Mock Cycle: A cycle which mimics a Frozen Embryo Transfer cycle with the goal of monitoring the development of a woman’s endometrial lining.

Background

Mock cycles are performed when a physician wants to monitor the growth of a member’s endometrial lining as though she was planning for an embryo transfer. A small portion of the lining is then biopsied when the embryo would have otherwise been transferred. Typically, this occurs when there is a medical indication, such as recurrent pregnancy loss. The biopsy is then sent to a lab so they can run an analysis to see if the uterus would have been receptive to an implantation at that time. If not, medications or timing may be adjusted for the actual transfer cycle. Data on the utility of this testing is limited and controversial.

Mock Cycle Policy

Mock cycles are a covered service under the Progyny benefit for certain clinical indications.

The authorization covers:

• ultrasounds
• blood work
• endometrial biopsy
• endometrial biopsy testing at the lab:
  • ERA (Endometrial Receptivity Assay) (Igenomix)
  • ERPeak (Cooper)
• medications via Progyny Rx, if applicable

Mock Cycle Authorization Process

Via the provider portal, provider must submit required documentation as well as clinical justification for mock cycle.

Mock cycle authorizations will be denied without clinical documentation identifying one of the following conditions:

• Recurrent implantation failure – defined as three or more failed embryo transfers (negative pregnancy test following embryo transfer in past).
• Recurrent pregnancy loss history – defined as two or more pregnancy losses.
• Member has undergone at least one embryo transfer without success and has only one usable/euploid embryo remaining in cryostorage.
• Member is utilizing embryo(s) created from donor tissue, either egg or sperm.

All mock cycles must be pre-authorized. See above.

References

1. Hashimoto T, Koizumi M, Doshida M, et al. Efficacy of the endometrial receptivity array for repeated implantation failure in Japan: A retrospective, two-centers study. Reprod Med Biol. 2017.
2. Doyle N, Jahandideh S, Hill M, Wildra E, Levy M, Devine K. Effect of Timing by Endometrial Receptivity Testing vs Standard Timing of Frozen Embryo Transfer on Live Birth in Patients Undergoing In Vitro Fertilization: A Randomized Clinical Trial. American Medical Association. 2022.
3. Rubin SC, Abdulkadir M, Lewis J, Harutyunyan A, Hirani R, Grimes CL. Review of Endometrial Receptivity Array: A Personalized Approach to Embryo Transfer and Its Clinical Applications. J. Pers. Med. 2023.