The uterus lining is usually assessed during an ultrasound, but then only the thickness and structure are examined. However, the bacterial flora (microbiome) is also important for fertility and the ‘implantation window’ i.e. the correct time for embryo transfer.
The bacterial balance in the endometrium is important for successful embryo implantation. If pathogenic bacteria are in the uterus, this balance can be disturbed. The EMMA test can detect the presence of the bacteria that cause chronic inflammation.
Recently, numerous studies have looked at the function of microorganisms in the human body. The results of new studies have shown that in most women the uterine microbiome (that is the number of microorganisms in the uterus) consists of mainly lactobacilli (lactic acid-producing bacteria). The appearance of other bacteria or a lack of lactobacilli in the uterine cavity can significantly reduce fertility. If the microbiome in the uterus is rich in lactobacilli, chances of implantation of the embryo is 60 per cent, if the endometrium has few lactobacilli, implantation is only 23 per cent. The proportion of live births falls from 58 to 7 per cent.
The EMMA test (Endometrial Microbiome Metagenomic Analysis) can be carried out at the Kinderwunsch Institut Dr Loimer. This presents a new opportunity, particularly for women with repeated implantation failure. During the EMMA test in Linz, a small tissue sample is taken from the uterine lining and the composition and type of bacteria present are determine using genetic testing. Depending on the result, we determine the individual treatment, for example with lactobacilli or antibiotics.