Optimizing Reproductive Outcomes:
Queendom®, the Science of Endometrial Wellness

 

The quality of the embryo is crucial in ensuring a successful embryo transfer, as it directly impacts implantation and pregnancy development. However, it’s important to recognize that the significance of a successful embryo transfer extends beyond just the embryo itself. The endometrium, the lining of the uterus, also holds immense importance in this intricate process.

Recent studies have brought to light that conducting embryo transfers outside the period of endometrial receptivity, called the window of implantation (WOI), may lead to a notable reduction in pregnancy success rates. Furthermore, an unhealthy endometrium containing pathogenic microorganisms and/or unbalanced levels of immunological cells has been linked to recurrent miscarriages and lower rates in pregnancy outcomes.

Our endometrial test Queendom® is the most complete endometrial evaluation service studying endometrial receptivity (ER Map®), endometrial microbiome (MicroBioMap®), and endometrial Immunology (Im Map®).

Queendom® Diagrama global del proceso Las tres pruebas pueden realizarse de forma independiente, a discreción del facultativo y según la edad y el historial clínico de la paciente, o agrupadas en packs, siendo esta última opción de interés para las pacientes que necesiten estudios más completos, con la ventaja de que todos pueden realizarse a partir de un solo acto médico, una biopsia que será fraccionada en dos, para su posterior procesamiento y análisis.
IGLS Genetic and immunology testing laboratory With a strong bet on innovation, research & development, IGLS top-tier scientists and multidisciplinary teams, pool the best of their expertise and know-how to deliver best-in-class, precise and reliable solutions for assisted reproduction centres, hospitals and healthcare institutions across the world.

What sets Queendom® apart from other tools studying the endometrium?

ER Map®:

Our service ER Map® employs transcriptomic analysis to accurately predict the state of endometrial receptivity. Through its utilization, we can reliably identify the optimal WOI and create a customized schedule for embryo transfer. The incorporation of ER Map® has shown promising results in studies, indicating a significant enhancement in pregnancy rates. These are the strengths of ER Map®:

 

Specificity

ER Map® is a highly optimized tool, specifically designed to target 40 genes that play crucial roles in endometrial receptivity. These genes are unique to the endometrium and have been extensively studied for their involvement in the process of endometrial proliferation, receptivity, and embryo implantation.

Precision

ER Map® uses high-throughput RT-qPCR, the most accurate and reliable technique currently available. This validated technique is considered the gold standard for gene expression analyses and determines the precise timing for embryo implantation.

Personalization

ER Map® approach to WOI identification guarantees a personalised determination of the best time for embryo transfer. While other tools determine the optimal implantation stage using a statistical estimation with an associated significant error, ER Map® takes into account the unique characteristics of each patient’s endometrium and confirms each patient receptivity period minimising diagnostic error.

Pregnancy rates

Studies have demonstrated that when ER Map® is used for personalized embryo transfer guidance, pregnancy rates significantly increase. Our data show 35% increment in implantation rates and a 50% reduction in pregnancy loss, guaranteeing the evolution of pregnancy in 80% of the cases.

 

MicroBioMap®:

Our service MicroBioMap® uses qPCR to check the status of the endometrial microbiome, verifying the quality of the endometrial environment. Through its utilization, we can reliably identify the appropriate treatment and maximize the conditions for a successful embryo implantation. The integration of MicroBioMap® has yielded encouraging findings in research, signifying a notable improvement in pregnancy rates in women diagnosed with MicroBioMap®. Here are the key advantages of utilizing MicroBioMap®:

 

Wide-Range

MicroBioMap® analyses at the molecular level the presence of a great number of pathogens, culturable and non-culturable, that are associated with endometrial pathologies, such as Chronic Endometritis (CE). MicroBioMap® detects up to 18 pathogenic microorganisms including bacteria, fungi, and protozoa. Moreover, this test identifies the presence of 4 species of lactobacilli that may be beneficial to the reproductive process.

Accuracy

MicroBioMap® uses RT- qPCR which is the most accurate and reliable technique for the identification of microorganisms. This accurate technique is highly sensitive and identifies small amounts of microbial genetic material, regardless of their culturable and nonculturable nature. Furthermore, another related advantage is that MicroBioMap enables the quantification of microorganisms present per cell in the human tissue.

Specific treatment / Personalization

By accurately detecting these pathogenic agents, MicroBioMap® contributes to the precision and effectiveness of treatment strategies aimed at eliminating the underlying causes of chronic endometritis. This approach aligns with the broader objective of enhancing patient care and well-being by ensuring a more individualized and comprehensive management of this condition.

