EMMA (Endometrial Microbiome Metagenomic Analysis) and ALICE (Analysis of Infectious Chronic Endometritis) are tests are performed on endometrial biopsy samples to analyze the endometrial microbiome. Endometrial biopsies are typically collected during the luteal phase using a sterile technique, which is then analyzed by DNA sequencing to detect the bacterial species present.
EMMA provides a comprehensive profile of the bacterial composition in the endometrium, indicating whether it is dominated by beneficial Lactobacillus species (a sign of a healthy environment) or by other bacteria. Dysbiosis, where patients have endometrial microbiomes that are lacking beneficial Lactobacillus species, could be corrected by supplementing vaginal Lactobacillus probiotics.
ALICE specifically detects pathogenic bacteria associated with chronic endometritis, which could be corrected using antibiotics.