BloomMap

16S rRNA profiling of endometrial bacteria, reporting Lactobacillus dominance and, where the data supports it, Lactobacillus species. In published studies, Lactobacillus-dominant profiles are associated with better implantation outcomes (Moreno 2016, n=35).

• Designed for low biomass: the endometrium carries little bacterial DNA, so we run negative controls alongside patient samples, subtract known reagent contaminants, and flag low-biomass samples rather than report them.
• Lactobacillus species, such as L. crispatus and L. iners, reported where the data supports it.
• Clinician-ordered and collected in clinic. Never a home test.

For women being investigated for suspected chronic endometritis, read alongside CD138 histology. It supports clinical judgement and does not replace histology. It is not offered as an add-on to embryo transfer, in line with NICE guideline NG257, recommendation 1.41.1.

Lactobacillus share of the bacterial community, reported against the 90% threshold used in the published literature, with Lactobacillus species, such as L. crispatus and L. iners, where the data supports it, the relative abundance of the other key genera detected, and a clear flag when a sample holds too little bacterial DNA to report.

Evidence: Growing evidence base

A Lactobacillus-dominant endometrium and the absence of chronic endometritis are increasingly linked to better implantation, with randomised outcome data still maturing.

Limitations

Most evidence comes from small, low-biomass sequencing cohorts, and randomised evidence that treating dysbiosis improves live birth is not yet available. A dysbiotic result describes a bacterial pattern; it is not a diagnosis of infection.

Endometrial microbiome and implantation: published evidence