About ReceptivaDx

What is ReceptivaDx?

ReceptivaDx is the only test that can identify endometriosis, progesterone resistance, and endometritis in a single sample.

If the test results are positive, it indicates a high level of BCL6, identifying the presence of uterine lining inflammation, most often associated with endometriosis.

If the test results are negative, it suggests a high likelihood that no inflammation is present.

Download our patient information brochure

How it works

ReceptivaDx includes BCL6, a marker that identifies uterine inflammation most often associated with endometriosis, often asymptomatic (known as “silent” endometriosis).

For the Fertility Patient Undergoing IVF

BCL6 is found in more than 50% of women with unexplained infertility and 65% of women with two or more IVF failures. The ability to identify progesterone resistance via the BCL6 marker has been previously linked in published data to both implantation failure and recurrent pregnancy loss. Progesterone resistance is a condition that causes unfavorable changes on the uterine lining blocking the important hormone progesterone from carrying out its vital role in preparing the lining for embryo survival. ReceptivaDx can also be used to identify endometritis (chronic bacterial infection of the uterine lining) via the addition of our CD138 marker.

Women who test positive for BCL6 and are left untreated are 5 times less likely to succeed in IVF than women who test negative. If endometriosis goes untreated, issues with fertility are likely to persist, even throughout IVF treatment. 

For the Pain Patient

In simple terms, BCL6 is a very reliable marker for endometriosis. Here’s how. BCL6 is an inflammatory marker. Endometriosis is an inflammatory chronic condition fueled by estrogen. In women without endometriosis or other inflammatory conditions, BCL6 should not be present. We test  during the secretory (aka luteal) phase of the menstrual cycle (days 15-28) because during this phase, the largest differential between normal vs endometriosis appears, giving us great diagnostic accuracy. 

A positive or negative test allows you and your physician to narrow down potential courses of action, increasing your chances of a successful live birth or detection of endometriosis. Women going through IVF who test positive for BCL6 and are left untreated are 5 times less likely to succeed in IVF than women who test negative.

When to use ReceptivaDx

In IVF centers, recommendations on when to use our test clinically, center around proven transfer failure histories even with genetically tested embryos (PGTA),  recurrent pregnancy losses (2 or more miscarriages), women with limited embryo reserves or limited financial means to cover multiple IVF cycles.

Outside of IVF, specifically for patients wanting clarity on potential endometriosis, the test is recommended for patients experiencing symptoms of endometriosis such as recurrent pregnancy loss, pelvic pain, or history of endometriosis. When used in conjunction with other clinical tools such as imaging and blood work up, and a clinician that is receptive to your symptoms, ReceptivaDx can quickly guide decision making. 

ReceptivaDxTM testing is suggested for the following:

Women with unexplained infertility

  • Rule out uterine inflammation usually caused by endometriosis or endometritis (chronic bacterial infection).
  • Establish chances of success or failure before beginning advanced fertility treatment options.

Women with a history of implantation failure

  • Rule out uterine inflammation usually caused by endometriosis.
  • Rule out progesterone resistance, shown to be correlated with IVF failure.

Women with recurrent pregnancy loss

  • Rule out uterine inflammation usually caused by endometriosis.
  • Rule out progesterone resistance, shown to be correlated with recurrent pregnancy loss.

Women with limited embryo reserves

  • Helps provide success probabilities upfront before the next transfer procedure regardless of the results of PGT testing.
  • Identifies potential progesterone resistance, reducing risk for recurrent pregnancy loss.

Women with limited fertility coverage

  • Helps better understand the potential causes of unexplained infertility.
  • Provides potential treatment pathways if IVF is not a financial option.
  • Helps women not pursuing advanced fertility assistance to potentially gain more information regarding recurrent pregnancy loss

Women with history of endometriosis

  • A family history of endometriosis combined with any common symptoms such as difficulty conceiving or pain are all indications where ReceptivaDx may add guidance in diagnosing the disease.

