MiFert Microbiome

The Endometrial Microbiome: A New Frontier in Fertility

For decades, the uterine cavity was considered sterile. Revolutionary research over the past 10 years has proven this assumption wrong: The endometrium has its own unique microbiome that profoundly influences reproductive outcomes.

Key Discoveries:

• Endometrial microbiome composition directly impacts implantation success
• Lactobacillus dominance (>90%) correlates with optimal implantation rates
• Dysbiosis (pathogenic bacteria presence or low Lactobacillus) reduces implantation by up to 50%
• Chronic endometritis (often asymptomatic) affects 14-30% of infertile women
• Microbiome can be optimized through targeted interventions (antibiotics, probiotics)

What is MiFert Microbiome?

MiFert Microbiome uses Next-Generation Sequencing (NGS) technology to comprehensively analyze the bacterial composition of the endometrium, providing:

• Lactobacillus Percentage: Quantification of beneficial bacteria dominance
• Pathogen Detection: Identification of harmful bacteria associated with implantation failure
• Dysbiosis Classification: Categorization of microbiome health status
• Treatment Recommendations: Specific antibiotic/probiotic protocols to optimize microbial balance

Clinical Applications

Primary Indications:

Recurrent Implantation Failure (RIF)

• Unexplained failure despite good embryo quality
• Dysbiosis found in 15-20% of RIF patients

Recurrent Infections

• History of bacterial vaginosis
• Recurrent urinary tract infections
• Previous pelvic inflammatory disease

Chronic Endometritis

• Diagnosed or suspected chronic inflammation
• Often asymptomatic; only detectable through biopsy

Previous Antibiotic Treatments

• History of broad-spectrum antibiotic use
• May have disrupted healthy microbiome

Recurrent Pregnancy Loss

• Dysbiosis may contribute to early pregnancy loss

Suboptimal Endometrial Development

• Thin endometrium despite hormonal support
• May be related to chronic inflammation from dysbiosis

MiFert Microbiome Analysis

• Technology: 16S rRNA Gene Sequencing
• Next-Generation Sequencing (NGS) of bacterial DNA
• Identifies all bacterial species present in endometrial sample
• Quantifies relative abundance of each species
• Database comparison for pathogen identification

What the Test Measures:

• Lactobacillus Percentage: Precise quantification (e.g., "85% Lactobacillus")
• Lactobacillus Species: Identification of specific strains present
• Pathogenic Bacteria: Detection and quantification of harmful species
• Microbial Diversity: Assessment of overall bacterial balance
• Dysbiosis Score: Overall endometrial microbiome health classification

Microbiome Classification & Interpretation

Optimal Microbiome:

• >90% Lactobacillus dominance
• No significant pathogenic bacteria
• Recommendation: Proceed with embryo transfer as planned

Mild Dysbiosis:

• 70-90% Lactobacillus
• Low levels of non-pathogenic bacteria
• Recommendation: Consider vaginal probiotic supplementation; re-test optional

Moderate Dysbiosis:

• <70% Lactobacillus
• Presence of potential pathogens at low-moderate levels
• Recommendation: Targeted antibiotic therapy; probiotic restoration; re-test before transfer

Severe Dysbiosis:

• <50% Lactobacillus or complete absence
• High levels of pathogenic bacteria
• Possible chronic endometritis
• Recommendation: Aggressive antibiotic treatment; probiotic therapy; mandatory re-test before transfer

Sample Collection

Same Biopsy as MiFert Receptivity:

• Single endometrial biopsy divided into Blue Tube (Receptivity + Microbiome)
• Performed during mock cycle
• 16S RNA extracted for bacterial analysis

Critical Collection Notes:

• Avoid contamination from vaginal/cervical flora during biopsy
• Use sterile technique
• Direct endometrial sample collection (not cervical swab)
• Turnaround Time: 13-15 days