• Dr. H. Singh, ND

Important Fertility Testing for Patients with multiple failed IVFs and Recurrent Miscarriages



On average I see that there are about 150 new research papers published per week, in a year averaging over 7000 research papers published in a year relating to fertility and reproductive health. It is our focus and commitment to filter through these studies and continue to learn, update our protocols and implement changes to provide up-to-date fertility care for our patients and provide them with the best possible chance of success. A huge area of research over the last years has been focused on the microbiome, particularly the reproductive microbiome, and how it affects IVF success rates and recurrent miscarriage rates.


Some of the newer studies have found that having an unhealthy reproductive Microbiome may increase the risk of miscarriage by up to 10x compared to patients with a healthy reproductive Microbiome. More concerning is that up to 50% of patients may have some level of dysbiosis (imbalance) in the uterine microbial flora. So how do we adjust our approach to addressing recurrent miscarriages or recurrent implantation failure for patients planning another fertility treatment or transfer.


A newer test that many patients are recently learning about with their fertility clinics is an EMMA analysis from a uterine biopsy. The EMMA analysis is usually offered as an additional add-on to the ERA testing done with the uterine biopsy typically. It will screen for the microbial composition of the uterus and determine if it reflects a healthy (lactobacillus dominant) or unhealthy (non-lactobacillus dominant). This allows for us to address how to potentially treat patients and support their Microbiome. This is usually treated, if in dysbiosis with an antimicrobial to help eliminate the harmful microbes and and oral or vaginal suppository probiotic. It is important to mention that not all strains of typical lactobacillus spp. are beneficial for reproductive functions. Lactobacillus reuteri and Lactobacillus rhamnosus have some research on them supporting the uterine microbiome. It is important to work with a licensed healthcare provider, including your physician and Naturopathic Doctor to help determine the correct course of treatment specifically for you and your case.


This article is in no way a replacement for medical advice or medical care, it is advised that anyone concerned about their Health should speak with their Naturopathic Doctor. Please discuss with your healtcare provider and only make changes to your medications regimen if recommended by your doctor and under their guidance.




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