Women with pelvic pain

  • Helps guide decision making on diagnosing the cause of pain.
  • 95% specific for endometriosis

Next steps after a ReceptivaDxTM result

If you have experienced infertility or pelvic pain, ReceptivaDx™ test results can give you clarity on developing an action plan along with your clinician 

If endometriosis goes untreated, issues with fertility are likely to persist, even throughout IVF treatment.

How the ReceptivaDx test can help you with Dr. Aimee and Dr. Lessey

If positive, there are two courses of action that have proven effective in thousands of IVF patients:

  • Hormone treatment to suppress the inflammation OR
  • laparoscopic surgery to remove the problematic tissue.
  • Removing endometriosis around the endometrial lining has also proven to increase the chances of conception even without IVF.

A negative BCL6 test result provides the reassurance that endometriosis is not a current concern and that future attempts at pregnancy are more likely to be successful.

If positive and not currently doing IVF, there are several courses of action depending on the patient’s objectives:

  • Identify an endometriosis specialist to consult and build a lifestyle plan for your individual wishes. Click here for a list https://myreceptiva.com/endometriosis-specialists/
  • Hormone treatment to reduce the pain. There are many different FDA approved drugs in this category
  • Laparoscopic surgery to remove the problematic tissue and potentially identify other related conditions like adenomyosis, polyps, etc
  • Ancillary practitioners who specialize with living with endometriosis with or without surgery.

A negative BCL6 test result provides the reassurance that endometriosis is not likely the issue. If on a fertility journey, identifying other causes of your pain is recommended and natural conception probability is not reduced by the presence of endometriosis.

Success Stories from Patients

  • A new mom holding a sleeping infant lovingly to her chest while sitting in a chair.
    “Our journey to our miracle baby has been one filled with heartache, frustration and many tears. However, through perseverance and a lot of hope, faith and the ReceptivaDx test, I am so happy to report that we finally had our beautiful blessing on 11-11-20. I consider the ReceptivaDX biopsy to be my miracle test, the test that allowed my baby girl to make it into my arms.”
    – Melissa
  • Intimate view of a new mom looking looking lovingly at her newborn.
    “After my failed transfer with our first donated embryo I felt lost and broken. The PA at my office suggested that I research ReceptivaDx, she said it was new but could give me some answers, so I did. A few months later I had a 2nd transfer with our remaining donated embryo, and it worked! He is now a perfect, healthy 9 month old boy! Do yourself a favor, get this test! I had no symptoms, 1.5 years of infertility treatments and who knows if my journey would have been much shorter or a different outcome if I would have a had this test from the beginning!”
    – Kerri Morgan
  • Infant smiling at the camera wearing a "onesie" that says, "Worth Every Needle"
    “We were losing all hope until we did the ReceptivaDx test. After we did it, we finally had an answer and a way forward. What I wouldn’t give to have been able to do it sooner.”
    – Andrea
  • Newborn sleeping peacefully against her mother's chest.
    “We feel that the discovery from the ReceptivaDx test and the change in our protocol was what gave us the biggest gift in our lives, our sweet baby girl.  We didn’t know what the future would hold for us for future children but to our surprise we got pregnant naturally with the first cycle after our first was born. These two baby girls are the absolute light of our lives and we hope that this test helps more families like ours.”
    – Haley S.
  • Coulpe standing in front of palm trees outside holding a baby onsie announcing a pregnancy.
    “After almost 3 years of unexplained infertility, 4 failed medicated IUI’s, and 3 failed embryo transfers, we felt completely defeated, hopeless, and unsure of our next steps. It’s an absolute miracle and I’m endlessly grateful for the ReceptivaDx test and the research that is currently being done to investigate the link between unexplained infertility and silent endometriosis.”
    – Caroline C.
  • “After two egg retrievals and two failed transfers (with the loss of three embryos) my husband and I were in the depths of desperation and despair. It wasn’t until we switched clinics that we discovered Receptiva testing. The biopsy itself was quick and results were sent to my clinic in less than a week! We finally had an answer for our struggles and a clear path forward! I now have a sweet, silly, adorable ten-month-old thanks to the pioneering efforts of the team behind ReceptivaDx”
    – Maggie B

Frequently Asked Questions

Endometriosis is a complex disease in which tissue that is similar to the endometrial lining of the uterus grows outside of the uterus. It typically grows on the ovaries, ovarian tubes, the outer wall of the uterus, the intestines, or other organs in the abdomen. In some cases, endometriosis has been found growing in other areas of the body, outside of the abdomen. Endometriosis is a leading cause of infertility, implantation failure, and pelvic pain.