Pregnancy rates

Recent investigations have unveiled a compelling link between the existence of these pathogens and the occurrence of recurrent miscarriages, affecting 32% of women afflicted by such microorganisms. The implementation of MicroBioMap® offers a promising avenue for detecting these pathogens, followed by targeted antibiotic treatment. This comprehensive approach holds the potential to yield a remarkable increase of 36% in pregnancy rates, underscoring the pivotal role of MicroBioMap® in enhancing the outcomes.

 

 

Im Map®:

Our innovative service ImMap® analyses the relative abundance of immunological cells within the endometrium. Through its utilization, we can reliably identify the optimal treatment to improve the success rates of pregnancy. These remarkable points underscore the effectiveness and potential of ImMap®:

 

Precision

ImMap® employs advanced flow cytometry to quantify the levels and activity of endometrial immune cells. This approach enables the precise measurement and differentiation of individual cells, such as NK cells, T lymphocytes, and B lymphocytes, providing accurate data and a comprehensive understanding of cell populations. Furthermore, ImMap® identifies unique cell subsets even in complex mixtures.

Specific treatment/ Personalization

The identification of deviations from normal levels of various immunological cell populations within the endometrium represents a crucial step towards tailoring optimal immunotherapy strategies for individual patients. By analysing these unique immunological profiles with ImMap®, targeted treatments can be developed, aligning with the emerging paradigm of personalized medicine.

Pregnancy

Several studies have demonstrated that endometrial immunology appeared to be dysregulated in 82% of recurrent implantation failure (RIF) patients. Moreover, an unbalanced composition of endometrial immunological cells has been associated with a diminished pregnancy rate of 61%. Therefore, a correct identification of the endometrial immunological cells using ImMap® and the consequent personalized treatment with immunotherapy may improve the understanding of RIF and subsequent live birth rates.

 

Conclusión:

Our comprehensive endometrial study Queendom encompasses three advanced services: the endometrial receptivity analysis ERMap®, the exploration of the endometrial microbiome through MicroBioMap®, and the study of the endometrial immunology with ImMap®. This wide suite of analyses establishes a new benchmark for thoroughness and innovation. A notable feature is that, from a simple biopsy, all three analyses can be seamlessly conducted, as they harmoniously complement each other. This unique attribute offers an unmatched level of convenience for patients, streamlining their experience and minimizing medical interventions. Considering the characteristics of each single test mentioned above, we believe that Queendom is a reliable and a powerful tool for ART professionals.

 

 

Referencias

 

Enciso M, Aizpurua J, Rodríguez-Estrada B, Jurado I, Ferrández-Rives M, Rodríguez E, Pérez-Larrea E, Climent AB, Marron K, Sarasa J. The precise determination of the window of implantation significantly improves ART outcomes. Sci Rep. 2021 Jun 28;11(1):13420. doi: 10.1038/s41598-021-92955-w. PMID: 34183760; PMCID: PMC8238935.

Enciso M, Carrascosa JP, Sarasa J, Martínez-Ortiz PA, Munné S, Horcajadas JA, Aizpurua J. Development of a new comprehensive and reliable endometrial receptivity map (ER Map/ER Grade) based on RT-qPCR gene expression analysis. Hum Reprod. 2018 Feb 1;33(2):220-228. doi: 10.1093/humrep/dex370. PMID: 29315421.

Lédée, N, Petitbarat, M, Chevrier, L, Vitoux, D, Vezmar, K, Rahmati, M, Dubanchet, S, Gahéry, H, Bensussan, A, Chaouat, G. The uterine immune profile may help women with repeated unexplained embryo implantation failure after in vitro fertilization. Am J Reprod Immunol 2016; 75: 388–401

L Medina Ruiz and others, P-365 The composition of the endometrial microbiota, as determined by MicroBioMap®, significantly affects clinical outcomes in assisted reproduction treatments, Human Reproduction, Volume 38, Issue Supplement_1, June 2023, dead093.723, https://doi.org/10.1093/humrep/dead093.723

Marron K, Harrity C. Endometrial lymphocyte concentrations in adverse reproductive outcome populations. J Assist Reprod Genet. 2019 May;36(5):837-846. doi: 10.1007/s10815-019-01427-8. Epub 2019 Mar 7. PMID: 30847699; PMCID: PMC6541687.

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The queen of endometrial testing