Testing for ENDOMETRIOSIS | Endometrial Receptivity Test VS Receptiva DX
March is Endometriosis Awareness Month, and last week, I started the conversation about endometriosis, talking about diet and how diet can really impact endometriosis and the symptoms associated with endometriosis. Today, I want to answer the most common questions that I get about endometriosis other than what should I eat to help support my endometriosis or get rid of it, which I answered last week, by the way. But the two most common questions that I get asked are how do I know if I have endometriosis and what test can I get to confirm it?
Well, we do know that endometriosis is one of the leading causes of fertility issues and implantation failure, and countless women, actually roughly about 20% of women, don’t even know that they have endometriosis until they start the fertility journey and lesions are found. That’s pretty unbelievable considering that most women with endometriosis do have some sort of pain or discomfort and inflammation associated with it. But even with that, we have this high number, almost a quarter of the women with endometriosis are never even diagnosed. They don’t even know that they have it. That’s really profound.
And one of the most shocking revelations when I was doing more research on endometriosis that I found was that actually it can take upwards of 11 years, 3 to 11 years to actually be diagnosed once a woman has symptoms associated with endometriosis. That’s huge. That means almost 10 years of your life, you could have endometriosis, have symptoms of endometriosis and never know or actually get confirmation of diagnosis.
So considering that it’s Endometriosis Awareness Month, I want to make sure that we figure out, teach all of you, how to shorten that time to diagnosis. Because if we can shorten that time, then we can get you the care and support and attention that you deserve and hopefully allow you to get pregnant sooner.
So how exactly can we do that? Well, testing and advocating for testing. That’s right. You need to get the proper testing and you need to speak up for yourself. You need to demand that you get the proper testing that you deserve to make sure and rule out or rule in endometriosis. And you all, I know, have heard me say that it’s about testing and not guessing. So why guess if we have endometriosis? We want to make sure that we know for certain if we do have it.
So if we suspect that we have endometriosis, what do we do, where do we go, and what are the next steps? And that’s exactly what I want to discuss in this week’s video. I want to cover the three main tests that you can use to figure out if you have endometriosis and which one of those is my favorite. So keep watching to learn more.
Hi, my name is Dr. Marc Sklar, also known as the fertility expert, and I’ve been working with couples for almost 19 years through my online coaching programs and right here in San Diego at my clinic. And endometriosis is such an important topic, but the reason we’re talking about it today is because getting you the proper information and knowledge is so important, and one of my missions, it’s actually why I started this channel, FertilityTV, because I want to educate all of you to get the information that you deserve and get the results that you need. I believe that many of you are misdiagnosed or misled, and that is no more true than when we talk about endometriosis. So we need to make sure that we restore your hope, get you the proper information and diagnoses so that you can get the results that you deserve.
One of the ways that I do that is this channel right here, and one of the small things that you can do to actually help me spread my mission and inform more women and more couples about what they need to do on their infertility journey and what testing they need to get is to spread this video to more people. Share it. Comment below. Like this video. The more we do those things, the more couples and women are going to see this video, get better education and learn what they need to be doing, and we’re helping more couples throughout the world. So I’d like to ask you to support me on my mission of spreading fertility information by doing one or more of those things.
So now it’s time to start talking about testing and endometriosis. What tests should we be doing and what are the benefits of each one? Well, I’m going to start with the two more well-known ones and the ones that most of you have heard or discussed if you’ve ever started to dive deeper into endometriosis and wanting to understand if you have it.
The first one and the gold standard for diagnosis when it comes to endometriosis is what’s called a laparoscopy. So this is when your doctor will make small incisions on your low abdomen and pelvic area to go in with a camera and investigate to see if they find the endometriosis lesions, those chocolate cyst that we discussed or think about when we think about endometriosis. So they’re going in to see visually with their eyes. Do they actually see these lesions? Do they see them growing in different aspects of the uterus, the fallopian tubes, the ovaries, the pelvic area. If they see that, then we have confirmation. And then the next step of that diagnosis is what stage, how severe is the endometriosis.
So this is definitely the gold standard and it’s the gold standard for a couple of reasons. One is because you can see it. Your doctor can visually see the lesions and then, actually, if they’re there and they’re willing and able, they can actually remove some of those lesions, they can get rid of them, right? So this definitely helps both with diagnostic and with treatment. So that’s part of the reason why it’s the gold standard. It’s also, you can count on it. You know exactly what you’re going to get. So if you really suspect endometriosis, if you are questioning, if you have it because you’ve had these symptoms for a period of time, I want you to advocate for yourself and ask for a laparoscopy sooner rather than later.
Now, let’s say not sure if you have endometriosis and you don’t know if you really want to have laparoscopy. I mean, it is still a procedure. It still is a surgery and it is invasive, so we’d all rather not have that if we don’t need to, right? So maybe there are places, there are other diagnostic methods that we can utilize before we ever get to have that need, before we ever have to get to the surgery. Well, there are. They’re not as accurate, because I talked about laparoscopy as the gold standard, but there are and we can absolutely start there if we need to.
