Looking at the lining of the womb to find out about miscarriage risk

Scientists are looking at the lining of the womb to find out whether there are particular features that could make miscarriage more likely.
  • Authors list

    Professor Jan Brosens, Dr Joanne Muter, Dr Sascha Ott, Professor Siobhan Quenby, Dr Emma Lucas, Dr Pavle Vrljicak

    Start date: 2021
    End date: 2026

Why do we need this research?

There are two factors that have a big impact on how likely it is that a woman or birthing person will have a miscarriage. The first is age and the second is the number of previous pregnancy losses, with the risk of another miscarriage increasing after each loss.

Our researchers want to find out more about the causes of miscarriage. They know that the presence of defects in the lining of the womb when a baby is conceived can make miscarriage more likely, and now they want to understand exactly how this works. 

What’s happening in this project?

The team believe that defects in the lining of the womb before pregnancy can cause something called ‘implantation checkpoint failure’. When this happens, the womb lining is neither able to stop the implantation of an embryo that is not fit to develop properly, or to support the growth of high-quality embryos. Both of these scenarios lead to miscarriage.

To investigate this further, our researchers studied womb lining samples taken from women before they became pregnant to find out more about the cells and DNA that are present. They identified several markers that are indicative of an ‘abnormal’ implantation environment in the womb and showed that the chance of having a menstrual cycle with an abnormal implantation environment increases with each previous miscarriage.

Using their findings, the team developed a novel clinical test, called the digital endometrial function test – or dEFT – which can be used to assess the state of the womb lining before pregnancy. This test is now being trialled at the Implantation Clinic, a dedicated experimental research clinic at the University Hospitals Coventry and Warwickshire NHS Trust, where it is already helping families to understand more about why they have experienced miscarriage.

The team also found that sitagliptin – a diabetes drug that may help reduce the risk of miscarriage – improved the condition of womb lining samples in the lab. As a result, our researchers now want to carry out a larger clinical trial to assess the use of their clinical test alongside preconception sitagliptin treatment to prevent miscarriage. 

What difference will this project make?

The ultimate aim of this project is to introduce into clinical practice a test that can be used before pregnancy to predict the likelihood of a woman or birthing person having either a first miscarriage or a recurrent miscarriage. This test could potentially identify the women and birthing people most likely to benefit from new treatments that can improve the condition of the womb lining – treatments such as sitagliptin.

This research will also help us to understand more about the causes of miscarriage and could lead to the development of other new treatments that might help prevent it.

Thanks for your interest in our research

Tommy's funds research across the UK investigating the reasons for miscarriage, stillbirth and premature birth. We can keep you updated on ways you can support our work. If you would like to join our fight against baby loss and premature birth, click here.