ReceptivaDx is an endometrial biopsy test that is used for the detection of BCL6, a marker for inflammation of the uterine lining, which is most commonly associated with endometriosis. ReceptivaDx also includes a full histologic analysis providing endometrial dating, cycle phase confirmation, and identifying any abnormal cell changes. In addition, you have the option to add CD138 to test for endometritis. Endometritis is a bacterial infection that often goes unnoticed but can lead to infertility or recurrent pregnancy losses.

ReceptivaDx is performed using an endometrial biopsy sample, a routine procedure that can be performed during an office visit with your healthcare provider. The biopsy is a timed biopsy meaning it  must be taken 7-10 days after ovulation. If you are in an IVF setting you can also have the biopsy taken in a mock cycle which is 6-10 days after the start of progesterone.

During a routine office visit, a thin catheter (compared to a spaghetti noodle in diameter) is gently inserted through the vaginal canal, then passed through the cervix into your uterus. A suction-like technique is used to pull cells from the uterine lining into the tube. You will experience temporary discomfort and possibly some light cramping in the 5-10 minutes following the procedure. Most patients can resume normal daily activities within 15-20 minutes after a brief resting period. The sample is collected into a vial with preservative and then shipped overnight to our lab.

ReceptivaDx results are communicated to your healthcare provider within 7-10 business days. Although results are sometimes available sooner, your healthcare provider’s office may need time to review and chart results before contacting you.

Patients should not have any invasive procedures in the 60 days leading up to the ReceptivaDx test. This includes hysteroscopies and other procedures such as D&Cs. The biopsy should not be performed in an IVF egg retrieval cycle. Patients should be off birth control for at least one cycle prior to performing the biopsy.

A Fertility Specialist, Ob-Gyn or other healthcare provider who performs endometrial biopsies can collect a sample for ReceptivaDx. A list of fertility centers routinely offering ReceptivaDx to their patients can be found here. A directory of minimally invasive surgeons, Ob-Gyns, and other healthcare providers who offer ReceptivaDx testing can be found here. If you need additional help finding a center near you, please contact our customer service desk at 800-795-5385.

The cost of the ReceptivaDx test (BCL6 result and full pathology report) is $690. This includes overnight shipping via FedEx to our nearest licensed testing center. CD138, a marker that identifies endometritis, a chronic bacterial infection, can be ordered for an additional $145.
Cicero Diagnostics requires payment via credit card at the time of sample submission. If preferred, patients may call our office to make payment in advance. Cicero Diagnostics provides a detailed receipt that can be used for potential reimbursement from insurance or healthcare spending accounts. Please provide an email address on the test request form to receive the detailed receipt. Cicero Diagnostics does not bill or contract with insurance plans.

Cicero Diagnostics, Inc. is a diagnostics company dedicated to the advancement of clinical assays in women’s healthcare. Cicero Diagnostics has exclusive rights to BCL6 analysis on endometrial tissue. Our company has forged relationships with key academic research centers and is dedicated to the development of new testing modalities for endometriosis and unexplained infertility.

Cicero Diagnostics maintains two laboratory locations. Both testing sites operate under CLIA guidelines established for best laboratory practices and are fully licensed. Cicero Diagnostics is the only licensed provider for detection of the BCL6 marker in endometrial biopsy samples.
Please feel free to contact us at 800-795-5385 for further information. International clients can email us at info@cicerodx.com or call us at 1-714-951-9245.

Discuss treatment and management options with your healthcare provider. Proven treatment options may include medical management or hormonal therapy including GnRH medications. Minimally invasive surgery such as laparoscopy to diagnose and remove endometriosis lesions may be considered prior to trying to conceive. The most appropriate treatment depends on symptom severity, fertility goals, and guidance from a healthcare provider.

