UK researchers have identified a link between womb lining issues and recurrent miscarriage, leading to a new test that may help detect risks before pregnancy.
Researchers in the UK have identified a malfunction in the womb lining as a significant contributor to recurrent miscarriages—even when embryos are healthy. The new study entitled “Stalling of the Endometrial Decidual Reaction Determines the Recurrence Risk of Miscarriage,” was published June 25 in the journal Science Advances. The scientists’ findings have led to the development of a new diagnostic tool aimed at identifying women at risk before pregnancy begins.
The study, led by scientists at the University of Warwick, sheds light on a poorly understood biological process called the “decidual reaction,” which prepares the endometrium—the inner lining of the uterus—for embryo implantation.
“This is about identifying preventable miscarriages,” said lead author Joanne Muter, PhD of Warwick Medical School in a press release. “Many women are told they’ve just had ‘bad luck’, but our findings show that the womb itself may be setting the stage for pregnancy loss, even before conception takes place.”
The team analyzed 1,555 biopsies from 1,308 women who sought care at the Implantation Research Clinic at University Hospitals Coventry and Warwickshire (UHCW) NHS Trust. These patients had experienced one or more miscarriages or ongoing fertility issues.
In many of these women, the researchers observed that the decidual reaction did not activate or progress as it should. This disruption results in an unstable uterine environment that still allows embryos to implant but increases the likelihood of early pregnancy loss.
Senior author Jan Brosens, PhD, Professor of Obstetrics & Gynaecology at Warwick and UHCW NHS Trust and Scientific Director of the Tommy’s National Miscarriage Research Centre noted in the press release, “It is well-established that chromosomal errors in embryos account for the rise in miscarriage rates in women older than 35 years. This study shows that each miscarriage increases the risk of an embryo implantation in an abnormal womb, regardless of age.”
“… we now have the tools to screen for the risk of preventable miscarriage and to evaluate treatments that improve the womb lining before pregnancy,” said Senior Author Professor Jan Brosens. (Photo credit: University of Warwick)
“The endometrium’s role is to receive the embryo and support the development of the placenta throughout pregnancy,” the researchers explained in the release. “The decidual reaction transforms the womb lining into a supportive tissue for the embryo to implant.
When it doesn’t fully activate or becomes dysregulated, it creates an unstable environment that, while still allowing embryos to implant, increases the risk of bleeding and early pregnancy loss.”
New Test Measures Womb Readiness and Immune Cell Activity
To detect these abnormalities, the research team developed the Digital Endometrium Function Test—abbreviated as (d)EFT—which is currently undergoing a large-scale pilot trial at UHCW. According to the university, more than 1,000 patients have already received the test as part of their clinical care.
The (d)EFT test requires a small biopsy of the womb lining, according to the Warwick Medical School website. In addition, patients provide a blood sample—used to measure progesterone level—and undergo a transvaginal ultrasound scan. They must also use an ovulation test or wearable device to determine their peak fertility day.
The test evaluates three key markers:
Endometrial readiness: Digital PCR technology measures biomarkers that indicate whether the endometrium can support embryo implantation.
Timing of implantation window: PCR results combined with mathematical modeling determine when the womb lining is most receptive.
uNK cell levels: Digital image analysis measures uterine natural killer cells, which, in abnormal numbers, are linked to IVF failure or increased miscarriage risk.
“High uNK cells are linked to implantation and IVF failure, whereas low levels of uNK cells may increase the risk of miscarriage,” according to the Warwick Medical School website.
The research, funded by UK pregnancy charity Tommy’s, has the potential to shift how clinicians assess and treat miscarriage risk. Current diagnostics often focus on embryo quality, hormone levels, or genetic issues—overlooking the role of the uterine environment.
By offering a more targeted, womb-centered approach, the researchers hope their work will lead to effective new treatments for the estimated 15% of pregnancies that end in miscarriage.
Genetic test that analyzes DNA to identify men at greatest risk for developing the disease could become common clinical laboratory screen for cancer
Researchers in the UK believe a common spit test can be more accurate at determining which men are more likely to develop prostate cancer than the clinical laboratory prostate-specific antigen (PSA) blood test currently used by the National Health Service (NHS) for that diagnosis.
