Fertility Decoded

Endometrial microbiome test (EMMA/ALICE)

A biopsy analysing the womb's bacteria, claimed to guide antibiotic or probiotic treatment before transfer.

The verdict

Not shown to improve your chance of a baby.

Evidence positions on Endometrial microbiome test (EMMA/ALICE) from HFEA, ESHRE, NICE and ISAR
BodyPosition
HFEA
  • Red — may reduce effectivenessfor chance of a baby
ESHRENot recommended

Not recommended (same endometrial-receptivity-test family).

Source
NICEDo not offer (2026)

NG257 1.41.1 names it explicitly under 'do not offer endometrial receptivity testing... including microbiological analysis (endometrial microbiome metagenomic analysis, analysis of infectious chronic endometritis)'.

Source
ISARNo position

Not addressed in the 2021 ISAR add-ons consensus.

In India

~₹30,000–50,000 (often sold alongside ERA); approximate.

Sources

Take this further

Last reviewed .