PGS + ERA Synchrony

Technical

Synchrony
Benefits
Indications

The aim of our work at IGENOMIX is to help families to achieve a pregnancy that will lead to a healthy baby at home.
There are two main factors to consider in order to maximize the chances of implantation during an IVF treatment; a chromosomally normal embryo and a receptive endometrium.

What is PGS + ERA Synchrony?

Embryo factor: PGS (PGT-A)

PGT-A testing analyzes the embryos obtained during an IVF cycle.
Determines which embryos have a normal number of chromosomes.
Embryos with the correct number of chromosomes have higher chances of implantation.

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Endometrial factor: ERA

ERA test analyzes the woman’s endometrium, where the embryo is to implant.
Only an endometrium in a receptive stage will allow implantation.
ERA test will determine if the endometrium is receptive or not at the time of sampling, helping the clinician to schedule transfer at the right time.

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Why PGS + ERA Synchrony?

Reduced miscarriage rates.
Higher pregnancy rates per transfer.
Fewer cycles of IVF treatment needed (less time and money).
Greater chance of having a healthy child.
Fewer wasted transfers (implantation failure).
If both the embryo and the endometrium are synchronized, the IVF clinician can transfer the right embryo at the right time.
Combining IGENOMIX ERA and PGT-A allows to cover the two key factors to achieve your goal, a healthy baby at home.

Who should use PGS+ERA Synchrony?

Advanced maternal age: 35 years or above
Recurrent miscarriages: 2 or more miscarriages of unknown cause
Assisted reproduction cycles without pregnancy: 2 or more assisted reproduction cycles without pregnancy result
Male factor: Males with low sperm concentration, below 5 million per ml
Previous pregnancies with anomalies: 1 previous pregnancy with chromosome abnormality, especially in an assisted reproduction cycle

Documentation

PGS (PGT-A)
ERA

Rubio et al: In vitro fertilization with preimplantation genetic diagnosis for aneuploidies in advanced maternal age: a randomized, controlled study. Fertil Steril. 2017 May;107(5):1122-1129.

Yang Z, Liu J, Collins GS, Salem SA, Liu X, Lyle SS, et al. Selection of single blastocysts for fresh transfer via standard morphology assessment alone and with array CGH for good prognosis IVF patients: results from a randomized pilot study. Mol Cytogenet 2012 May 2; 5(1):24.

Coates A, Kung A, Mounts E, Hesla J, Bankowski B, Barbieri E, Ata B, Cohen J, Munné S. Optimal euploid embryo transfer strategy, fresh versus frozen, after Preimplantation Genetic Testing for Aneuploidies with next generation sequencing: a randomized controlled trial. Fertil Steril. 2017 Mar;107(3):723-730.e3.

Coates A, Bankowski BJ, Kung A, Griffin DK, Munne S. Differences in pregnancy outcomes in donor egg frozen embryo transfer (FET) cycles following Preimplantation Genetic Testing for Aneuploidies (PGT-A): a single center retrospective study. J Assist Reprod Genet. 2017 Jan;34(1):71-78.

Sanchez-Ribas et al., Transcriptomic behavior of genes associated with chromo some 21 aneuploidies in early embryo development. Fertility and Sterility, 2019; 111, 5:991-1001.

Goldwaser, Tamar et al. Cell-free DNA for the detection of fetal aneuploidy. Fertility and Sterility, 2018; 109, 2, 195 – 200.

Kuznyetsov V, Madjunkova S, Antes R, Abramov R, Motamedi G, Ibarrientos Z, et al. Evaluation of a novel non-invasive preimplantation genetic screening approach. PLoS ONE; 2018; 13(5): e0197262.

Munné S, Status of preimplantation genetic testing and embryo selection. RBMO. 2018; 37(4):393-396.

Levy et al., Prenatal diagnosis by chromosomal microarray analysis. Fertility and Sterility, 2017; 109, 2, 201–212.

Ottolini C. et al., Scientific Reports. Tripolar mitosis and partitioning of the genome arrests human preimplantation development in vitro, 2017;7:9744.

Munné, Santiago et al. Mosaicism: “survival of the fittest” versus “no embryo left behind”. Fertility and Sterility, 2016; 105, 5, 1146 – 1149.

Bolton et al., Mouse model of chromosome mosaicism reveals lineage-specific depletion of aneuploid cells and normal developmental potential. Nature Communications, 2016; 29;7:11165.

Cimadomo D. et al, The Impact of Biopsy on Human Embryo Developmental Potential during Preimplantation Genetic Diagnosis. Hindawi, 2016, 7193075.

Scott RT, Galliano D., The challenge of embryonic mosaicism in preimplantation genetic screening. Fertility and Sterility, 2016; 105, 5.

McCoy RC, Demko ZP, Ryan A, Banjevic M, Hill M, Sigurjonsson S, et al. Evidence of Selection against Complex Mitotic-Origin Aneuploidy during Preimplantation Development. PLoS Genet, 2015; 11 (10): e1005601.

Kung A. et al., Validation of next-generation sequencing for comprehensive chromosome screening of embryos. Reproductive BioMedicine, 2015; 1472-6483.

Greco E, Minasi MG, Fiorentino F. Healthy Babies after Intrauterine Transfer of Mosaic Aneuploid Blastocysts, N Engl J Med, 2015; Nov 19;373(21):2089-90.

Yang Z et al., Selection of single blastocysts for fresh transfer via standard morphology assessment alone and with array CGH for good prognosis IVF patients: results from a randomized pilot study., 2012, 5:24.

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.

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.

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Igenomix and fertility

We work to make a world in which infertility is no longer an impossible barrier. Together with clinics and fertility specialists worldwide, we investigate human reproduction to change the lives of those who are trying to conceive.