Uterine NK cells and recurrent miscarriage
Dr Siobhan Quenby, at Liverpool Women’s Hospital, is currently recruiting women to take part in research investigating the use of the steroid Prednisolone amongst women who have a history of unexplained miscarriages and a raised level of uterine NK (uNK) cells.
There will be several stages to the trial, including:
- An endometrial biopsy, to screen for high levels of uNK cells (ordinary blood tests aren’t accurate)
- If you have high uNK levels*, taking either Prednisolone or placebo (dummy) tablets daily for eight weeks when you become pregnant (you won’t know which tablets you are having). If you don’t have raised uNK levels, you won’t be eligible to continue in the trial. But you will have had the only reliable test for this possible cause of recurrent miscarriage.
- Regular follow-up (which can be at your nearest early pregnancy unit and by telephone if you don’t live near Liverpool)
The trial is open to women aged between 20 and 40*, who have had 3 or more consecutive miscarriages and who have had all the standard investigations without any problems being identified. (* The funding for the trial covers only women between 20 and 40. If you are over 40, you may be able to be referred by your GP and part-funded by the NHS, but there will still be some costs involved.)
If you are interested in taking part and would like more information, you can read the patient information sheet and/or you can contact Dr Quenby’s secretary directly on 0151 702 4271. You’re also welcome to talk to us at The M.A.
The PROMISE (PROgesterone in recurrent MIScarriage) trial
Dr Raj Rai and a team from St Mary’s Hospital in London and seven other university hospitals will soon be starting a three-year research study to investigate whether progesterone therapy in the first 12 weeks of pregnancy is beneficial to women with a history of unexplained recurrent miscarriage. The study will be:
Randomised
Women taking part will need to agree to be placed at random in either the treatment (progesterone) or nontreatment (placebo) group
Double-blind
The women in the study won’t be told whether they are in the treatment or non-treatment group – and nor will their doctors.
Placebo-controlled
The best way to compare the treatment and non-treatment groups is for them to have exactly the same conditions except the actual drug. This is done by giving the nontreatment group a placebo (dummy) pessary that looks and is used exactly like the real progesterone pessary, but has no active ingredients.
Multi-centre
To get good results, the team estimate that they need a sample of 790 women (395 who will have the progesterone, and 395 who’ll have the placebo). To reach that number and to have a wide range of women from all sorts of backgrounds, there are seven university hospitals taking part in the study, all with a particular interest and expertise in recurrent miscarriage:
- Imperial College/St Mary’s Hospital, London (Including Raj Rai and Prof Lesley Regan)
- King’s College/Guy’s & St Thomas’ NHS Trust, London
- University of Liverpool/Liverpool Women’s Hospital
- University of Birmingham/ Birmingham Women’s Hospital
- Academic Medical Centre, Amsterdam, Netherlands
- University of Sheffield/Royal Hallamshire Hospital
- University of Southampton/ Southampton General Hospital
- Ayrshire Maternity Unit
Teams will start recruiting patients in the autumn.