Analysis of Infectious Chronic Endometritis

 ALICE detects the bacteria causing chronic endometritis to improve your patient's reproductive outcome

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  • Chronic endometritis is a persistent inflammation of the endometrial lining caused by the infection of the uterine cavity, mainly by bacterial pathogens
  • 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%*

  • According to our scientific publication The diagnosis of chronic endometritis in infertile asymptomatic women: a comparative study of histology, microbial cultures, hysteroscopy, and molecular microbiology, ALICE method is similar in reliability to the three classic diagnostic methods

    Moreno et al. Am J Obstet Gynecol. 2018, DOI: 10.1016/j.ajog.2018.02.012.

More info

The diagnosis of chronic endometritis in infertile asymptomatic women a comparative study of histology, microbial cultures, hysteroscopy, and molecular microbiology_Página_01.png

ALICE can be performed on a small piece of endometrial biopsy.

If the patient is undergoing an ERA test, a small portion of the same biopsy can be used, so no additional sample will be required.


  • ALICE is a diagnostic test to detect and quantify abundance of the most common pathogenic bacteria causing chronic endometritis, recommending appropriate antibiotic and probiotic treatment
  • ALICE uses Next Generation Sequencing (NGS), allowing the identification of culturable and nonculturable endometrial pathogens associated with chronic endometritis
  • If ALICE tests positive, the report will provide information about the specific bacteria causing CE
  • A list of recommended antibiotics and probiotics will be provided depending on ALICE results
  • Microbiology counseling will be available
  • Histology is the current gold-standard method for the assessment of CE.
  • Only microbial culture can provide information about the causative infectious agents.
  • It has been demonstrated that between 20 and 60% of bacteria cannot be cultured or are not assessed in the clinical setting. Among them, Gardnerella vaginalis, one of the most common pathogens of the reproductive tract, is not culturable under the standard microbiological methods. The molecular assessment of the microbiome using NGS allows to detect culturable and non-culturable bacteria.
  • Una serie de muestras analizadas mediante histología, histeroscopia y cultivo microbiano obtuvieron una concordancia del 20% en los resultados obtenidos. El análisis mediante NGS obtuvo coincidencia para el 78% de las muestras analizadas.


ALICE can be beneficial for any patient wishing to conceive, by assessing the microbiological environment that the embryo will encounter at implantation.

ALICE may also be beneficial for patients with a history of recurrent pregnancy loss or recurrent implantation failure because chronic endometritis has been linked to these events.



ALICE uses the latest Next Generation Sequencing technology to provide microbiome information in endometrial tissue by analyzing the abundance of specific bacteria causing chronic endometritis.




  • Human Microbiome Project Consortium. Structure, function and diversity of the healthy human microbiome. Nature 2012; 486:207–14.
  • Moreno I, Codoñer FM, Vilella F, Valbuena D, Martinez-Blanch JF, Jimenez-Almazan J, Alonso R, Alama P, Remohi J, Pellicer A, Ramon D, Simon C. Evidence that the endometrial microbiota has an effect on implantation success or failure. Am J Obstet Gynecol. 2016; 215:684-703.
  • Moreno I, Cicinelli E, Garcia-Grau I, Gonzalez M, Bau D, Vilella F, De Ziegler D, Resta L, Valbuena D, Simon C. The diagnosis of chronic endometritis in infertile asymptomatic women: a comparative study of histology, microbial cultures, hysteroscopy, and molecular microbiology. Am J Obstet Gynecol. 2018, DOI: 10.1016/j.ajog.2018.02.012.
ALICE Specialist Brochure

ALICE Specialist Brochure





ALICE Infographic

Endometrial receptivity array: Clinical application.

Mahajan N.
J Hum Reprod Sci.2015 Jul-Sep;8(3):121-9. doi: 10.4103/0974-1208.165153. PMID: 26538853 [PubMed] PMCID: PMC4601169. [Epub ahead of print]

Human Endometrial Transcriptomics: Implications for Embryonic Implantation.

Gómez E, Ruíz-Alonso M, Miravet J, Simón C.
Cold Spring Harb Perspect Med. 2015 Mar 27. pii: a022996. doi: 10.1101/cshperspect.a022996. [Epub ahead of print]

The genomics of the human endometrium.

Ruiz-Alonso M, Blesa D, Simón C.
Biochim Biophys Acta. 2012 Dec;1822(12):1931-42.

Profiling the gene signature of endometrial receptivity: clinical results.

Garrido-Gómez T, Ruiz-Alonso M, Blesa D, Diaz-Gimeno P, Vilella F, Simón C.
Fertil Steril. 2013 Mar 15;99(4):1078-85.

Impact of final oocyte maturation using gonadotropin-releasing hormone agonist triggering and different luteal support protocols on endometrial gene expression.

Bermejo A, Cerrillo M, Ruiz-Alonso M, Blesa D, Simón C, Pellicer A, Garcia-Velasco JA.
Fertil Steril. 2014 Jan;101(1):138-146.e3.

The impact of using the combined oral contraceptive pill for cycle scheduling on gene expression related to endometrial receptivity.

Bermejo A, Iglesias C, Ruiz-Alonso M, Blesa D, Simón C, Pellicer A, García-Velasco J.
Hum Reprod. 2014 Jun;29(6):1271-8. doi: 10.1093/humrep/deu065. Epub 2014 Apr 4.

Clinical management of endometrial receptivity.

Blesa D, Ruiz-Alonso M, Simón C.
Semin Reprod Med. 2014 Sep;32(5):410-3. doi: 10.1055/s-0034-1376360. Epub 2014 Jun 24.

Transcriptomics of the human endometrium.

Díaz-Gimeno P, Ruíz-Alonso M, Blesa D, Simón C.
Int J Dev Biol. 2014;58(2-4):127-37. doi: 10.1387/ijdb.130340pd.

Timing the window of implantation by nucleolar channel system prevalence matches the accuracy of the endometrial receptivity analysis.

Nejat EJ, Ruiz-Alonso M, Simón C, Meier UT.
Fertil Steril. 2014 Sep 17. pii: S0015-0282(14)02025-1. doi: 10.1016/j.fertnstert.2014.07.1254.

Deciphering the proteomic signature of human endometrial receptivity

Hum Reprod. 2014 Sep;29(9):1957-67. doi: 10.1093/humrep/deu171. Epub 2014 Aug 8

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    of infertility is caused by     

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