Our test provides us information on the presence and activity of immune cells which are needed for future embryo implantation. In effect, understanding the mechanisms which cause implantation failures (a fault or, on the contrary, a locally excessive immunological activity which can cause failure of an embryo implant) This test allows us to define precise and customised management of infertility in order to re-establish endometrial equilibrium, and support embryo implantation.
This is addressed in particular to:
- Women presenting with repeated and unexplained implantation failures after several attempts at IVF/ICSI.
- Women with several unexplained miscarriages
- Couples who wish to use a donation of oocytes and would like to ensure beforehand that they are properly receptive in order to optimise attempts
- Women with unexplained infertility
This test can nevertheless be performed on any woman who would like to confirm that she has no problem with uterine receptivity, even at the start of a PMA course
It is a sample of the endometrial mucosal membrane. Using a Cornier pipette, the gynaecologist takes a sample of your endometrium. He will put it in two separate tubes. This very rapid procedure can nevertheless be painful at the time it is taken. We encourage you to talk with your doctor about it beforehand.
We do not perform a biopsy in our laboratory. You need to set an appointment with your gynaecologist. The material needed for the biopsy is sent to your doctor upon his request by email. If your gynaecologist would not like to have this test performed, we can refer you to other gynaecologists who are near to you.
This date should be set with the physician who will take this sample, because it fully depends upon your cycle.
For women with regular cycles:
The biopsy can be done in a natural cycle 5 to 9 days after ovulation, or 7 to 11 days after peak LH.
For women with irregular cycles or women donating oocytes:
The biopsy is performed under a “substitute cycle” after at least 10 days of solely oestrogen and 7 days of oestrogen plus progesterone. Your gynaecologist can prescribe this treatment. Oestrogens are to be started on the first day of the cycle (first day of menstruation). For those who do not have a cycle, your physician can prescribe that you take the pill for one month (in order to re-create a cycle), then to start oestrogens on the first day of menstruation.
We recommend, however, that the biopsy should be done in a substitute cycle whatever the regularity of your cycle. In fact, nearly 3% of biopsies performed during a natural cycle cannot be tested, because the biopsy was not performed during an implantation window; patients are then requested to have a new biopsy taken.
All testing starts with histological confirmation of the date of the endometrium, which confirms the luteal phase (confirmation performed by the Passy pathology centre). If the dating shows a proliferative phase or a secretory phase which is too late, the uterine receptivity test cannot be performed, nor can it be interpreted. In this case, tests are not invoiced. Only the histological dating is billed (if not paid by health insurance).
In this case, set another appointment with your physician to schedule another biopsy.
Upon simple request (email), we send kits with the material needed for 2 to 10 patients to the physician (we do not send these to the patient).
These kits contain, for each patient:
- A vial of formalin
- A tube of RNA Later (stabiliser and preservative for RNA)
- An information sheet (to be filled in by the patient and physician) about fertility issue antecedents
- A consent form to be signed by the physician and the patient
- An information sheet for the patient related to the mail to send and the course to follow
- Packaging to send these samples
A copy of the serology results for HIV, hepatitis B and C, dated less than one year before the biopsy, with signature of the laboratory physician, must be provided with the biopsy. For regulatory reasons, we can only test samples which have negative serology results (or on patients immunised for hepatitis B). Without a valid copy of these results, we cannot perform the tests (screen shots of the medical file or printed results sent electronically are not accepted).
Must one have specific documents or material to perform a test?
The kits are sent on Wednesdays by TNT/Fedex. The requests made Monday or Tuesday are fulfilled by sending during that week. Requests made on the following days are sent Wednesday of the following week.
These kits are sent free-of-charge to the physician. The shipping costs are included in the biopsy charges which are paid by the patient.
These kits can be stored for many months at room temperature.
It’s not possible to deliver the samples to the laboratory; access is limited to staff and transporters
They should be sent by post or specialised transporters (in the case of patients with healed hepatitis B)
Send the two envelopes as quickly as possible (use rapid courier for biopsies taken outside of continental France) to ensure that we receive the samples within 48 hours.
Avoid sending them at the end of the week or the day prior to a holiday. You can store the biopsy in the refrigerator before sending it.
In the “MatriceLAB Innove” envelope:
- The box containing the small tube with the biopsy in a plastic bag
- The signed consent form
- The “MatriceLAB Innove” receptivity test
- The order signed by your physician
- A copy of the serology results which are not older than one year
In the “Pathology centre” envelope:
- The plastic bag containing the formalin container with biopsy
- The “Pathology centre” instruction sheet with your address and that of your physician
The endometrial biopsy and histological test are 100% paid by Social Security (for French patients).
On the other hand, MatriceLAB Innove tests are not reimbursed by Social Security, and are completely the responsibility of the patient (see the table below). We encourage you, however, to contact your supplemental health insurer for any possible reimbursement. An invoice will be sent by email within two weeks from the date that we receive the biopsy. This will state the amount for the tests to be paid to MatriceLAB Innove by bank transfer.
If the sample cannot be interpreted (wrong phase of the cycle, sample too small, etc.), the tests will not be billed. In this case, set another appointment with your physician.
The histological analysis for foreign patients is also the responsibility of the patient, and costs about EUR 33. You will receive an invoice from the pathology centre by mail for this with their payment method.
Prices for 2020 in euros (included taxes and shipping)
|Prices in continental France||Prices in non-continental|
French territories and in the EU countries
|Prices outside the EU|
|Prices for initial screens||490||495||500|
* The test fee under therapy applies only to biopsies taken with the treatment proposed by MatriceLAB Innove at the time that the first biopsy is taken
You will receive your results by mail within 3-4 weeks from the date that we receive the biopsy, as long as payment has been made. This period can be extended during holiday periods such as Christmas, Easter and during the month of August (see “Contact” section). A copy of these notes with possible therapeutic recommendations will be sent to your physician. We advise that you contact him for interpretation of the results and deciding proposed therapeutic strategies.
The next IVF attempt can be planned at the earliest two months after the biopsy (period to obtain the results + any planned treatment), but must in any case be done within 6 to 9 months after the biopsy : The immune status of the uterus can change over one’s life, and can be influenced by many factors. This uterine immune profile is therefore valid for 9 months in the absence of an event which occurs in the meantime (uterine surgery, pregnancy, pelvic infection). Beyond that, the test must be performed again in order to customise such attempts.
In some cases (less than 5%), we cannot perform the tests because:
- the quantity of the sample is too low
- the biopsy has deteriorated (deterioration of the RNA) due to a transport period which was too long, or improper packaging, etc.
- the biopsy is performed at the wrong phase of the cycle (proliferative phase or late secretory phase)
In this case, tests are not invoiced. Only the histological dating is billed (if not paid by health insurance). In this case, you should set a new appointment with your physician to re-do a biopsy after completing the next cycle. This new biopsy can only be done the month after. There is therefore a two-month gap between the first and second biopsy to avoid the first biopsy affecting the second.