Using organoids to understand recurrent missed miscarriage
Professor Jan Brosens, Professor Phillip Bennett, Dr Tom Rawlings, Dr Emma Lucas, Dr David MacIntyre
Start date: 2021
End date: 2024
Why do we need this research?
A missed miscarriage happens when a baby has died in the womb but there haven’t been any symptoms, such as bleeding or pain. For some women and birthing people, this devastating loss can happen time and time again. At our Implantation Clinic – a dedicated experimental research clinic at the University Hospitals Coventry and Warwickshire NHS Trust – around 15% of miscarriage patients have experienced 3 or more missed miscarriages, which is often referred to as recurrent missed miscarriage.
Our researchers want to find out more about the causes of missed miscarriage. One way of doing this is to use an organoid – a 3D miniature organ that has been grown artificially in a lab from human stem cells. Scientists have recently managed to grow endometrial gland organoids – or EGOs – by taking stem cells from the lining of the womb. As endometrial glands provide the nutrients that the baby needs to grow and thrive throughout the first trimester, these EGOs can be used to find out more about what happens in the earliest stages of pregnancy.
What’s happening in this project?
In this project, our researchers have been growing EGOs from two groups of women – those who have had recurrent missed miscarriage and those who have never had a miscarriage. The team found that endometrial glands from the recurrent missed miscarriage patients were impaired, even before pregnancy, meaning that they were less able to provide nutrients to the growing baby. This could be the reason that recurrent missed miscarriage is often preceded by slow growth of the baby. The team are now working to identify specific markers that can be used to identify women and birthing people who are at risk of recurrent missed miscarriage, so that they can develop a novel clinical test to be used before pregnancy.
What difference will this project make?
This project will help us understand more about the causes of recurrent missed miscarriage and could lead to the development of a simple test that can be used before pregnancy to work out which women and birthing people are most at risk.