EMMA

by with No Comment Specialists

EMMA Endometrial Microbiome Metagenomic Analysis

The most comprehensive and precise panel, encompassing the most frequently detected and clinically relevant bacteria to evaluate the endometrium at the microbiological level

30% of infertile women
have pathogenic bacteria detected in their endometrium

Upgraded EMMA panel: the most precise panel available, developed after analysing over 70,000 clinical samples during the last 5 years

The upgraded EMMA panel now identifies bacteria at the species level, enabling more precise and targeted treatments

What is the EMMA test?

> EMMA is a test that analyses the endometrial microbiome to help identify abnormalities associated with a poor reproductive prognosis.

> EMMA assesses the endometrial microbiome, providing information about the most common and relevant bacteria, including those linked to higher pregnancy rates. EMMA also includes ALICE, which detects pathogenic bacteria that can cause chronic endometritis.

> Igenomix has analysed over 70,000 clinical samples during the last 5 years.

> Through our experience with the EMMA&ALICE tests, we have identified the bacterial pathogens most frequently detected in the endometrium.

> Based on this data, we have developed the most comprehensive and precise panel, encompassing all clinically relevant bacteria, with most identified at the species level, enabling a more precise and targeted treatments.

What is the procedure?

 

Why use EMMA test?

> EMMA uses the latest RT-PCR technology to provide endometrial microbiome information by analysing the presence and quantity of the most common and relevant bacterial pathogens of the reproductive tract.

> EMMA can determine the percentage of Lactobacillus present in the endometrium; low proportions of Lactobacillus are associated with poor reproductive outcomes

> EMMA also includes ALICE, which detects pathogenic bacteria that can cause chronic endometritis.

> EMMA determines whether the endometrial microbial environment is optimal or not for embryo implantation.

> If the endometrial microbial environment is not optimal for embryo implantation, a recommendation for a precise and targeted treatment is provided.

Who should use the EMMA?

> Patients with repeated implantation failure (RIF)

> Patients with repeated pregnancy loss (RPL)

Test limitations

> These tests are not able to detect resistance to antibiotics

> A negative result doesn’t rule out the presence of other endometrial pathogens

EndomeTRIO

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EndomeTRIO: The endometrium matters

A new dimension of endometrial health to improve the reproductive prognosis of your patients.

EMMA + ALICE + ERA

A better understanding of endometrial health to improve reproductive prognoses

30% of infertile women have pathogenic bacteria

What test does the EndomeTRIO analysis include?

Endometrial Receptivity Analysis

> The ERA test evaluates the stage of an endometrium to determine if a receptive or non-receptive genetic profile is present at the time of biopsy.

Endometrial Microbiome Metagenomic Analysis

> A screening test to evaluate the endometrium at the microbiological level.

Analysis of Infectious Chronic Endometritis

> ALICE detects the bacteria causing chronic endometritis to improve your patient’s reproductive prognosis.

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.

> Since 2011, 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 who have an atrophic endometrium (< 6mm) present higher risk of having a displaced WOI.

> Women with Chronic Endometritis

ERA Test limitations

> There is a risk (<5%) to get a non-informative result, in which the biopsy procedure has failed to obtain a sufficient quantity and/or quality of tissue to be able to make a diagnosis. If this should occur a new biopsy will be required.

> Pregnancy is not guaranteed, even with a receptive result. Poor embryo quality, genetic abnormalities, or previous pathologies can also reduce the likelihood of becoming pregnant.

> The ERA® does not test for any other endometrial pathology and does not asses or provide a prediction for the health of a subsequent pregnancy.

EMMA/ALICE Limitations

> These tests are not able to detect resistance to antibiotics.

> ALICE only detects the presence of pathogens associated with chronic endometritis.

> A negative result does not rule out the presence of other endometrial pathogens.

> The tests are not 100% accurate at determining the bacterial species.

ERA

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ERA® Endometrial Receptivity Analysis

Maximize the chances of pregnancy without losing valuable embryos

3 in every 10 women have their a displaced implantation window shifted

What is the ERA® (Endometrial Receptivity Analysis) test?

> ERA® test, developed and patented by Igenomix (PCT/ ES2009/000386), is a test designed to evaluate endometrial receptivity.

> ERA® is the first diagnostic test that determines each woman’s unique personalized embryo transfer timing, therefore synchronizing the embryo transfer with the individualized window of implantation.

What is the procedure?

1 – Learning from more than 200,000 women, the highest number of cases in the market

> With over 200.000 women worldwide having undergone the test, the ERA predictor algorithm is based on artificial intelligence, allowing for continual refinements, and learning from those women who have successfully had pregnacies following the ERA recommendation.

> ERA is the test with the most data published about clinically monitoring patients during pregnancy, enabling us to make a personalised embryo transfer recommendation with the highest accuracy.

2 – ERA is the endometrial receptivity test powered by most scientific background in the market

> 16 external publications supporting ERA and 6 internal with convincing clinical outcome.

> Since it was developed and patented in 2009, both the Igenomix research team and independent clinics have written numerous publications showing the results of carrying out a personalised embryo transfer using the ERA.

> The first endometrial receptivity test with UNE-EN ISO 15189 accreditation.

3 – The highest published clinical rates compared to any other test in the market

> In the recurrent implantation failure (RIF) population, patients who underwent a personalized embryo transfer (pET) guided by ERA had significantly increased clinical outcomes versus those patients who did not undergo a pET guided by ERA. (Jia et al., 2022).

> ERA is the endometrial receptivity test with the highest published clinical rates for patients with RIF. (Jia et al., 2022 vs Ohara et al., 2022)

> RIF patients who undergo a pET guided by ERA found to have similar outcomes to those achieved by good prognosis patients. (Liu et al., 2022).

4 – Clinical support all the way. The largest Scientific community by your side

> Igenomix maintains the strongest scientific team in the market, consisting of 15 global Scientific Advisors, dedicated endometrial specialists, and in-house clinicians to support you all the way.

5 – The originals and the first to approach endometrial health with a 360 view.

> More than 65.000 EndomeTRIO (ERA, EMMA, and ALICE) samples analyzed in 5 years. Combined over 26 publications supporting our endometrial tests.

> The endometrium is important: an imbalance in the endometrial flora caused by a low level of Lactobacillus and the presence of some pathogens is linked to worse reproductive results. (Moreno et al, AJOG 2016).

> The presence of pathogenic bacteria in the endometrium can cause chronic endometritis, a silent illness suffered by 30% of women with infertility problems.(Cicinelli et al, Reprod Sci 2014).

> By carrying out the EMMA and ALICE tests in addition to the ERA, we can discount or solve important causes of implantation failure and recurrent miscarriage based on just one sample of the endometrium.

Why use ERA® test?

> ERA maximizes your patient’s chances of pregnancy.

> This molecular diagnostic tool uses NGS to analyze the expression level of 248 genes related to the status of endometrial receptivity.

> ERA is backed by ERA is backed by 25 publications; 16 from Igenomix and 9 external publications.

> Proprietary algorithm based on machine learning that minimizes the need for second biopsy (90% of cases).

> Allows clinicians to identify transition phases with 12 hours shifts.

Who should use ERA® Endometrial Receptivity Analysis test?

> ERA® test is indicated for patients with recurrent implantation failure

 

When is the second endometrial biopsy needed?

90 % of cases don’t need a second biopsy. The second biopsy is only required under two circumstances:

> Patients with a “Pre-receptive” result needing 2 more days with progesterone.

> Patients with a “Post-receptive” result.

Test limitations