Endometrial Testing in IVF: Promise, Precision, and Ongoing Debate
Advanced endometrial tests such as ERA, EMMA, and ALICE aim to personalise embryo transfer by assessing receptivity timing, the uterine microbiome, and chronic endometrial infection. These tools are designed to identify potentially modifiable factors in patients with recurrent implantation failure or repeated unsuccessful IVF cycles. While some studies suggest benefit in selected patients, particularly those with repeated failures, overall evidence remains mixed and continues to be debated. These tests should therefore be used thoughtfully, alongside clinical judgement, rather than as routine investigations for all IVF patients.
