing.

What kind of information does the test bring?

The results of the analysis determine whether or not the patient will be responsive to embryo implantation at the time of sampling. If so, i.e. receptive, then the window of implantation is defined as the day on which the biopsy was taken, meaning the embryo is capable of implanting in the uterus during this particular period. A state of non-receptivity means that the window of implantation is displaced. Once a displaced window of implantation (personalized window of implantation) is identified, the embryo may successfully implant in a subsequent cycle in what we call personalised embryo transfer.

What is your personal advice to the couples who still have not faced with the problem of infertility?

Definitely, not to postpone the conception of a baby. Today, age is one of the biggest threats of infertility. With age, the ovarian reserve diminishes, the quality of the oocytes deteriorates, respectively the risk of genetic abnormalities is increased. That is why, my advice to all young couples, is not to delay the conception of a baby. Let them first deliver a healthy baby and later on pursue new career opportunities.

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