The endometrium is the layer of mucous tissue of the uterus, the place where the baby develops if fertilization occurs. The most common problems that arise in the endometrium are a displaced implantation window and endometriosis. Here, we discuss conceiving with endometriosis and other issues with the uterus lining.
Displaced Implantation WindowDuring each menstrual cycle, sex hormones are responsible for preparing the endometrium for the possible arrival of an embryo. After fertilization, the embryo goes through cellular divisions until the 6th day, where implantation takes place. The implantation window (or period of receptivity) is the period of time in which the endometrium presents a suitable environment for the embryo to implant. It takes place between days 19 and 21 of the menstrual cycle, 5-7 days after ovulation. In some women, the window is displaced. For these women, if an embryo is transferred at the typical time for assisted reproduction treatment, the chance of implantation is significantly reduced.
EndometriosisEndometriosis is the presence of endometrial-like tissue outside the uterine cavity. It can appear in the fallopian tubes, the intestines, or the bladder, but it most often appears in the ovary. In some women, this produces painful menstruation with pain occurring in the abdomen, pelvis, lower back, and is sometimes is accompanied by so-called “chocolate” cysts that contain clotted menstrual blood. Often, conceiving with endometriosis can be challenging. Furthermore, some women do not present symptoms, but are diagnosed when they come to the clinic for assistance getting pregnant.
Chronic EndometritisEndometritis is the inflammation of the endometrium, the mucous layer lining the uterus. It can be caused by an infection of chlamydia or gonorrhea, or by a combination of normally existing vaginal bacteria. A few years ago, the belief was the endometrium was a sterile cavity, free of microorganisms. But recent discoveries show that not only is it colonized by microorganisms, but some are vital for its proper functioning. A group of researchers from Igenomix revealed that women with endometrial flora colonized by Lactobacillus (a benign bacteria that predominates in our digestive, urinary, and genital systems), have a rate of higher implantation and lower miscarriage. Hence, it is important to maintain endometrial flora balance.
Conceiving With Endometritis: Igenomix TestsAt Igenomix we have tests focused on solving endometrial problems to help you achieve pregnancy:
- ERA (Endometrial Receptivity Analysis). Allows identification of each woman’s implantation window, and the carrying out of a personalized embryo transfer (pET). This has shown an increase in reproductive success in treatments using assisted reproductive techniques. This analysis is indicated for women with recurrent implantation failure.
Available in the U.S. end of 2019
- ALICE (AnaLysis of Infectious Chronic Endometritis). A diagnostic test that detects eight bacteria responsible for chronic endometritis. If the test is positive, the recommendation is the administration of antibiotics or probiotics. This test and protocol are indicated for women who have had more than one miscarriage or recurrent implantation failures. With this analysis, women can improve their chances of conceiving with endometriosis.
- EMMA (Endometrial Microbiome Metagenomic Analysis). This determines the percentage of bacteria required in the endometrium to improve the reproductive prognosis of women. It includes the ALICE test so that it also detects the presence of pathogenic bacteria. It indicates if the microbial environment of the uterus is adequate (or not) for embryo implantation. This test is indicated for any woman who wants to become pregnant, but especially for those who have had recurrent implantation failures.