Yes, that’s right your endometrium has its own microbiome! And it may have an influence on implantation. 


First off? What is a microbiome? A microbiome is a collection of bugs, particularly bacteria in this case, that are essential for function. We need them, they need us. However, we need them at optimal levels for things to function optimally. 


The gut microbiome is where most of the literature is focused – with good reason. About 99% of our microbiome is situated in our gut lining and thought to influence the microbiome in other regions. More and more literature is coming out exploring microbiomes in other areas, such as skin, lungs, vagina, and even the uterine microbiome.


This new systematic review came out in 2020 exploring the role of the uterine microbiome and embryo implantation. Defined as chronic endometritis, “CE”, is a persistent inflammatory condition of the endometrial lining, and its pathogenesis is largely thought to be due to an imbalance of the endometrial microbiome. Several studies have found CE to be cured with antibiotic cycles, further supporting the role of the microbiome in its etiology.


CE cannot be identified by ultrasound and is often overlooked. The current gold standard for diagnosing is through an endometrial biopsy. 


How does the endometrial microbiome impact fertility? 

This review outlines the potential interaction between CE and fertility. 

“Several studies have found that CE is highly prevalent among women suffering from unexplained infertility (from 40.7 to 55.7%), recurrent IVF failures (from 13.95 to 57.55%), and repeated early pregnancy loss (from 42.9 to 56%). Importantly, adequate therapy of CE can lead to a complete normalization of endometrial histology and to the restoration of the reproductive function in women with CE.”


How can we help?


One of the major takeaways from this systematic review was that the predominant types of bugs found in CE were coming from the intestinal flora – Enterococcus faecalis, Escherichia coli and Streptococcus.  Additionally, lipopolysaccharide, an endotoxin for gram-negative bacteria and known indicator for leaky gut, may be a trigger and mediator of chronic endometritis.

Several studies have found this to be a curable condition with the rebalance of the microbiome.

I believe our gut health and microbiome is a foundational piece of health, healing, and prevention. I’ve seen pretty incredible shifts in clinical pictures with microbiome assessment and treatment.


Let’s use the gut microbiome as an example. At Acubalance, we do comprehensive stool and microbiome analysis. This gives us a great overview of:

  1. Bad bugs – cause problems like diarrhea, inflammation, heartburn etc.
  2. Normal bugs – interact with our immune system, keep things balance, produce essential factors of a healthy gut lining
  3. Opportunistic bugs – bugs that are part of our normal microbiome, but when overgrown may be problematic in some cases. Certain opportunistic bugs have also been correlated with autoimmune conditions, small intestinal bacterial overgrowth, urinary tract infections, and more.
  4. Intestinal health – how many digestive enzymes are you producing? How reactive is your immune system? How is your estrobolome? Any blood in your stool?


This test allows us to rebalance the microbiome, reduce digestive inflammation and heal the gut lining, and get to the root of the issue.


If you’ve tested your endometrial microbiome, we can support you with specific probiotic strains to help rebalance both vaginal and intestinal ecosystems.


Other interesting findings from this paper were the role of inflammation and blood flow at the level of the endometrium. These are two aspects that laser, acupuncture, and target nutrition and supplement are excellent at supporting. For more info on our laser baby program – check here.


In Health

Dr. Ashley Damm
Naturopathic Doctor – Vancouver, BC

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