Medical Professionals
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Endometrial Receptivity Array (ERA) Endometrial Biopsy Since the birth of the first in vitro fertilization (IVF) baby 40 years ago, the field of reproductive endocrinology has undergone major advances in medications, retrieval procedures, and laboratory techniques. Despite these innovations, the cumulative live pregnancy rate per egg retrieval is 35-48% for women 35 to 37 years old and 13-18% for women over the age of 40. Even though we are able to obtain eggs and sperm to create an embryo, the live birth rate is still less than 50 % nationally. The area that is still an enigma is the “window of implantation.” This denotes the appropriate time to transfer an embryo to maximize the implantation potential of an embryo. Over the years we have found that a specific sequence of events must occur for an embryo to implant and grow. Currently, it is preferable to transfer a blastocyst embryo, which occurs 5 days after fertilization. The blastocyst is transferred into the uterine cavity and the embryo hatches out and makes direct contact with the uterine lining. When it does, both the endometrium and the blastocyst adhere to each other. The embryo begins to undergo a process of invasion to establish a blood supply with the mother. For this sequence of events to occur, the lining of the uterus must have a specific component; this is called receptivity. In the past, we would assess uterine receptivity indirectly using an ultrasound. The lining had
to be a specific thickness and pattern. In recent years, studies have shown this is not an accurate assessment. As a result, we may be transferring embryos at the inappropriate time. A test has been developed that directly evaluates the uterine lining for receptivity: endometrial receptivity analysis (ERA). This is a genetic test which uses a small sample of a woman’s endometrial tissue to evaluate whether or not the uterine lining is prepared and is able to accept an implanting embryo. This test analyzes the endometrial lining at the molecular level, evaluating for 248 genes. It detects a specific genetic signature which identifies the lining as being receptive for an embryo. If it is not ready (pre-receptive) or over-mature (postreceptive), the test will denote changes required to make the lining receptive. In the era of personalized medicine, a “one size fits all” policy is no longer acceptable. With IVF, we individualize ovarian stimulation protocols based on a patient’s/couple’s medical situation. We now recognize the importance of individualized uterine preparation protocols to facilitate an appropriate uterine environment to optimize treatment outcome. ERA is the most objective and accurate test available today for diagnosing endometrial receptivity. It has been used to define an altered “window of implantation,” and thus establish a personalized protocol for each patient. It has been shown to be beneficial in improving reproductive performance in patients with recurrent pregnancy loss, IVF failures, and unexplained infertility.
Helping Small Miracles Happen
• Comprehensive Fertility Care • InVitro Fertilization (IVF) • Intrauterine Insemination • Intracytoplasmic Sperm Injection (ICSI) • Preimplantation Genetic Testing • Egg Freezing • Donor Egg • Treatment for Recurrent Pregnancy Loss • Advanced Robotic Reproductive Surgery
The Compassionate Connection
Pictured (L-R): Dr. William F. Zeigler • Dr. Alan M. Martinez
We are Open and Offering Telehealth Appointments Eatontown • Toms River • Lawrenceville
732-918-2500 • FERTILITYNJ.COM
For more information call 732-918-2500 or visit www.FertilityNJ.com.
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Happy Valentine’s Day
X and O Rice Krispy Treats- A Fun Unique Craft For Kids
1. In large saucepan melt butter over low heat. Add marshmallows and stir until completely melted. Remove from heat. 2. Add KELLOGG’S RICE KRISPIES cereal. Stir until well coated. 3 tablespoons butter or margarine 3. Using buttered spatula or wax paper, evenly press mixture into 15 x 10 x 1-inch pan coated with cooking spray. Cool slightly. Using 1 package JET-PUFFED Marshmallows cookie cutters coated with cooking spray cut into X and O shapes. Decorate with frosting and/or candies. Best if served the same day. 6 cups Kellogg’s® Rice Krispies® cereal Microwave Directions: In microwave-safe bowl heat butter and marshmallows on HIGH for 3 minutes, stirring after 2 minutes. Stir Canned frosting or decorating gel until smooth. Follow steps 2 and 3 above. Microwave cooking times may vary. Food coloring Note: For best results, use fresh marshmallows. 1 jar (7 oz.) marshmallow crème can be substituted for marshmallows. Diet, reduced Assorted candies calorie or tub margarine is not recommended. Store no more than two days at room temperature in airtight container. To freeze, place in layers separated by wax paper in airtight container. Freeze for up to 6 weeks. Let stand at room temperature for 15 minutes before serving.
You will need:
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The County Woman Magazine www.TheCountyWoman.com
January/February 2021