GERT: GENNET Endometrium Receptivity test
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The Gennet Endometrium Receptivity Test (GERT) is a diagnostic test designed to determine the receptivity of the inner lining of the uterus (endometrium). For successful embryo transfer in assisted reproduction, not only implantation of a good embryo is important, but also the time when the embryo is transferred. The role of GERT is to determine the appropriate time when the endometrium is correctly receptive to the embryo. Using the GERT method, we analyse the uterine lining at the molecular level and determine the so-called implant window, the time when the endometrium is properly receptive for embryo transfer. Insufficient receptivity of the endometrium can negatively affect embryo nesting and therefore the success of assisted reproduction, so the examination is especially suitable for women with repeated failed embryo transfers. For this examination, endometrial tissue is taken for RNA testing. The endometrial tissue biopsy and RNA testing are performed optimally in the previous cycle before embryo implantation is planned. mRNA is isolated from the collected tissue and reverse transcribed into complementary cDNA. From it, a sequencing library is prepared, which is then sequenced on Illumina platform sequencers. Sequencing data is uploaded to the ChromGo application in the form of fastq, where information about the receptivity of the endometrium is analysed and released.
The aim of GERT is to detect the expression of relevant genes at the mRNA level at the time of collection. The expression rate is determined by FPKM (Fragments Per Kilobase Million), which are further processed and compared with the transcriptomic profile of the endometrium using bioinformatic calculations. This profile was defined for a short receptive period and thanks to it a prediction model was created that reliably identifies the receptive, prereceptive and postreceptive phases and the specific implant window.
