Recurrent IVF Failure and ERA

Personalized embryo transfer window guided by Endometrial Receptivity Analysis (ERA).

Written by: Saygı Hospital Health Guide Editorial Board

Last updated: June 10, 2026

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Recurrent IVF Failure and ERA?

ERA (Endometrial Receptivity Analysis) profiles the expression of 248 genes to classify the endometrium as receptive, pre-receptive, or post-receptive. It is used in recurrent implantation failure (RIF).

The test is performed on an endometrial biopsy obtained during a simulated hormonal cycle. Based on the result, the embryo transfer day is shifted earlier or later in a personalized manner.

Beyond ERA, RIF work-up may include immunological evaluation (NK cells, cytokines), thrombophilia screening, investigation of chronic endometritis, hydrosalpinx excision, and hysteroscopic cavity assessment.

Symptoms

Three or more failed embryo transfers

No pregnancy despite high-quality embryos

Recurrent biochemical pregnancies

Early loss after implantation

Risk Factors

Advanced female age

Chronic endometritis

Hydrosalpinx

Uterine anomalies

Thrombophilia

Autoimmune disorders

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

After three failed IVF attempts
When good-quality blastocyst transfer fails
Recurrent biochemical pregnancies
Unexplained implantation failure

Treatment Methods

ERA testing and personalized transfer window

Hysteroscopy and cavity evaluation

Treatment of chronic endometritis (doxycycline)

Salpingectomy for hydrosalpinx

Selective immunotherapy (intralipid, IVIG)

PGT-A for euploid embryo transfer

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.