EndomeTRIO: A Comprehensive Evaluation of the Endometrium!


As promised, each Thursday, we will now offer you a piece of educational, science, or research related information.  The purpose of our #ThursdayThoughts post is to share with you fact-based content that can enlighten and assist you on your fertility journey.  Enjoy our post! Helping to Create New Beginnings….

EndomeTRIO: A Comprehensive Evaluation of the Endometrium!

The EndomeTRIO test is comprised of three different tests.

  1. ERA
  2. EMMA
  3. ALICE


The ERA test or Endometrial Receptivity Analysis is a test that evaluates the timing of an embryo transfer. An embryo has a window of time in which it is able to implant into the endometrium. It is important that an embryo transfer is done at the right time or there is a possibility that implantation will not occur. 

The results can come back as pre-receptive, receptive or post- receptive.  If the test comes back receptive the same protocol should be used for the embryo transfer. If the test comes back non-receptive (pre or post) the timing of the embryo transfer should be adjusted accordingly


The EMMA test or Endometrial Microbiome Metagenomic Analysis is a test that evaluates the endometrial flora or bacteria.  There can be both good and bad bacteria present in the endometrium.  This test will help provide a complete view of which bacteria is present and if any treatment should be done to balance the endometrial flora.


The ALICE test or Analysis of Infectious Chronic Endometritis is a test that is able to detect the bacteria that is responsible for causing chronic endometritis. Chronic endometritis is inflammation of the endometrium or endometrial lining that is caused by an infection inside the uterine cavity. 

How is the test done?

The EndomeTRIO is performed by a fertility clinic. The patient will undergo preparation for an embryo transfer with a protocol that their physician feels is best for them.  The test is performed by doing an endometrial biopsy at the time that the transfer would have been scheduled for. An endometrial biopsy is a sampling of the endometrial lining that is done through the cervix without any needles or incisions. The biopsy can cause moderate cramping that should subside within a few hours.

What are the indications?

The EndomeTRIO test can be offered to all fertility patients that will be doing an embryo transfer. It is particularly recommended for patients with previous failed implantations.

Why is this important?

The endometrial lining is an important factor in fertility. Having a good quality embryo is very important but we also must make sure we are putting that embryo into the best environment possible. This will give patients the best chance of a successful embryo transfer.

For more information regarding treatment options that are available, please schedule an appointment with one of our providers at the Fertility Institute of Hawaii 808-545-2800 or visit our website at https://www.ivfcenterhawaii.com.

References: https://www.igenomix.com/our-services/endometrio/

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