Fertility: Candidates include:

  • All women with unexplained infertility.
  • Women 34 and under who have failed to conceive after 12 months of trying to conceive without fertility treatments.
  • Women 35 and over with unexplained infertility after 6 months of trying to conceive without fertility treatments.
  • Women with one or more miscarriages.
  • Women and families wanting to screen before considering expensive next steps such as IVF.
  • Women who have failed one or more IVF cycles.
  • Women with limited embryo reserves.
  • Women who have experienced recurrent pregnancy loss.
  • Women who cannot afford IVF or have limited fertility coverage.

Endometriosis Detection Candidates include all women between 18-45 with:

  • Undiagnosed pelvic or abdominal pain.
  • Family history of endometriosis, pelvic or abdominal pain.
  • Pain during and after sex.
  • Recurrent bladder or bowel pain.
  • High Body Mass Index (BMI) combined with non-specific symptoms such as anxiety, depression or fatigue.
  • For additional common symptoms, visit icarebetter.com.

  • All women with unexplained infertility.
  • Women 34 and under who have failed to conceive after 12 months of trying to conceive without fertility treatments.
  • Women 35 and over with unexplained infertility after 6 months of trying to conceive without fertility treatments.
  • Women with one or more miscarriages.
  • Women and families wanting to screen before considering expensive next steps such as IVF.
  • Women who have failed one or more IVF cycles.
  • Women with limited embryo reserves.
  • Women who have experienced recurrent pregnancy loss.
  • Women who cannot afford IVF or have limited fertility coverage.

Endometriosis can hinder a fertilized egg’s ability to implant, affecting both spontaneous pregnancy and IVF outcomes. While many people associate endometriosis with symptoms such as pelvic pain, painful periods, and pain during or after intercourse, “silent endometriosis” can occur without any noticeable symptoms, making it challenging to detect. ReceptivaDx is valuable for patients as it detects endometriosis, even in asymptomatic cases, allowing for better-informed treatment options and an increased likelihood of pregnancy.

Silent endometriosis does not have the typical symptoms of endometriosis. Frequently, the only apparent symptom is the inability to get pregnant or remain pregnant. Endometriosis affects the uterine lining, impacting the ability of a fertilized egg to implant and grow in the uterus. The condition can develop outside the uterus on other organs like the ovaries as well. Women with symptomatic endometriosis often experience symptoms like pelvic pain, painful periods, and/or painful intercourse. The absence of symptoms makes silent endometriosis harder to diagnose and the leading cause of unexplained infertility.

Any Fertility Specialist or Ob-Gyn, or other healthcare provider who performs endometrial biopsies can collect a sample for ReceptivaDx. A list of fertility centers routinely offering ReceptivaDx to their patients can be found here. If you need additional help finding a center near you, please contact our customer service desk at 800-795-5385.

The ReceptivaDx test was originally validated in natural cycle biopsies collected 7-10 days after ovulation.

If a mock cycle biopsy is preferred by your provider, ReceptivaDx has been validated in more than 15,000 mock cycle biopsies and can also be performed accurately in this setting. Providers are reminded that 5 full days of progesterone administration (120 hours) must be onboard to obtain accurate results. Chances of a false negative can occur if protocols are not properly followed.

Unfortunately, the BCL6 marker was not validated during egg retrieval cycles and should not be obtained in that same cycle. While convenient for the provider and patient, performing a biopsy at the time of egg retrieval is too early in the cycle to detect the presence of BCL6. Medications used during the egg retrieval cycle can also impact results. It is suggested to wait until the cycle after egg retrieval to obtain an optimal biopsy.

CD138 is a marker found on plasma cells, a type of immune cell that can indicate chronic inflammation and may suggest an underlying infection. In normal endometrial tissue, plasma cells are rare or absent. When plasma cells are present in higher numbers, it can indicate chronic endometritis, a persistent inflammation caused by bacteria. This infection of the uterine lining can affect fertility and implantation. Chronic endometritis is a frequently missed infection, treatable with antibiotics.

