Endometrial microbiome

The endometrial microbiome is the collection of microorganisms found inside the uterus. These microorganisms, which are primarily lactobacilli, act as regulatory and protective factors within the endometrial environment. In a healthy and balanced intrauterine environment, the percentage of lactobacilli, the dominant microorganism, should exceed 90%.

Pathogenic Microorganisms and the Endometrial Microbiome

However, pathogenic microorganisms, such as chlamydia, enterococcus, and streptococcus, can colonize the endometrium. This condition, often asymptomatic, can lead to chronic endometritis, disrupt normal uterine function, and become a significant inhibiting factor in achieving pregnancy or successful embryo implantation. The endometrial microbiome plays a crucial role in fertility and reproductive health.

Endometrial Microbiome Testing

Testing for the endometrial microbiome is essential for women with a history of serious infections (such as chorioamnionitis), consecutive miscarriages, repeated embryo implantation failures, and unexplained infertility. Understanding the balance of microorganisms in the endometrial environment is critical for addressing these fertility issues.

Examination Procedure 

The examination for endometrial microbiome analysis is either performed during a hysteroscopy or during a routine visit to the doctor’s office. It is a safe and painless procedure. During the examination, a small sample of endometrial tissue is collected using a thin catheter, then placed in a preservative fluid, and sent to a specialized laboratory for analysis. The identification of microorganisms present in the endometrial cavity is conducted using the PCR method.

Results and Treatment

The test results are typically available within about 10 days. If pathogenic microorganisms are detected and the endometrial microbiome is disrupted, treatment includes the administration of oral antibiotics and probiotics containing various species of lactobacilli. This approach helps restore a healthy endometrial microbiome, which is essential for improving fertility outcomes, particularly in women undergoing fertility treatments like IVF.