Womens Health Mission
Our Missions
Women's Health
Women spend a significantly greater proportion of their lives in ill health compared to men despite statistically living longer. Access to health care for girls and women, and the scale of funded research programmes tackling their health needs falls woefully short. Not enough is known about conditions that only affect women such as miscarriage and menopause, and because of an under-representation of women in clinical trials we also have gaps in knowledge about how conditions affecting both men and women impact them differently. This is exacerbated by inequalities in access and quality of reproductive health care. The publication of the government’s Women’s Health strategy in 2022 sets out a roadmap to make substantial and measurable improvements over the next decade.
We are working to transform the health of women across the life course with our multi-disciplinary research community. Our mission is to drive change through new diagnostics and interventions, whilst generating evidence and shaping policy, informed at every step by the voices of the women and girls at the heart of the endeavour. We are committed to improving outcomes, reducing inequalities, delivering equal access for all girls and women to high quality healthcare, and ensuring representation of all women across all health research.
To make breakthroughs we seek to accelerate challenge-focused programmes.
Challenges
The Coventry & Warwickshire region is home to leading researchers and health care professionals who are in a strong and unique position to make significant progress across multiple women’s health challenges. Warwick Medical School leads the Centre for Early Life, which includes over 15 principal investigators who form a hub of multidisciplinary expertise, pioneering research that will lead to more successful pregnancies, better health for parents and children, and new treatments and tests. Our clinical academics with University Hospital Coventry & Warwickshire connects our research with patients through the Biomedical Research Unit in Reproductive Health, and Centre for Reproductive Medicine, which underpins our role in the Tommy’s National Centre for Miscarriage Research.
To address the challenge of improving the health of women, centralised accessible care, better diagnosis and new treatments are key.
The medical school is also home to clinical academics in Primary Care and Public Heath enabling improvements in access and quality of reproductive healthcare, tackling inequalities and supporting self-management. We are shaping national policy as part of the NIHR Policy Research Unit in Reproductive Biology, and the NIHR Applied Health Collaboration West Midlands.
Mission Leads
Dr Beck Taylor joined WMS in early 2023 as an Associate Clinical Professor. Beck is an academic public health doctor and her research focuses on maternity and women’s health.
Dr Erin Greaves is an Associate Professor and expert in pathophysiology of endometriosis and endometriosis-associated pain.
Challenges
Eliminate Pain from Endometriosis
Endometriosis is the growth of tissue like the uterine lining (endometrium) outside the uterus, usually within the pelvic cavity as ‘endometriosis lesions’. The result is chronic pain, infertility and diminished quality of life - 190 million women world wide are affected.
Endometriosis is currently diagnosed by invasive surgery and is treated by surgical removal of lesions or with drugs that suppress sex hormones. Sadly, in many women symptoms recur after surgery and available medical treatments have undesirable side-effects and are contraceptive. New non-invasive diagnostic approaches and treatments for endometriosis are desperately needed
Erin recently shared her research on a Podcast with Warwick PhD student Eleanor Harrison who runs the Youterus podcast, Listen to the interview here on her latest endometriosis research.
Breakthroughs:
- We have used a disease model of endometriosis to provide vital insight into the pathophysiology of the disorder, with a specific focus on role of the immune system. We now know enough about particular immune cells to begin to target them therapeutically, with our first phase 1 clinical trial funded and poised to begin recruiting patients.
- We are also performing research into how peripheral blood immune cells can be exploited for diagnostic purposes. Our vision is to provide new, non-hormonal medical therapies for endometriosis and revolutionise non-invasive diagnosis of the disorder, collectively enhancing the lives of millions of women worldwide.
- We are developing behaviour change interventions in the management of long-term pain including those with endometriosis. Together these breakthroughs will improve the quality of life of women with endometriosis.
Challenge Lead
Dr. Erin Greaves
Challenges
Preventing Pregnancy Loss and Pre-term Birth
Miscarriage and infertility are devastating conditions for many women and their partners. Both conditions are often caused by failure of an embryo to implant successfully in the womb lining. The precise causes of miscarriage and implantation failure remain incompletely understood. Aside from physical trauma, each miscarriage compounds the risk of significant psychological morbidity.
