Cause of recurrent miscarriages identified

A lack of stem cells in the womb lining may be responsible

By Lizzie Harrett

Hopes have been boosted of preventing multiple miscarriages, after recent research has identified that they can be caused by a depletion of stem cells in the womb lining.

Researchers based at University of Warwick examined womb lining tissue samples from 183 donors. The study, which was published in journal Stem Cells, found that those who had miscarried three consecutive pregnancies had a reduced number of womb lining stem cells compared to the control group.

They further found that a stem cell shortage causes cellular aging in the womb to accelerate. After every menstrual cycle, miscarriage and successful birth, the womb lining has to renew itself. This capacity to regenerate is dependent on a resident stem cell population, with a stem cell shortage in patients suffering from recurrent loss being associated with aging tissue. When tissue ages it causes an inflammatory response which can be detrimental for foetal development, and may result in miscarriage.

Between 15 and 25 per cent of pregnancies result in miscarriage, with most occurring before the 12-week gestation mark. Miscarriages frequently involve the foetus having multiple chromosome errors in their genetic code. However, women who have multiple, consecutive miscarriages are regarded as having a distinct disorder. It is estimated that one in 100 women who trying to conceive suffer these from these recurrent miscarriages.

The research leader Jay Bosens stated that the identification of this link between multiple miscarriage and stem cells may lead to a prevention strategy, saying: “We have discovered that the lining of the womb in the recurrent miscarriage patients we studied is already defective before pregnancy.

“I can envisage that we will be able to correct these defects before the patient tries to achieve another pregnancy. In fact, this may be the only way to really prevent miscarriages in these cases.”

Siobhan Quenby, a professor of obstetrics, spoke of the implementing these findings in a miscarriage prevention strategy, “Our focus will be two-fold. First, we wish to improve the screening of women at risk of recurrent miscarriage by developing new endometrial tests.

“Second, there are a number of drugs and other interventions, such as endometrial ‘scratch’, a procedure used to help embryos implant more successfully, that have the potential to increase the stem cell populations in the womb lining.”

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