Endometrial Receptivity (ERA) Protocol
Instructions
1. Report cycle day one of your period via the patient portal or 781-944-0052. A full
flow period before 3:00 p.m. is considered cycle day one. Abstain from
unprotected intercourse day one of menses until after you have the
pregnancy test at the end of your cycle
2. You will be instructed to return to the office for cycle day 2 baseline blood work
and vaginal ultrasound. The doctor will review your ultrasound and blood work to
determine whether it is appropriate to start Estrace supplementation.
3. You will get portal instructions to start Estrace 2 MG vaginally twice daily. Use your finger to insert the tablet 1" into the vagina. A blue/green tinged discharge is normal.
4. You will return to the office approximately 10 - 14 days later for blood work and a
vaginal ultrasound to evaluate the uterine endometrial lining and progesterone
level.
5. You will get portal instructions that afternoon. If your endometrium is 7-8 mm or
greater, you will be given a start date for Progesterone support and an antibiotic. You will also be scheduled for your endometrial biopsy. The endometrial biopsy (ERA Bx) will be scheduled for the sixth day of progesterone. Please be aware that it is the policy of FCNE that children are not allowed in the Procedure Suite on the second floor.
Please take morning injectable medications at a time that works with your morning schedule
within a 2-hour time frame from day to day.
Please take evening injectable medications between 7 – 9 PM within a 2-hour time frame from
day to day. If there is a day that you have plans to be out in the evening it is better to take the
injection earlier before you go out.
The trigger injection (Human Chorionic Gonadatropin, Pregnyl) will be injected at a time specified
by FCNE and will be included in your instructions.
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6. If your endometrium is less than 7mm, you will likely continue on estrace 2 mg
and may be increased to three times a day. We may add estrogen patches every
other day as well and repeat blood work and vaginal ultrasound in 3-6 days.
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7. You will be instructed to take 1,000 mf of Tylenol 1 hour prior to the appointment.
You can eat and drink that morning unless otherwise instructed.
8. You will stop the estrace and progesterone after the biopsy is completed.