diff --git a/app/api/job/handler/sync-analysis-groups.ts b/app/api/job/handler/sync-analysis-groups.ts
index c9bd2e0..59703fc 100644
--- a/app/api/job/handler/sync-analysis-groups.ts
+++ b/app/api/job/handler/sync-analysis-groups.ts
@@ -3,9 +3,9 @@ import { XMLParser } from 'fast-xml-parser';
 import fs from 'fs';
 import { createAnalysisGroup, getAnalysisGroups } from '~/lib/services/analysis-group.service';
 import { IMedipostPublicMessageDataParsed } from '~/lib/services/medipost/medipost.types';
-import { createAnalysis, createNoDataReceivedEntry, createNoNewDataReceivedEntry, createSyncFailEntry, createSyncSuccessEntry } from '~/lib/services/analyses.service';
+import { createAnalysis, createNoDataReceivedEntry, createNoNewDataReceivedEntry, createSyncFailEntry, createSyncSuccessEntry, getAnalyses } from '~/lib/services/analyses.service';
 import { getLastCheckedDate } from '~/lib/services/sync-entries.service';
-import { createAnalysisElement } from '~/lib/services/analysis-element.service';
+import { AnalysisElement, createAnalysisElement, getAnalysisElements } from '~/lib/services/analysis-element.service';
 import { createCodes } from '~/lib/services/codes.service';
 import { getLatestPublicMessageListItem } from '~/lib/services/medipost/medipostPublicMessage.service';
 import type { ICode } from '~/lib/types/code';
@@ -82,42 +82,60 @@ export default async function syncAnalysisGroups() {
     const codes: ICode[] = [];
     for (const analysisGroup of analysisGroups) {
       const existingAnalysisGroup = existingAnalysisGroups?.find(({ original_id }) => original_id === analysisGroup.UuringuGruppId);
+      let groupExistingAnalysisElements: AnalysisElement[] = [];
+      let analysisGroupId: number;
       if (existingAnalysisGroup) {
-        console.info(`Analysis group '${analysisGroup.UuringuGruppNimi}' already exists`);
-        continue;
+        console.info(`Analysis group '${analysisGroup.UuringuGruppNimi}' already exists, only creating new analysis elements`);
+        groupExistingAnalysisElements = await getAnalysisElements({ analysisGroupId: existingAnalysisGroup.id });
+        analysisGroupId = existingAnalysisGroup.id;
+      } else {
+        analysisGroupId = await createAnalysisGroup({
+          id: analysisGroup.UuringuGruppId,
+          name: analysisGroup.UuringuGruppNimi,
+          order: analysisGroup.UuringuGruppJarjekord,
+        });
+
+        const analysisGroupCodes = toArray(analysisGroup.Kood);
+        codes.push(
+          ...analysisGroupCodes.map((kood) => ({
+            hk_code: kood.HkKood,
+            hk_code_multiplier: kood.HkKoodiKordaja,
+            coefficient: kood.Koefitsient,
+            price: kood.Hind,
+            analysis_group_id: analysisGroupId,
+            analysis_element_id: null,
+            analysis_id: null,
+          })),
+        );
       }
 
-      // SAVE ANALYSIS GROUP
-      const analysisGroupId = await createAnalysisGroup({
-        id: analysisGroup.UuringuGruppId,
-        name: analysisGroup.UuringuGruppNimi,
-        order: analysisGroup.UuringuGruppJarjekord,
-      });
-
-      const analysisGroupCodes = toArray(analysisGroup.Kood);
-      codes.push(
-        ...analysisGroupCodes.map((kood) => ({
-          hk_code: kood.HkKood,
-          hk_code_multiplier: kood.HkKoodiKordaja,
-          coefficient: kood.Koefitsient,
-          price: kood.Hind,
-          analysis_group_id: analysisGroupId,
-          analysis_element_id: null,
-          analysis_id: null,
-        })),
-      );
-
       const analysisGroupItems = toArray(analysisGroup.Uuring);
 
       for (const item of analysisGroupItems) {
-        const analysisElement = item.UuringuElement;
+        const analysisElement = item.UuringuElement!;
+        const isExistingAnalysisElement = groupExistingAnalysisElements
+          .find(({ analysis_id_original }) => analysis_id_original === analysisElement.UuringId);
+        if (isExistingAnalysisElement) {
+          console.info(`Analysis element '${analysisElement.UuringNimi}' already exists`);
+          continue;
+        }
 
         const insertedAnalysisElementId = await createAnalysisElement({
-          analysisElement,
+          analysisElement: analysisElement!,
           analysisGroupId,
           materialGroups: toArray(item.MaterjalideGrupp),
         });
 
+        if (Array.isArray(analysisElement.UuringuElement)) {
+          for (const nestedAnalysisElement of analysisElement.UuringuElement) {
+            await createAnalysisElement({
+              analysisElement: nestedAnalysisElement,
+              analysisGroupId,
+              materialGroups: toArray(item.MaterjalideGrupp),
+            });
+          }
+        }
+
         if (analysisElement.Kood) {
           const analysisElementCodes = toArray(analysisElement.Kood);
           codes.push(
@@ -135,7 +153,15 @@ export default async function syncAnalysisGroups() {
 
         const analyses = analysisElement.UuringuElement;
         if (analyses?.length) {
+          const existingAnalyses = await getAnalyses({ originalIds: analyses.map(({ UuringId }) => UuringId) });
+
           for (const analysis of analyses) {
+            const isExistingAnalysis = existingAnalyses.find(({ analysis_id_original }) => analysis_id_original === analysis.UuringId);
+            if (isExistingAnalysis) {
+              console.info(`Analysis '${analysis.UuringNimi}' already exists`);
+              continue;
+            }
+
             const insertedAnalysisId = await createAnalysis(analysis, analysisGroupId);
 
             if (analysis.Kood) {