So the second test that we can use is actually a cancer marker. It’s called CA-125, and this is specifically a cancer marker for ovarian cancer. That’s right. Now, I’m not suggesting that if you have endometriosis that you’re going to have ovarian cancer. Not necessary, okay, but there is a correlation between the two. And what we do find is that for women with symptoms of endometriosis, this marker, the CA-125 marker, was actually relatively accurate in diagnosing, actually upwards of 93% accurate, of diagnosing endometriosis. So it absolute can be a nice place to start. Again, if you don’t have symptoms, it might not be the most accurate for you, but, again, it is just a blood test. It’s not invasive, so it could very well be a good place to start and often one of the places that I start if we want to do a superficial ruling out of endometriosis.
Okay, so the third test is a relatively new test and certainly relatively new for many of you watching. It’s a test called ReceptivaDx, and this test actually detects inflammation on the uterine lining. So why is testing for inflammation on the uterine lining important? Well, we do know that we have higher levels of inflammation with endometriosis, and we know that this can impact implantation. Actually, it makes it harder for the embryo to stick. So wouldn’t it be nice to know in advance if we have more inflammation in the endometrium, in the tissue of the uterus, and if that’s going to impact our ability to have a successful implantation, or if you’re doing IVF, a successful IVF transfer with implantation?
Well, ReceptivaDx actually is testing for BCL6. That’s right. So if it finds higher levels of BCL6, then we know that we have higher levels of inflammation. And women who test positive for this are actually five times, five times less likely to have a successful in vitro fertilization transfer of an embryo. That’s right. So if this number is there, if that inflammation marker is there and positive, then your five times less likely to be successful on an embryo transfer if you do in vitro fertilization. That’s huge. So we definitely would want to know that if we’re going forward using IVF and spending the money to go forward with IVF. We want to make sure that it’s going to be successful and that we have as little inflammation in the endometrium as possible.
Now, if this test is actually negative, then that can give you a reassurance that you do not have endometriosis. Now, this is still a relatively invasive procedure, okay? So the only one of the three that I mentioned that is non-invasive is the blood test, the second one, the CA-125. Now, this is not as invasive as a laparoscopy and certainly not nearly as expensive as a laparoscopy, but it is still invasive because they’ve got to go in and get a sample, a biopsy of your endometrium, the tissue in your uterus so that they can test that.
So who would qualify for the ReceptivaDx? Well, we already know, if you suspect that you have endometriosis, then definitely I would suggest getting this test done. But if you have what’s called unexplained infertility, then this might also be a reasonable test for you to look into. You all know that I do not believe in unexplained, but we’re going to go there for the sake of this conversation. If you’ve had one or more unsuccessful IVF transfers, this also might be a test to look at. Or, if you’ve had a recurrent pregnancy loss or miscarriage, again, this might be another reason to look at, doing the ReceptivaDx.
Now, you can do this test at either your OB/GYN office or your fertility doctor’s this, your reproductive endocrinologist. Either one is absolutely fine, but I have yet to find any OB/GYNs that actually do this test routinely. So most of the time, you’re going to be going to your fertility clinic and asking for this test.
The other important piece about this is when should it be done? Well, the ReceptivaDx website does say that you can do it either during a natural cycle or a mock IVF cycle. Either one is fine, but it does need to be done in the luteal phase, right? And why does it need to be done in the luteal phase? Because it needs to be done during the implantation window because that’s when the test is the most accurate. So if you’re going through it, just know and expect, now your doctor should know when to do it, but you should also know to when expect the timing of when this is done because that will help you plan a little bit better for it.
I know that one of the main questions that you all are thinking right now is, well, what do I do if I know I have endometriosis or one of these tests shows that I have endometriosis. Well, that’s not what we’re talking about in this video, but I did start that conversation last week when we talked about diet because it can be a huge difference maker when you are dealing with your endometriosis and want to reduce the inflammatory process and not allow that to thrive. So that is one step, and if you didn’t watch last week’s video, go ahead and check it out after you’re done with this one.
But I do have other videos that cover that in more detail in terms of steps that you can take to address that. Now, my number one step and suggestion in what you can start to do now to address your endometriosis is get the proper help and support. Now that assumes you’ve already done the testing. If you haven’t already done the testing and you need guidance there too, then you’d still need the proper care and support to lead you down that testing route and to get the proper treatment that you deserve and need.
One of my recommendations would be to invite all of you watching to join me in my HOPE Fertility Coaching Program, because that is where I take an active role in supporting you on your fertility journey, endometriosis or any other fertility-related condition. So if you want more hands-on care, you want my eyes on your case, and you want a customized plan to get you the results that you need and deserve then I want to invite you to apply to join me in my HOPE Fertility Coaching Program, and all you have to do is use the link in the description below.
All right, what did you learn in this video? I want to hear from all of you and I know for sure from this video, you learned something new. At the very least, many of you learned about this new test, the ReceptivaDx test. So comment below and let me know what you learned. I also want to hear more from you. So if you’ve got other comments having to do with endometriosis, testing, or treatment, comment below or ask a question and I’ll do my best to get back to you. If you like this video, give me a thumbs up. If you’re not already a subscriber to my YouTube channel, then you make sure you hit that bell to subscribe so that you can get notified when I put out a new video for all of you. And until the next video, stay fertile.