ReceptivaDx™ – A Test for Inflammation and Endometriosis

Struggling to bring a child into the world is challenging for many different reasons.  It can feel like an even bigger emotional and financial burden when you’ve tried some of the most sophisticated fertility treatments, spent tens of thousands of dollars, and still have no baby and no answers as to why.

For those who have experienced failed IVF cycles, unexplained infertility, and recurrent pregnancy loss, it may be helpful to look at ReceptivaDx.

What is ReceptivaDx?

ReceptivaDx is a first-of-its-kind test that detects inflammation of the uterine lining that is highly characteristic of endometriosis.  The ReceptivaDx test is run on a collection/sample/biopsy of endometrial tissue from an endometrial biopsy scratch procedure.  

Why is Detecting Inflammation Important?

Inflammation on the uterine lining is a common sign of previously undetected endometriosis.  This test can also detect recurring endometriosis in patients previously diagnosed and treated for the condition.

Endometriosis and generalized inflammation are two of the leading causes of infertility and implantation failure so having a tool to detect its presence can help fertility specialists put an appropriate treatment plan in place.

Who is a good candidate for testing?

Those who have experienced…

Failed Implantation

Failed implantation occurs when an embryo is transferred and does not result in a clinical pregnancy.  Failed implantation is usually the result of embryo quality or uterine factors. 

By testing for BCL6, ReceptivaDx can help to identify the presence of potential uterine issues.  If BCL6 levels are identified and uterine issues are discovered, physicians can recommend treatment that may reduce the chances of implantation failure.     

Unexplained Infertility

Unexplained infertility is when no cause is identified for a couple or a woman’s inability to get pregnant after standard fertility testing.  Fertility testing is often useful for identifying male and female infertility factors, but they don’t always point to a direct cause.  

ReceptivaDx is not considered a standard fertility test.  In fact, it was designed to identify one of the leading causes of unexplained infertility, inflammation.  

Recurrent Pregnancy Loss

Recurrent pregnancy loss, as defined by the American College of Obstetrics and Gynecology (ACOG), is experiencing two or more miscarriages. Although,  physicians usually don’t recommend a thorough exam and workup until after a woman’s third pregnancy loss.

ReceptivaDx testing can help to identify positive BCL6 levels which may be the cause of a woman’s recurrent pregnancy loss.  By identifying this potential miscarriage factor, women can receive treatment for their positive BCL6 which could lower their risk for miscarriage, and in some cases, it could help to avoid pregnancy loss altogether. 

Diminished Ovarian Reserves

Ovarian reserve is the number and quality of eggs a woman has left within her ovaries, also known as her reproductive potential. Diminished ovarian reserve is a condition in which the ovaries lose their normal reproductive potential, reducing fertility.  

Diminished ovarian reserve most commonly occurs as a result of normal again.  However, some women experience diminished ovarian reserve as early as 30 years old.  

Since women with diminished ovarian reserve only have a limited number of eggs, it may be helpful to have additional testing prior to treatment to optimize the chance of each treatment’s success. 

ReceptivaDx testing identifies if high levels of BCL6 are present.  High levels of BLC6 indicate inflammation which can limit the ability of the embryo to stick to the endometrial lining. 

If high levels of BLC6 are detected, your physician may recommend treatment intended to reduce inflammation and increase the chances of successful implantation and pregnancy. 

ReceptivaDx Results

An endometrial biopsy is collected during the window of implantation in a controlled cycle.  ReceptivaDx measures a protein called BCL6. 

BCL6 is ReceptivaDx’s marker of inflammation most likely caused by endometriosis. In a study conducted by the American Society for Reproductive Medicine (ASRM) reviewing the efficacy of ReceptivaDx testing, researchers concluded that BLC6 expression was strongly associated with poor reproductive outcomes for women undergoing IVF treatment.

If negative 

If negative for BCL6, women can be more confident that endometriosis is not the underlying issue.  

In the ASRM study mentioned above, women who tested negative according to ReceptivaDx testing had more than a 70% pregnancy rate in their next IVF transfer attempt.  The study produced more than a 59% success rate resulting in a live birth for women who tested negative according to ReceptivaDx testing.

If positive

If positive for BCL6, inflammation of the uterine lining is a likely cause of implantation failure.  This inflammation is usually caused by the body’s immune response to endometriosis.

In the same ASRM study mentioned above, women who tested positive according to ReceptivaDx testing had less than an 18% success rate in their next transfer.  The positive test group also had less than an 11% success rate resulting in a live birth.

Recommended Treatment if Positive

Positive BCL6 results have been shown to be a predictor of IVF transfer success or failure.  Depending on your BLC6 levels, your provider may recommend several different treatments.  Treatments range from low intervention treatments like Letrozole to laparoscopy to suppress or remove visible endometriosis.

Recommended treatments are very specific to BLC6 levels.  Results and options will be discussed in detail after testing between you and your provider. 

ReceptivaDx with ERA

As mentioned, ReceptivaDx is collected during an endometrial biopsy procedure. Another test conducted via an endometrial biopsy is the ERA. As such, the ReceptivaDx is often added on to and completed in conjunction with Endometrial Receptivity Analysis (ERA). 

An ERA is a test in which a biopsy/sample of uterine tissue is collected and analyzed to determine the optimal timing for an embryo transfer in an In-Vitro Fertilization (IVF) and frozen embryo transfers cycle. 

That said, ReceptivaDx can be performed in either a medicated/mock cycle or natural cycle. The ERA can only be performed in a mock cycle. If performing the Receptiva test during a natural cycle, the biopsy is done approximately 7-10 days after ovulation is detected. 

The Bottom Line

The ReceptivaDx is a test performed on an endometrial tissue sample that helps fertility doctors detect uterine inflammation and endometriosis and potentially plan an appropriate treatment course.

It may be helpful for some, including those with unexplained infertility, failed IVF cycles, recurrent pregnancy loss, and is a potential test/treatment option to discuss with your physician.