EMMA / ALICE (Endometrial Microbiome Testing)
Molecular diagnostic tests that analyze the endometrial microbiome from a biopsy sample. EMMA (Endometrial Microbiome Metagenomic Analysis) measures the abundance and composition of endometrial bacteria, including the proportion of Lactobacillus (considered protective) and the presence of dysbiotic organisms. ALICE (Analysis of Infectious Chronic Endometritis) identifies pathogenic bacteria specifically associated with chronic endometritis. EMMA and ALICE are often ordered together with Endometrial Receptivity Analysis (ERA) from a single biopsy as an "EndomeTRIO" panel. Microbiome-targeted probiotic and antibiotic treatments guided by these results have been studied as adjuncts for women with recurrent implantation failure and recurrent pregnancy loss, though evidence quality varies across studies.65
Sources
- Moreno I, Codoñer FM, Vilella F, et al. Evidence that the endometrial microbiota has an effect on implantation success or failure. Am J Obstet Gynecol. 2016;215(6):684-703. . American Journal of Obstetrics and Gynecology
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