CD138 testing for chronic endometritis is particularly recommended for individuals who:

  • Experience infertility- women who have been trying to conceive without success.
  • Have a history of miscarriages- those with recurrent pregnancy loss may benefit from testing, as chronic endometritis can affect implantation.
  • Show symptoms- individuals with persistent symptoms such as abnormal uterine bleeding, pelvic pain, or unusual discharge, even if not severe, should consider testing.
  • Have underlying conditions- those with known conditions that may affect the uterus, such as endometriosis or fibroids, might also warrant testing.
  • Previous infections -women with a history of pelvic infections or sexually transmitted infections (STIs) could be at higher risk for chronic endometritis.
  • Post-surgical changes- individuals who have undergone uterine surgeries (like a D&C or myomectomy) may be at risk and should discuss testing with their healthcare provider.

CD138 testing can be added to ReceptivaDx. Both tests can be performed on a single biopsy. The addition of CD138 testing is $145.

Discuss treatment and management options with your healthcare provider. Proven
treatment option may include medical management or hormonal therapy including GnRH medications.
Minimally invasive surgery such as laparoscopy to diagnose and remove endometriosis lesions may be considered prior to trying to conceive. The most appropriate treatment depends on symptom severity, fertility goals, and guidance from a healthcare provider.

If your ReceptivaDx test result is negative, you have less than a 7% chance that endometriosis will be found via laparoscopy. A negative test result allows your healthcare provider to focus on other causes of infertility to guide the next steps in your fertility journey.

An Ob-Gyn or healthcare provider who performs endometrial biopsies can collect a sample for ReceptivaDx testing. A list of endometriosis specialists, many of whom can perform the biopsy, can be found here.

Speak to your healthcare provider to see if they offer ReceptivaDx testing in their office. You can also order the test kit here and schedule the timed endometrial biopsy with your healthcare provider. If you need additional help finding a center near you, please contact our customer service desk at 800-795-5385.

Endometriosis can be difficult to diagnose because it doesn’t look the same in every patient. Symptoms vary widely. Some people have severe pelvic pain or painful periods. Others struggle with infertility or digestive symptoms like bloating. Some have very little pain at all. Because these symptoms overlap with other common conditions, endometriosis is often overlooked.
Ultrasound and MRI may appear normal, even when endometriosis is present. For many years, surgery has been the only definitive way to confirm a diagnosis. Adding to the challenge, painful periods are often dismissed as “normal,” which can delay further evaluation. Many people live with symptoms for years before getting answers. ReceptivaDx can help to expedite that process.

Symptoms vary widely and can look differently in every patient. Some recognized symptoms include:

  • Undiagnosed pelvic or abdominal pain.
  • Family history of endometriosis, pelvic or abdominal pain.
  • Pain during and after intercourse.
  • Recurrent bladder or bowel pain.
  • High Body Mass Index (BMI) combined with non-specific symptoms such as anxiety, depression or fatigue.

Discuss treatment and management options with your healthcare provider. Proven
treatment options may include medical management for pain or hormonal therapy including GnRH medications. Minimally invasive surgery such as laparoscopy to diagnose and remove endometriosis lesions may be considered. Complementary approaches such as acupuncture, nutrition counseling, or pelvic floor physical therapy may be beneficial. The most appropriate treatment depends on symptom severity, fertility goals, and guidance from a healthcare provider.

If your ReceptivaDx test results are negative, you have less than a 7% chance that endometriosis will be found via laparoscopy. A negative test result allows your healthcare provider to focus on other causes of pelvic pain, helping to pinpoint the right treatment. Test results should always be taken in context to your complete medical history.

Many healthcare providers are not endometriosis specialists, but they can help you obtain a sample for the ReceptivaDx test. When preparing for your conversation, be prepared to:

  • Explain your symptoms clearly.
  • Share your medical history.
  • Discuss goals: clarify whether you’re hoping to guide treatment, understand inflammation, or guide long term decision making about fertility, etc.
  • Communicate that you want to explore options to get a timely diagnosis.
  • Ask about ReceptivaDx testing directly i.e. “Could Receptiva help to understand my pelvic pain or other symptoms?”
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