The Fertility Home

Endometrial Health Assessments

Understanding Endometrial Health:
Key to Reproductive Success

Discover your endometrial health with our comprehensive ERA, EMMA, and ALICE tests.

Dive into the world of reproductive success and discover how a deeper understanding of your endometrial health can pave the way for a healthy and successful pregnancy.

ERA, EMMA, and ALICE Tests:
Your Guide to Endometrial Health

Our Endometrial Health Assessments are crafted to give you a clear understanding of your health, identified as a crucial element in reproductive success. 

The endometrium, the nurturing lining of your womb where an embryo implants and grows, plays a pivotal role in your journey towards pregnancy. 

By exploring your endometrial health, you are taking a significant step in understanding your overall reproductive health and the possibilities for a successful pregnancy.

The TFH Endometrial Quartet encompasses three essential fertility tests, utilising a single sample to examine various aspects of your endometrial health:


(Endometrial Receptivity Assay)

What is an ERA Test?

The ERA test involves analysing 248 genes within your endometrium to identify any abnormalities. The insights gained from this test can pinpoint the best timing for embryo transfer, enhancing your chances of a successful IVF treatment. Armed with your ERA test results, we can schedule your embryo transfer during your personalised window of implantation.


(Endometrial Microbiome Metagenomic Analysis)

What is an EMMA Test?

The EMMA test is a comprehensive screening to ensure your endometrial microbial environment is conducive to embryo implantation. It provides an in-depth look at your endometrial bacteria, highlighting the balance between healthy and potentially harmful bacteria. A flourishing endometrium rich in Lactobacilli correlates with better reproductive outcomes. The EMMA test is particularly beneficial for individuals experiencing recurrent pregnancy loss or implantation failure, offering a closer look at the microbiological landscape of the endometrium.


(Analysis of Infectious Chronic Endometritis)

What is an ALICE Test?

The ALICE test identifies pathogenic bacteria responsible for chronic endometritis, an often asymptomatic inflammation of the endometrium mainly due to bacterial infection. This condition can significantly affect reproductive outcomes, especially in cases of repeated implantation failure or recurrent pregnancy loss. The ALICE test provides a crucial assessment for anyone looking to conceive, focusing on the endometrial microbiological environment.

Risks of ERA, EMMA, and ALICE Tests

When undergoing the ERA test, it is important to know there are minimal risks involved, such as a slight risk of bleeding or infection and a small chance of uterine perforation. In rare cases, results might conclude with no diagnosis, potentially requiring a repeat biopsy. Additionally, there is a small risk that the biopsy will not collect enough high-quality tissue for analysis, leading to the possibility of another biopsy.

For the EMMA and ALICE tests, similar minor risks apply, including bleeding, infection, and rare instances of uterine perforation. Occasionally, results may be inconclusive, termed as a no diagnosis, which might necessitate considering a new biopsy due to factors like low bacterial DNA levels or sample issues.

These tests, while insightful, are not mandatory and are conducted based on your fertility consultant’s recommendation or personal choice, aiming to tailor your treatment plan effectively.

If needed, the ERA, EMMA, and ALICE tests can also be carried out individually

 to suit your specific needs.

Navigating “Add-Ons”

ERA testing, is considered as Add-On. 

The HFEA categorizes “Add-Ons” as optional treatments with varying levels of evidence regarding their effectiveness.

We commit to offering “Add-Ons” only when they are believed to be beneficial, based on our continuous efforts to develop and validate new treatments.

Embrace your journey with us today

Begin your fertility journey and explore Endometrial Health Assessments with us. 

Schedule a 60-minute online consultation to discuss your medical and fertility history and your treatment aspirations with one of our expert fertility consultants. 

They are ready to address your questions and guide you through your options for fertility investigation and Endometrial Health Assessments, tailoring the journey to your unique path to parenthood.