Know your tests and add-ons: ReceptivaDx™, ERA (& the big difference)

It’s a question we see frequently on all sorts of fertility forum chats – the Receptiva test vs ERA. Are they both add-ons, what’s the difference and how does each affect endometriosis and implantation concerns? 

Senior editor Jessie picked up with Dan Angress, COO and Scientific Liaison at ReceptivaDx™ to clarify, and answer a few questions about the essential differences between these two test options.

It’s a niche but important topic for anyone looking into endometrial biopsy. So if you come across the question, please do share this Q&A with your TTC (trying to conceive) community, and DM any questions over on Insta (or, pop them straight to ReceptivaDx™). 

Over to Dan.

1. Can you define what we mean by a ‘fertility add-on’, in 2023?

A fertility add-on typically refers to an additional treatment or procedure offered by fertility clinics to individuals going through IVF.

These add-ons are often marketed as supplementary interventions that may increase the chances of a successful pregnancy. The effectiveness can vary and they often come at an additional cost.

2. Why are add-ons often slammed as ‘unsafe’ in the press? 

Editor’s note – in a recent Insta poll our community response differed with the press on this, with only 8% of respondents sharing concern over the safety of add-ons. Unpacking the point, Dan says – 

There are several reasons why add-ons may be slammed as ‘unsafe.’ 

First, there’s a difference between “unsafe” and “ineffective”. These concerns include the lack of scientific evidence for many tests and treatment.

Many of these add-ons have not been tested in clinical trials or the evidence is anecdotal, meaning they come from a center’s experience but aren’t part of a randomized controlled study. 

It is important to note that many of these add-ons do indeed offer benefits even without a large clinical trial. However, It is always important for patients to be well informed consumers, by reading lots and asking questions.

3. Why are so many add-ons ‘unproven’, or come with limited evidence?

Several factors contribute to the prevalence of unproven or inadequately tested fertility add-ons. 

Fertility is a very complex field of medicine and the contributing factors can vary widely. This makes it challenging to conduct clinical trials to assess the effectiveness of every single potential add-on in every situation. 

Some of these studies may have small sample sizes, which makes it difficult to draw significant conclusions on their effectiveness. However, limited or no studies should be a red flag for any product or service.

The ReceptivaDx test is near the top of the most studied and published tests on the market. What this means is the test has been proven to be outstanding in identifying and detecting endometriosis (sensitivity and specificity studies and positive predictive value studies).

It has also proven to be effective in predicting outcomes by identifying patients who are likely to fail if left untreated.

With over 20 publications covering prospective randomized controlled trials as well as retrospective studies demonstrating the success of the test from IVF centers globally, the value of the test is hard to refute.

4. In the context of all of this, is ReceptivaDx an ‘add-on’?

Depending on the center, ReceptivaDx™ can be considered a fertility add-on given it is recommended after an IVF cycle failure or after patients have been diagnosed with unexplained infertility.

Most centers have begun offering the test in the same way as PGS testing for embryo analysis. 

ReceptivaDx™ is a pathology test looking for the presence of BCL6, a protein marker used to assess the uterine lining for inflammation usually associated with endometriosis, a well-published disease shown to impact IVF success.

The results of the test will help guide the treatment plan. 

5. Can you explain the difference between the Receptiva test vs ERA? 

Yes, there’s a common misconception here – let’s unpack both and their key differences.

Both are tests in the field of reproductive medicine and the confusion lies with the fact that both are done off of an endometrial biopsy. However, they serve very different purposes and provide two distinct types of information.

ReceptivaDx™, specifically BCL6, is looking for uterine lining inflammation highly associated with endometriosis. It is typically used in cases of recurrent implantation failure and recurrent pregnancy loss. 

The ERA test is used to determine the optimal timing for embryo transfer during IVF. It helps to identify the window of implantation when the uterine lining is most receptive to embryo implantation. 

To sum it up, the ReceptivaDx test focuses on assessing the uterine environment for signs of inflammation, whereas ERA helps determine optimal timing for embryo transfer.

6. Can you break down the cost of the ReceptivaDx test, and what goes into it? 

The overall cost of the test (BCL6 and full pathology report only) includes overnight shipping costs via FedEx to our nearest licensed testing center and an analysis of BCL6 expression along with a full pathology analysis of the tissue.

This means in the rare case of any precancerous or cancerous lesions, it will be identified. 

You can add other markers, too. CD138, a marker that identifies endometritis, can be ordered for an additional $145.

Keen to rule out endometriosis – and silent endometriosis – from your unexplained infertility? Connect with ReceptivaDx™ to book your test.

TRB readers can claim $75 off a ReceptivaDx test, use code TRB23 on your test request form.