Emma and Alice Tests

The Emma and Alice tests are two new practices that allow uterine mapping for a healthy pregnancy, thus significantly increasing pregnancy success. These two tests, which we have started to perform at the same time with the world’s most prominent centres, will shed hope for our patients, especially those experiencing recurrent miscarriages and failed IVF attempts.

The Emma and Alice tests provide an extremely detailed examination of the uterine tissue, and they are performed first and exclusively at Bahçeci clinics in Turkey.

For a successful IVF treatment, a healthy embryo as well as a healthy uterine environment are essential. Until recently, the uterine environment was thought to be completely sterile. But studies have shown the presence of some useful and some harmful germs inside the uterus.

The useful germs, called lactobacilli, help the pregnancy to continue in a healthy way. The EMMA test can detect these and other useful germs and provide the most accurate time for embryo transfer. If the microbial diversity of the internal structure of the uterus prior to embryo transfer is not appropriate for pregnancy, an additional treatment is planned to prepare the uterine environment.

The ALICE test allows us to determine the percentage of harmful germs in the uterus. Approximately 25% of patients experiencing recurrent miscarriages and recurrent failed IVF attempts suffer from chronic endometritis. The Alice test determines the presence and density of harmful germs that lead to chronic endometritis; this way, the endometritis can be treated with the appropriate treatment. With the improvement of the uterine environment, the chance of pregnancy also increases.

Tests are performed on an endometrial biopsy sampled between the 15th and the 25th days of the period prior to the IVF treatment, or in a cycle prepared as hormone replacement therapy on day P + 5 (day 5 of the

progesterone treatment). Within the DNA molecules obtained from the biopsy sample, a detailed analysis of the microbiota present in the uterus is performed as of the day of the biopsy. The findings are compared with the microbial distribution of healthy uterine environment. If, according to this microbial distribution, the uterine environment is found to be risky, an appropriate antibiotic/probiotic treatment is planned under the control of the specialist until healthy intrauterine microbiota is restored.

• The Alice test provides information about the presence or the absence within the uterus of bacteria that cause chronic endometritis (uterine inflammation).
• It provides information about genital pathogens that develop in relation with sexually transmitted diseases.
• In case pathogens are found, the Alice test gives an idea about the antibiotic treatment to be used. The relevant treatment should be performed by a specialist and planned individually.
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• The Emma test provides information about the percentage of lactobacilli.
• It provides information about the percentages of the 10 most common bacteria present in the endometrial sample.
• It provides information about whether the endometrial microbiota is normal or not.
• It gives an idea about the antibiotic treatment to be used. The relevant antibiotic/probiotic treatment should be planned individually.

The EMMA and ALICE tests can also be performed combined with the ERA test (EndomeTRIO); and thus the most comprehensive molecular and genetic mapping of the uterine environment can be done before embryo transfer.

These two tests, which are revolutionary in the field of IVF, are carried out exclusively at Bahçeci clinics in Turkey. For more information about the Emma and Alice tests, fill in our contact form.