EMMA & ALICE Tests
The EMMA and ALICE tests are screening procedures that examine the presence of bacteria in the uterine cavity, which could impact fertility and embryo implantation. While bacteria are naturally present in the womb, certain harmful bacteria linked to inflammation or illness may interfere with successful embryo implantation.
What is the EMMA test? The EMMA test offers a comprehensive analysis of the endometrial microbiome. It screens for the presence of bacteria that may affect fertility and implantation, determining the healthy levels of bacteria essential for a successful pregnancy. If imbalances are found, probiotic treatments may be recommended to restore microbiome and improve pregnancy chances.
What is the ALICE test? The ALICE test is a more targeted screening that specifically looks for bacteria known to cause chronic, low-grade infections in the womb lining (endometritis). It tests for 8 bacteria that could potentially harm an embryo’s ability to implant, and if necessary, antibiotic treatment is prescribed.
While it’s normal to have bacteria throughout the body, including in the vagina and womb, changes in the microbiome can occur due to illness, antibiotic use, or other factors. These changes can alter the acidity in the womb and create an environment less conducive to embryo implantation. Low-grade infections within the womb, even without noticeable symptoms, may lead to inflammation that hinders embryo success.
How are the tests done? Both tests require a small sample of endometrial tissue, which is then analyzed to create a profile of the bacteria present. This allows us to assess the overall health of the uterine environment.
Are there any risks? Endometrial sampling carries minimal risks, such as light bleeding, infection, or, in rare cases, uterine perforation. Occasionally, the sample may not provide a diagnosis, which could be due to low bacterial DNA levels or sample issues. If this happens, we may recommend a repeat biopsy to ensure accurate results.
Who can benefit from EMMA or ALICE testing?
EMMA is ideal for any patient struggling to conceive, especially those with unexplained infertility. It provides a detailed assessment of the microbiome, offering insights into conditions that may impact fertility.
It is recommended for individuals who:
- Have experienced 3 or more implantation failures with high-quality embryos.
- Have endometriosis, as some reports suggest microbiome changes in these patients.
- Have had recurrent miscarriage.
ALICE is a more focused test primarily recommended for patients experiencing recurrent pregnancy loss and trying to conceive naturally. It helps identify harmful bacteria that could interfere with implantation.