During a recent study, scientists at the Institute of Cancer Research, London (ICR), found that germline DNA extracted from saliva, which was then used to derive polygenic risk scores for cancer, resulted in a higher percentage of participants “found to have clinically significant disease” than the percentage that would have been identified with the use of PSA or MRI.
The salvia test works by analyzing men’s DNA to find out if they are genetically pre-disposed to developing the disease. Men who find out they are likely to develop prostate cancer can then pursue further testing and scans.
“The test assesses 130 genetic variants to provide a risk score for prostate cancer, which is the second most common cause of cancer deaths in men in the UK,” The Guardian reported.
The study found that 187 of the men in the study had prostate cancer. According to the American Cancer Society, one in eight men will be diagnosed with prostate cancer in their lifetime.
“We can identify men at risk of aggressive cancers who need further tests and spare the men who are at lower risk from unnecessary treatments,” said study leader Rosalind Eeles, PhD, of the ICR London, in The Guardian.
“With this test, it could be possible to turn the tide on prostate cancer,” Rosalind Eeles, PhD, of the Institute of Cancer Research, London, told the BBC. (Photo copyright: Prostate Cancer UK.)
Landmark Discovery
Michael Inouye, PhD, professor of systems genomics and population health at the University of Cambridge, told the BBC that researchers will look back on this study “as a landmark.” He also acknowledged that it would be a long road before widespread implementation of the test.
While some sources call the ICR’s test promising, they also acknowledge it may only have a modest effect and that there may be possible racial disparities in the findings. The study was primarily based on people with European ancestry. According to Prostate Cancer UK, black men in the UK have double the risk of developing the disease. A similar trend can be observed in the US, Statistica reported.
Dusko Ilic, PhD, professor in stem cell sciences at King’s College London, told the BBC that there was “no direct evidence” of these findings having an effect on survival or quality of life. He stressed the need for more studies to better assess the value of the test.
The salvia test is expected to be included in Prostate Cancer UK’s TRANSFORM trial, a $58 million research program partly funded by the NHS to determine the best way to screen for cancer in the UK.
Effect on Clinical Pathologists
Prostate cancer is expected to surge in the US over the next 15 years, according to UC Davis Health. Thus, pathologists should expect more men to seek ways to assess their risk. Pathologists would be wise to educate themselves fully on new and emerging tests and tools to best meet the needs of their patients.
Given the publicity generated by former President Biden’s announcement that he has an advanced case of prostate cancer, clinical laboratories should also expect more patients to request diagnostic tests that either screen for or confirm the presence of the disease.
Experts believe compressive sensing could find wide application in medical laboratory and pathology testing, particularly where large amounts of data are generated
Pathologists and medical laboratory managers may soon be working with a new tool in their labs. It is called “Compressive Sensing” (CS) and it is an innovative mathematical approach that quickly and efficiently gets an answer by sampling large volumes of a data.
Currently compressive sensing is used in medical imaging technology. CS reduces radiation and speeds up imaging diagnostics. Some experts familiar with this technology believe that it can be used in those clinical laboratories that are working with new diagnostic technologies that generate large volumes of data. CS could dramatically reduce times to analyze results and lower the cost of expensive tests like whole-genome sequencing. (more…)
Exogen uses crowdfunding to both collect needed specimens and raise capital to pursue FDA clearance for its proposed medical laboratory test that would identify an individual’s damaged DNA
It might be coming soon to a pharmacy or other retail store near you: a medical laboratory test kit allows consumers to test themselves for damaged DNA. This bold new world for genetic testing is the vision of a new company in San Francisco called Exogen Biotechnology.
This startup business was co-founded by Sylvain Costes, Ph.D., a nuclear engineer who serves as Exogen’s Chief Executive Officer, and Jonathan Tang, Ph.D., a bioengineer. Their team is developing a blood test that will enable consumers to monitor their own DNA damage and take actions to reverse the damage. (more…)
Mayo Clinic is collaborating with San Francisco-based Whole Biome, Inc., to conduct these clinical trials. Whole Biome developed the diagnostic tests to be used in the clinical study. (more…)
