Endometrial health is essential for a successful pregnancy. A healthy endometrium must contain the right amount of healthy bacteria. Infertility is caused by 20% of endometrial factors, with 30% of infertile women found to have pathogenic bacteria in the lining of the uterus. 

All the microorganisms in the lining of the uterus are called the endometrial microbiome, with a healthy endometrium has rich in healthy bacteria.

What is EMMA?

Endometrial Microbiome Metagenomic Analysis (EMMA) is an analysis of the microorganisms living in your endometrium. It can tell the balance of microorganisms (Good and bad bacteria ), as well as advice on how to eliminate bad bacteria and supplement the good bacteria, such as Lactobacillus associated with a higher pregnancy rate. To balance the microorganisms living in the endometrium to achieve optimal conditions for embryo implantation increase your chances of getting pregnant. 

In addition, the EMMA test covers the detection of bacteria that cause chronic endometritis. Also known as the Analysis of Infectious Chronic Endometritis (ALICE) test.

Why is endometrial microbiome important?

The balance of bacteria in the endometrium is one of the key factors for embryo transfer success. If there is a high percentage of healthy bacteria, the chances of getting pregnant are high. And the lower amount of the healthy bacterial with existing amount the pathogenic bacteria, the lower the chance of conceiving. Therefore, by examining the endometrial microbiome, it can identify abnormalities and prognosis in the reproductive system.

How does an EMMA work?

The doctor will collect a small sample of endometrial tissue. (Endometrial biopsy samples can be together used with ERA test), then Next Generation Sequencing (NGS) technology is used to analyze all the genetic components of bacteria and other organisms living in the endometrium. After the analysis, the doctor will report the EMMA results, which will provide endometrial microbiome data and recommend personalized treatment. This may include antibiotic and probiotic therapy containing lactobacillus. (Lactobacillus), a good bacteria to restore endometrial microbiome conditions. Using the recommendations from the report, the doctor can transfer the embryo into the uterus with suitable environment for embryo implantation. This will increase your chances of getting pregnant.

Why should I get an EMMA exam?

    • EMMA uses Next Generation Sequencing (NGS) technology to analyze all bacteria or microbiomes present in endometrial tissue.

    • EMMA can indicate the percentage of lactobacillus. (Lactobacillus), a good bacteria in the endometrium. A low percentage of lactobacillus was associated with poor reproductive outcomes.

    • EMMA includes an ALICE test, so it indicates the presence of bacteria that can cause chronic endometritis and other pathogenic bacteria.

    • If the endometrium is not Lactobacillus predominant, the report will recommend the appropriate course of treatment for each patient.

    • EMMA determines whether the uterine microbial environment is optimal for embryo implantation.

Who should have an EMMA exam?

1. EMMA is another option for women who are infertile. Or those who suffer from recurrent implantation failure (RIF) or recurrent miscarriage to help increase the success of the pregnancy.

2. All those who want to have children to prepare the endometrium properly for embryo implantation.