Endometrial Health

Endometrial Health Testing

Successful embryo implantation depends not only on the quality of the embryo but also on the health and receptivity of the endometrium—the lining of the uterus. For some individuals experiencing recurrent implantation failure or unexplained infertility, additional testing of the endometrium can provide insight into potential inflammatory or microbial factors that may interfere with implantation.

At Strong Fertility Center, we offer specialized endometrial testing to help personalize care and improve the chances of a successful pregnancy.

ReceptivaDx® (BCL6 ± CD138 Testing)

ReceptivaDx is a molecular test that evaluates the uterine lining for inflammatory markers suggestive of endometriosis, even in the absence of pelvic symptoms. The test measures:

• BCL6: An overexpressed protein often associated with inflammation and undiagnosed endometriosis, which may impair endometrial receptivity.
• CD138 (optional add-on): A marker used to identify chronic endometritis, a persistent low-grade inflammation of the endometrium.

These markers are assessed via endometrial biopsy, typically performed in the luteal phase of the menstrual cycle (around 7–10 days after ovulation or progesterone exposure). If abnormalities are detected, treatments such as anti-inflammatory medication or surgical evaluation for endometriosis may be recommended.

Learn more at ReceptivaDx.com

EMMA & ALICE (Endometrial Microbiome Tests)

The EMMA (Endometrial Microbiome Metagenomic Analysis) and ALICE (Analysis of Infectious Chronic Endometritis) tests analyze the endometrial microbiome using advanced molecular diagnostics. They are often performed together from the same endometrial biopsy sample.

• EMMA evaluates the balance of bacterial communities in the uterus, particularly looking for Lactobacillus species, which are linked to better implantation outcomes.
• ALICE screens for specific pathogenic bacteria associated with chronic endometritis, an inflammatory condition that can disrupt implantation.

If imbalances or infections are identified, your provider may recommend targeted antibiotic therapy, probiotics, or adjustments to the timing of your embryo transfer.

Learn more at Igenomix.com: EMMA & ALICE

Is Endometrial Testing Right for Me?

Endometrial testing may be appropriate for individuals who:

• Have experienced recurrent implantation failure
• Are preparing for frozen embryo transfer (FET)
• Have unexplained infertility despite high-quality embryos
• Have signs or history suggestive of endometriosis or inflammation
• Want to explore a more personalized approach to embryo transfer timing

Your fertility provider will review your medical history and treatment plan to help determine whether these tests are appropriate for you.