Around twenty percent of pregnancies end in miscarriage, and 1 in 100 women trying to conceive have three or more consecutive miscarriages. Most miscarriages happen in the first three months of pregnancy but they can happen up to the twenty fourth week (beyond that pregnancy loss is known as a stillbirth).
The possibility of prevention of multiple miscarriages has been increased as researchers at the University of Warwick have, for the first time, identified a cause. It turns out that in the lining of the womb of women who suffer from recurrent miscarriages there are a lack of stem cells and there is an increase in cellular senescence (cellular aging).
The discovery was made making use of sequencing methods that can identify both sequence as well as the methylation pattern of the DNA. This allows scientists to understand which genes are being expressed (turned on) or repressed (turned off). This technology has only recently been available to researchers due to its decline in cost.
This understanding of why recurrent miscarriages occur is key in the development of possible treatments. For example by increasing the recruitment of stem cells to the womb, as occurs during the monthly cycle of females, could improve its condition.
Two trials are being launched by the research team that are being funded by the baby charity Tommy’s which is opening a national miscarriage centre. The first of these trials involves scratching the lining of the womb to see if this prevents miscarriage by accelerating the process of stem cell recruitment. This method has increased the outcome of certain IVF patients. The second of the trials involves the use of a type two diabetes drug (a DPP4 inhibitor) which has a side effect of increasing stem cell recruitment.
These strategies are to be piloted in the spring of 2016.