The Tommy’s national miscarriage trial platform

With more than 90 hospitals already involved, Tommy’s are growing a network of researchers and doctors who can work together to carry out clinical trials that may lead to new treatments for miscarriage.
  • Authors list

    Professor Arri Coomarasamy, Dr Adam Devall, Dr Pedro Melo, Dr Jennifer Tamblyn, Professor Siobhan Quenby, Rajinder Kaur

    Start date: 2016
    End date: 2026

Why do we need this research?

Around 1 in 5 women will have a miscarriage in their lifetime. However, we still don’t have effective ways of predicting miscarriage or of preventing it from happening.

In order to test new treatments that could prevent miscarriage, researchers need to set up large clinical trials involving hundreds or maybe thousands of women and birthing people. This can be difficult for a single research centre to achieve. Collaboration between centres is essential if we are to set up trials that can answer the big questions about miscarriage.

What’s happening in this project?

To help researchers conduct large clinical trials of new treatments for miscarriage, we have established a national miscarriage trial platform that has brought together clinicians, midwives, pharmacists, academics and patient representatives from more than 90 hospitals across the UK. By connecting researchers from all over the country, the project has helped to make high-quality clinical trials possible. One such trial was MifeMiso, which helped to identify the best treatment for women who have had a missed miscarriage and whose baby has not passed out of the womb naturally. Another key trial was PRISM, which showed that treatment with progesterone should be recommended for women who have early pregnancy bleeding and a history of one or more previous miscarriages. This recommendation has been added to new NICE guidelines, meaning that our work is having a direct impact on clinical practice in the UK.

The Tommy’s national miscarriage trial platform is currently supporting a large number of ongoing trials. For example, SEE U and HYMMN are pilot trials that are finding out whether surgical removal of pregnancy tissue following miscarriage can be carried out more effectively by looking inside the womb during the procedure – either by ultrasound or by hysteroscopy, which involves a camera being inserted into the womb through the vagina. Another study – LOCI – is aiming to find out whether clomifene, the current standard of care, or letrozole, a drug with fewer side effects, is the best treatment for women with polycystic ovary syndrome (PCOS) who are struggling to get pregnant; these drugs will be given alongside either a placebo tablet or another drug called metformin. Other ongoing trials supported by the Tommy’s national miscarriage trial platform include the pAToMiUM, ALIFE-2, CERM and COSMisT studies.

As well as carrying out new studies, our researchers are using the national miscarriage trial platform to find out more about known risk factors for miscarriage and pregnancy outcomes. By looking at data from three large studies – PROMISE, TABLET and PRISM – our researchers want to see whether there is a relationship between the amount of early pregnancy bleeding and risk of miscarriage, premature birth or other pregnancy complications. The team also want to explore the link between ethnicity and the risk of miscarriage, premature birth, pre-eclampsia and having a baby that is smaller than expected.

What difference will this project make?

The Tommy’s national miscarriage trial platform is helping researchers to work together on high-quality clinical trials of new treatments for miscarriage. By doing this, we can influence international clinical practice and improve outcomes for women, birthing people and their families.

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.