EndomeTRIO: The endometrium matters

EndomeTRIO
Benefits
Indications

What test does the EndomeTRIO analysis include?

ERA

The ERA test evaluates the receptivity of the endometrium to determine if, at the time of biopsy, the uterine lining is receptive to embryo implantation. This information allows us to determine the ideal time for a personalised embryo transfer (pET). The ERA test resulted in a 73% pregnancy rate in patients with implantation failure.

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ALICE

ALICE (Analysis of Infectious Chronic Endometritis) is a diagnostic test to detect the bacteria causing chronic endometritis (CE), a condition that is associated with infertility.
Independent studies show that this condition affects up to 30% of infertile patients, and in cases of repeated implantation failure or recurrent pregnancy loss, this can rise to 66%*.
ALICE identifies the most common bacteria causing CE and helps clinicians to recommend appropriate antibiotic and probiotic treatments.

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EMMA

EMMA (Endometrial Microbiome Metagenomic Analysis) is a screening test to evaluate the endometrium at the microbiological level, improving clinical management of infertile patients.
By analysing the endometrial microbiome, EMMA determines whether the uterine microbial environment is optimal for embryo implantation.
EMMA provides information about the ten most abundant bacteria in the endometrium, recommending embryo transfer or appropriate treatment, depending on results.

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What is the procedure?

Why does the endometrium matter?

The endometrium has been noted as a key factor for a healthy pregnancy in recent scientific studies. In fact, 20% of infertility is caused by the endometrial factor.

Since 2014, Igenomix has been conducting a deep line of research to understand the role of the endometrial factor in recurrent implantation failure patients.

Our recent publications in the American Journal of Obstetrics and Gynecology (AJOG) demonstrate a new dimension of endometrial health that can improve your patient’s reproductive prognosis.

Why use endomeTRIO test?

A better understanding of endometrial health to improve your patient’s reproductive prognosis: Analyses Endometrial receptivity, chronic endometritis and endometrial flora.
EndomeTRIO uses the latest Next Generation Sequencing technology.

Who should use EndomeTRIO Analysis?

Women who have experienced implantation failure with morphologically good quality embryos
Women with a history of recurrent pregnancy loss
Women with a morphologically normal uterus and normal endometrial thickness (≥ 6 mm), where the physical features of the uterus and endometrium are unlikely to be the problem
Women with Chronic Endometritis

Methodology:

Only a single endometrial biopsy is needed to perform the combined ERA+EMMA+ALICE test, EndomeTRIO.

How should I and send the sample?

An endometrial biopsy taken from the uterine fundus must be immediately place into an ERA cryotube, shaken and stored in a refrigerator (4-8°C/ 39-46°F) for at least 4 hours.
Samples are sent at room temperature(<35ºC/95ºF) accompanied with the patient´s informed consent and a completed requisition form.

Test Limitations

Patients planning an assisted reproduction treatment
ERA test limitations
EMMA test limitations
ALICE test limitations

Documentation

Authors: Moreno I, Garcia-Grau I, Perez-Villaroya D, Gonzalez-Monfort M, Bahçeci M, Barrionuevo M. J, Taguchi S, Puente E, Dimattina M, Lim M. W, Meneghini G, Aubuchon M, Leondires M, Izquierdo A, Perez-Olgiati M., Chavez A., Seethram K., Bau D., Gomez C., Valbuena D, Vilella F, Simon C

Publication: Microbiome. 2022 Jan 4;10(1):1. doi: 10.1186/s40168-021-01184-w.

PMID: 34980280

Title: Chronic endometritis due to common bacteria is prevalent in women with recurrent miscarriage as confirmed by improved pregnancy outcome after antibiotic treatment

Authors: Cicinelli E, Matteo M, Tinelli R, Pinto V, Marinaccio M, Indraccolo U, De Ziegler D, Resta L

Publication: Reprod Sci 2014 May;21(5):640-7. doi: 10.1177/1933719113508817. Epub 2013 Oct 31.

PMID: 24177713

Title: Prevalence of chronic endometritis in repeated unexplained implantation failure and the IVF success rate after antibiotic therapy

Authors: Cicinelli E, Matteo M, Tinelli R, Lepera A, Alfonso R, Indraccolo U, Marrocchella S, Greco P, Resta L

Publication: Hum Reprod. 2015 Feb;30(2):323-30. doi: 10.1093/humrep/deu292. Epub 2014 Nov 10.

PMID: 25385744

Title: The diagnosis of chronic endometritis in infertile asymptomatic women: a comparative study of histology, microbial cultures, hysteroscopy, and molecular microbiology

Authors: Moreno I, Cicinelli E, Garcia-Grau I, Gonzalez-Monfort M, Bau D, Vilella F, De Ziegler D, Resta L, Valbuena D, Simon C

Publication: Am J Obstet Gynecol. 2018 Jun;218(6):602.e1-602.e16. doi: 10.1016/j.ajog.2018.02.012. Epub 2018 Feb 23.

PMID: 29477653

Title: Evidence that the endometrial microbiota has an effect on implantation success or failure

Authors: Moreno I, Codoñer F M, Vilella F, Valbuena D, Martinez-Blanch J F, Jimenez-Almazán J, Alonso R, Alamá P, Remohí J, Pellicer A, Ramon D, Simon C

Publication: Am J Obstet Gynecol. 2016 Dec;215(6):684-703. doi: 10.1016/j.ajog.2016.09.075. Epub 2016 Oct 4.

PMID: 27717732

Igenomix and fertility

We work to make a world in which infertility is no longer an impossible barrier. Together with clinics and fertility specialists worldwide, we investigate human reproduction to change the lives of those who are trying to conceive.