Womb lining test offers miscarriage hope to women
UK scientists say they have developed a test which can help identify women with an abnormal womb lining that increases their risk of miscarriage.They say their work could pave the way for new treatments for those going through repeated pregnancy loss. In some women with a history of miscarriage, the womb lining doesn't react the way it should - transforming into a supportive place for the embryo to implant, the Warwick University team discovered.Charities say the findings could help provide an explanation, in some cases, for the trauma and devastation of recurrent miscarriage.
Around one in six of all pregnancies are lost, most before twelve weeks, and each miscarriage increases the risk of another one happening. To date, most research in this area has focused on the quality of the embryo, with much less known about the role of the womb lining. Dr Jo Muter, study author and researcher at Warwick Medical School, said: "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 job of the womb lining is to receive the embryo and help it develop during pregnancy, thanks to a reaction which converts cells into a different, supportive state. But when that reaction is messed up and doesn't fully happen, the risk of bleeding and early pregnancy rises.Once a woman has had one faulty reaction, she is more likely to have another, the researchers say. They've developed a new test which can measure signs of a healthy or defective reaction in the womb lining, which is being piloted to help more than 1,000 patients at Tommy's National Centre for Miscarriage Research at University Hospital Coventry & Warwickshire (UHCW).
'A tiny miracle'
Charlie Beattie, 37, had countless early miscarriages over the course of four years, to the point where "a positive pregnancy test wasn't exciting any more", she says.She and her husband Sam, from Leamington Spa, felt devastated and resigned to considering other options for having a family.Then they found out about at a trial taking place at the miscarriage research centre.Charlie had a sample of her womb taken, and the new test showed it was not "hospitable for babies", she says.After taking the drug sitagliptin for three months, she had a pregnancy which finally stuck - and nine-week-old June is the joyful result."She's a tiny miracle. It doesn't feel real," says Charlie.She admits being anxious all the way through her pregnancy until June was safely in her arms.Even the pregnancy scans were a new experience."We'd never seen anything on a scan before that moved," she says. "When they said 'I can see it, it's in the right place', we both burst into tears."
Anyone can refer themselves to the clinic, but it has a long waiting list and funding issues mean patients must contribute to the cost of the test. Dr Jyotsna Vohra, director of research at Tommy's, said care and treatment for those who experience pregnancy or baby loss varied unacceptably across the UK. "There should be no barriers to accessing any test or treatment that has been proven to make a difference. "We hope NHS decision-makers will look carefully at the results of the Coventry pilot project and consider rolling this test out nationwide, so that everyone who might benefit has that opportunity."Dr Muter says the next step is to use the test to assess potential drug treatments. Sitagliptin, usually used to treat diabetes, is the go-to option for womb lining issues but there may be other existing drugs which can be repurposed, she added.With 80% of drugs not tested on pregnant women, it's unclear which ones might be effective.
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'When faced with a setback, think about what you can learn from it, and how adversity makes you stronger. Also, it's important to address the self-esteem challenges of ADHD with support scaffolds – spiritual, social, family and therapeutic,' he adds. Poor diet leading to blood sugar crashes Many ADHD-ers reach for sugar, caffeine and energy drinks as well as processed foods to give them a short-term hit. This can lead to issues like overeating or skipping meals, which is why they have higher rates of obesity and binge-eating disorder. 'Reaching for sugar hits can be addictive, and get you into a vicious cycle. If your blood sugar levels are spiking, that will heighten issues with attention, focus and restlessness. A lot of people with ADHD, and I do this myself, are often so focused on something or using all their brain capacity just to get through the day that they forget to eat, which also leads to a crash,' says Dr Coiffat. 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'There can be a struggle to get in for 9am because of their sleep rhythms, then there is the sensory overload of a journey on public transport in rush hour. The monotony of a desk job that involves little interaction can exacerbate physical and mental restlessness,' says Dr Kustow. However, many with ADHD are also on the autistic spectrum. 'I have a patient who loves archiving, because it's just bringing order into things, but that would be extremely boring for someone who doesn't have that combination,' he adds. Social media and excessive screen use are often a problem as ADHD-ers crave stimulation and the dopamine hits of excessive scrolling, but this can also exacerbate problems with concentration. What to do: In the workplace, it's important to limit screen time and schedule regular screen and meal breaks, as well as time to move around and get outside. 'Jobs that involve creativity, project work, variety and problem solving can be more suitable', says Dr Kustow. But take time to understand your individual needs. Toxins and environmental stressors This is an emerging area, but people with ADHD may be more likely to have allergies, autoimmunity and inflammation, says Dr Kustow. 'Some have more sensitive immune systems, with hypermobility, allergies or chronic illness.' He highlights mould. 'If you're in a mouldy home and struggling with brain function, they may be connected. Some evidence is anecdotal, but toxins may trigger inflammation in sensitive individuals,' he adds. What to do: If you are someone with ADHD who suffers from allergies and has poor immunity, it might be worth trying to reduce toxins in the areas that you have control over. You can gradually buy less toxic versions of cleaning products, both for your body and home, makeup, and natural, pesticide-free foods. Hormonal shifts like perimenopause and menopause Hormonal shifts can make ADHD worse, and also 'unmask' previously undiagnosed ADHD. Perimenopausal women are now one of the largest groups seeking diagnosis. 'During perimenopause, oestrogen levels become dysregulated and start going down, which also reduces dopamine. A woman with ADHD in their 40s may notice that their ADHD might worsen, and they might need higher doses of medication or HRT. Then there are the people who never got a diagnosis because they just about managed, but then suddenly it gets worse because of hormonal shifts and their ADHD is unmasked,' says Dr Kustow. What to do: Adjusting ADHD medication can be helpful, as can HRT. Some doctors might prescribe an antidepressant. Does ADHD get worse with age? ADHD is a neurodevelopmental condition, so it doesn't fundamentally change with age, although the way it manifests can evolve as a response to life events and physical changes. Children are more likely to be hyperactive than adults, and adults may have more issues with time management and organisation. 'In a minority, it can improve and resolve, but most will be stable but find that symptoms may get aggravated at different points in life, as demands change over time, including increasing life responsibilities, hormonal shifts, accumulated stress and physical decline. The demands of retirement are quite different from sitting at a desk doing complex calculations, for example, and symptoms may respond accordingly,' explains Dr Kustow. Dr James Kustow is the author of How to Thrive with Adult ADHD: 7 Pillars for Focus, Productivity and Balance. How to Thrive with Adult ADHD by Dr James Kustow is out now. All artwork by Nicholas Stevenson.
