Successful embryo implantation
As a global leader in reproductive health and by combining Igenomix’s portfolio of reproductive genetic testing services with Vitrolife’s best-in-class IVF device portfolio, the Vitrolife Group supports clinics and patients across the fertility journey. We offer our customers and patients ground-breaking solutions to create the best conditions for an embryo to implant, with one single goal: to fulfil the dream of having a healthy baby.
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Solutions for optimised implantation
Planning and performing infertility treatment to support the best possible patient outcome is hard work and each patient is unique. A culture system which protects the embryos and provides correct nutrients is a prerequisite for embryo viability and a successful outcome. Embryos cultured in a safe undisturbed environment and that are evaluated and selected to be the right embryo for transfer, ensuring a healthy and receptive endometrium, and optimisation of the transfer protocols, are all factors that play an important role for success in all patient treatments.
A healthy and receptive endometrium: ERA, EMMA & ALICE
Ensuring a healthy and receptive endometrium can optimise the outcome of an IVF transfer. Igenomix leads the research in the field of endometrial assessment and pioneered the development of tests to address both endometrial receptivity and endometrial microbial health.
The endometrial receptivity test with most scientific background on the market
ERA® (Endometrial Receptivity Analysisis) backed by more scientific publications than any other endometrial receptivity test in the market. The ERA test has been performed on more than 240,000 women worldwide, with 3 in every 10 women having a displaced WOI1. This extensive clinical experience paired with artificial intelligence (AI), allows for continual refinement of the ERA predictor algorithm, making ERA the most precise test for personalized transfer timing. The initial indication for ERA is repeated implantation failure (RIF), offering an implantation solution to those women who have not achieved a successful pregnancy otherwise.
ERA improves implantation and pregnancy rates
In an externally published study, women with RIF undergoing a pET guided by ERA experienced significantly improved pregnancy and implantation rates versus women with RIF who underwent a transfer at the standard timing and without ERA testing2. The ERA test can also be beneficial for women who are at increased risk for having a displaced WOI, including women with a BMI >303,4, adenomyosis5, or an atrophic endometrium6.Learn more about ERA
A healthy endometrial microbiome
EMMA (Endometrial Microbiome Metagenomic Analysis) and ALICE (Analysis for Infectious Chronic Endometritis). EMMA evaluates the endometrial flora, offering a complete view of microbial health, and provides information to guide a personalized treatment to balance the endometrial microbial environment, improving reproductive prognosis.
ALICE detects specifically for the most frequent bacteria causing chronic endometritis (CE), a known cause of infertility. Marked by endometrial inflammation and often undiagnosed due to no visible symptoms in most cases, chronic endometritis itself affects up to 30% of infertile patients and upwards of 60% in the case of RIF or recurrent pregnancy loss (RPL)7,8 .
Although each of our endometrial tests can be ordered individually, Igenomix offers the EndomeTRIO test, where with a single endometrial sample, both endometrial receptivity and microbiome can be assessed, giving providers a better understanding of their patient’s overall endometrial status to improve the chances of pregnancy.
Successful embryo transfer
A full infertility treatment from stimulation, embryo culture, embryo selection and uterine preparation is a long process all leading up to one important moment. The embryo transfer. The right embryo is selected, a healthy endometrium is ensured, and now we want to provide it with the best chance for implantation. Two meta-reviews presents the same outcome. Using EmbryoGlue, a hyaluronan rich medium, for transfer increases chances for pregnancy and live-birth9.
What is EmbyoGlue?
EmbryoGlue is a medium developed exclusively for embryo transfer and the only existing transfer media with a proven implantation enhancing effect9. EmbryoGlue has the basic composition of a rich blastocyst culture medium and contains a high concentration of hyaluronic acid and recombinant human albumin. It can be used for transfer of all embryo developmental stages.
How to optimise transfer
A meta-analysis from 2022 on transfer interventions showed that three methods stand out with positive outcomes in terms of clinical pregnancy rate and with significant clinical evidence for their effectiveness10.
• Hyaluronic acid-enriched media (EmbryoGlue)
• Ultrasound guidance
• Soft transfer catheter
The clinical outcome of using EmbryoGlue
The Cochrane review from 2020 shows an increased live birth rate from 33.3% to 40.2%9. According to a numbers needed to treat calculation, one additional live birth was achieved for every 14 patients. In this group there is a subset of patients that may benefit more. Published RCTs from the Cochrane review suggests patients ≥35 years of age and patients with previous or previous implantation failures11, 12.
PGT patients and EmbryoGlue - a perfect match
Do not hesitate to use EmbryoGlue for your PGT transfers. Recent data indicates that PGT embryos benefit from being transferred in EmbryoGlue compared to a media without hyaluronan. The data showed an increase in both clinical pregnancy and implantation rate13.Learn more about EmbryoGlue
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Coming soon: A new academy course about optimising implantation, about how EmbryoGlue, ERA, EMMA and ALICE can help to achieve a successful embryo implantation.
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1. Ruiz et al. (2013) Fertil Steril. 100(3):818-24.
2. Jia et al. (2022) Med Sci Monit. 28:e935634.
3. Comstock et al. (2017) Reprod Sci. 28(11):3171-3180.
4. Bellver et al. (2021) Reprod Sci. 28(11):3171-3180.
5. Kaur et al. (2017) Hum Reprod Sci. 11(4):353-358.
6. Valbuena et al. (2018) ESHRE Abstract. Hum Rep. 31:255-256.
7. Cicinelli at al. (2014) Reprod Sci. 21(5):640
8. Cicinelli et al. ( 2015) Hum Reprod 30(2):323-30.
9. Heymann et al. (2020) Cochrane Database of Systematic Reviews 9.
10. Tyler et al. (2022) Hum Reprod Update 28.
11. Urman et al. (2008) Fertil Steril (90):3.
12. Friedler et al. (2007) Hum Reprod Vol 22, Issue 9.
13. Reed (2022) Poster PCRS.