A cohort study of the early pregnancy and endometrial microbiome
Research type
Research Study
Full title
A cohort study of the early pregnancy and endometrial microbiome.\n(ASPIRE)
IRAS ID
199573
Contact name
Phillip Bennett
Contact email
Sponsor organisation
Imperial College Joint Research Compliance Office
Duration of Study in the UK
5 years, 0 months, 2 days
Research summary
Miscarriage is an emotional and devastating outcome for any couple and he underlying mechanism is not clearly understood. Emerging evidence has shown that oral, gut and vaginal microbiome play an important role in shaping reproductive health throughout pregnancy. It has also been shown that the placenta harbours a unique microbiome whose composition is similar to that found in the mouth. The idea that pregnancy needs to be a sterile environment to succeed is have since been disputed. The ability to isolate such complex communities is now possible with advanced DNA sequencing techniques. However, to date there is no data investigating the placental microbiome in sporadic or recurrent miscarriage populations. Furthermore, half of all miscarriages are caused by chromosome anomalies, but testing every miscarriage for karyotyping is not cost effective. Metabolomics is the study of small-molecule metabolite profiles, which are the end products of cellular processes. A tissue’s metabolome can be studied by Nuclear Magnetic Resonance or Mass Spectroscopy. There is currently no data available about the effect of aneuploidy on the metabolome.\nWe will prospectively collect oral, vaginal and rectal swabs, as well as urine, blood and tissue samples in the following patient groups at Hammersmith Hospital and St Mary’s Hospital over a 3 year period.\nGroup1 \nPatient diagnosed with miscarriage in the early pregnancy unit. \nGroup 2 \nWomen undergoing surgical termination of pregnancy.\nGroup 3\nPatients in the Recurrent miscarriage clinic undergoing an endometrial biopsy.\nGroup 4\nPatients aged between 18-45 in general Gynaecology clinics undergoing a hysteroscopy and endometrial biopsy. \n\nWe aim to answer the following questions;\nWhat is the normal placental and decidual microbiome in the first trimester?\nIs miscarriage associated with an abnormal placental microbiome?\nDoes chromosomally abnormal placental tissue have a different metabolome from normal tissue? \nIs there a normal endometrial microbiome and do women with recurrent miscarriage have an abnormal microbiome?\n
REC name
Wales REC 3
REC reference
16/WA/0357
Date of REC Opinion
21 Dec 2016
REC opinion
Further Information Favourable Opinion