ERA — Endometrial Receptivity Testing in Delhi
A biopsy that identifies your personal window of implantation before a frozen transfer.
What ERA — endometrial receptivity testing involves
The endometrium is receptive for a short window. In most women that window falls where standard protocols assume it does, but in a minority it is shifted by a day or more — and transferring outside it means even a perfect embryo will not implant.
ERA analyses gene expression in an endometrial biopsy taken in a mock cycle, and reports whether your window is receptive, pre-receptive or post-receptive. The next transfer is then timed to that result.
Who this is for
- Two or more failed transfers of good-quality euploid embryos
- Repeated implantation failure with a normal uterine cavity
- Before a transfer of a last remaining embryo
- Unexplained biochemical pregnancies
Not everything on this list means you need this treatment. The workup comes first, and the recommendation follows from what it shows — not from what was booked before you arrived.
Step by step
Mock cycle
Your endometrium is prepared exactly as it would be for a real transfer.
Biopsy
A brief outpatient endometrial sample, taking a few minutes.
Analysis
Gene expression profiling determines receptivity status.
Personalised transfer
The next frozen transfer is timed to your reported window.
Your results, in writing
Whatever the outcome of ERA — endometrial receptivity testing, you leave each stage with the findings written down — what was done, what was found, what it means, and what the options are from here. Reports are issued the same day wherever the laboratory allows it.
Case study: A window shifted by a day and a half
34, Panchsheel Park · three failed euploid transfers
What she came in with
Three transfers of PGT-A tested euploid blastocysts, all in well-prepared hormone-replacement cycles with good endometrial thickness, all negative. Hysteroscopy and immune workup were normal.
What the workup showed
With euploid embryos, a normal cavity and no endometritis, the remaining variable was timing. An ERA biopsy in a mock cycle identical to her transfer protocol returned a pre-receptive result.
What we did
The next transfer was moved 24 hours later in the progesterone exposure — a personalised window rather than the standard day.
Outcome
The fourth transfer, of her last remaining tested embryo, implanted and progressed to a term delivery.
The point of this case
ERA helps only the minority whose window is genuinely displaced, which is roughly a quarter of women with repeated implantation failure. Offered to everyone it is an expensive irrelevance; offered to this group it can be the whole answer.
Illustrative case. This is a composite of presentations commonly seen in this practice, written for explanation — it is not the record of an identifiable patient, and no individual's details are used. Outcomes vary, and nothing here is a prediction of what will happen in your case.
What is different about having this done here
Offered only after repeated failure, not routinely
Performed alongside a hysteroscopy where the cavity has not been assessed
Results explained with their genuine limitations
Combined with CD138 testing for chronic endometritis in the same sitting
Treated by the consultant, not by a rotating team
Dr. Tiwari performs the scans, the procedure and the follow-up herself, and looks after any pregnancy that results. Over a long treatment course that continuity is the difference between being known and being processed.
- MBBS, MS (Obstetrics & Gynaecology), FNB (Reproductive Medicine)
- Over ten years in reproductive medicine and gynaecological surgery
- Consultations and scans at Mother's Hope, Katwaria Sarai; theatre work at SHE Delhi Hospital, Greater Kailash II
- Itemised costs given in writing before anything begins
Areas we see patients from
Both locations are in South Delhi. Patients travelling from further out have appointments grouped to cut down the number of trips.
Questions about ERA — endometrial receptivity testing
Does ERA definitely improve outcomes?
The evidence is mixed. It clearly helps the subgroup with a genuinely displaced window, which is roughly a quarter of women with repeated implantation failure. It does not help unselected patients, and we do not offer it to them.
Does the biopsy hurt?
Brief cramping for under a minute. No anaesthesia is needed.
Talk it through before you commit
Consultations run for a full hour. Bring any previous reports — they are reviewed properly, not repeated.