Breakthroughs:
- Our teams have developed and continue to develop novel research tests and treatments to increase the likelihood of a successful pregnancy. They offer support, advice and specialised tests that investigate the womb lining (endometrium) in women affected by miscarriage or IVF implantation problems. The aim is to pinpoint defects in the womb lining and underpinning research has lead to the development of the digital endometrial function test - (d)EFT.
- In collaboration with colleagues in mathematics we have also pioneered the Miscarriage Support Tool. Data from women who miscarry has been used to generate an algorithm that predicts the chance of having a baby after 1 or several miscarriages and gives personalised information, support and advice based on a women’s experiences as well as tests and interventions that she should explore in preparation for trying again to conceive.
Challenges
Improving Care and Tackling Inequalities in Women's Reproductive Health
In England, women’s reproductive health services and funding are really fragmented, with care funded by different organisations and provided in different places including GP practices, hospital gynaecology services and sexual health clinics. For example, women might have to go to one place for a smear test, another for contraception and another for menopause support. Care often isn’t joined up, women can find it difficult to access, and there are inequalities in care for women who need it the most.
It is rare for mothers and babies to die in the UK, and rates have reduced over time. Recently this has changed: we are falling behind other similar countries, and our maternal death rates have increased, while infant death rates have flatlined. There are also stark inequalities between different groups. For example, compared to white women some groups are more likely to die during or shortly after pregnancy (three times more for black women, two times more for asian women or women living in deprived areas). Families in these groups also experience worse health and care in many other areas, such as premature birth and stillbirth. Careful planning is needed to improve care, reach women who have the greatest need and link effectively with other services.
Breakthroughs:
We have led a rapid national evaluation of Women’s Health Hubs identifying and exploring early models launched before the Women’s Health Strategy, which continues to inform policy and practice. We are leading research to look at how women’s reproductive health services are being commissioned across health systems in England in response to the Women’s Health Strategy. This will explore the different approaches local leaders are taking, how they are working, and how inequalities in women’s health and care are being addressed. We are also working to evaluate inequalities in preconception maternity and postnatal care while optimising the care of women following birth trauma and pregnancy loss.
Read more about the latest study into women's health hub's led by Dr. Beck Taylor here
Challenges
Improving Fertility Outcomes in IVF
Improve Assisted Reproduction
According to WHO estimates, one in six people experience infertility in their lifetime. The main strategy for fertility treatment is assisted reproduction, such as in vitro fertilisation (IVF). In this process, oocytes are collected from the ovaries and then mixed with sperm to form embryos. These are cultured outside the body and transferred to the patient around day 5 of development. Just in 2021, 55,000 patients had treatment in fertility centres in the UK, and the numbers are growing every year. While very successful in general, the IVF livebirth rate per embryo transfer is around 30%. Every cycle of treatment comes with a great financial and emotional cost for the couples: the NHS funding is limited, and the procedure is a physical and emotional burden, especially if it ends up with failure. Improving the outcomes of assisted reproduction procedures is key to improve patients’ experience, which can be approached by addressing the most common causes for treatment failure.
The abnormal number of chromosomes in a cell, known as aneuploidy, is a leading cause of IVF failure, as well as infertility, pregnancy loss or developmental syndromes such as Down’s (three copies of chromosome 21). Aneuploidy most often arises from the oocyte (the egg cell), and the risk of abnormal chromosome numbers increases as the women age. This is because oocytes are formed early in development and their chromosomes have to be maintained until the decision to start a family. With the average age of women at first birth increasing, this increases the need for assisted reproduction for older patients. Errors can also occur in an early embryo, causing a fraction of cells to have a different chromosome number from others. Such embryos are known as mosaics. The implications of mosaic aneuploidy for embryo development are yet to be fully understood.
Breakthroughs:
- We have recently discovered that early human embryos are prone to errors that could lead to mosaic aneuploidy that has implications for embryo development - read about it here. This is particularly important for in vitro fertilisation (IVF) process, and we have identified a potential small molecule intervention to reduce embryo aneuploidy.
- By studying the process of egg maturation and fertilisation we are revealing crucial age-related changes. Understanding this is key to address infertility in older female patients, especially since the mean age of first-time IVF patients has recently increase to just over 35 years of age, as reported by Human Fertilisation and Embryology Authority (HFEA). This has led to development of an “egg quality test”, that we hope will help to diagnose patients struggling with infertility due to poor egg quality.
- Warwick mathematicians are also striving to improve existing procedures and tools for IVF, such as oocyte collection needles used for surgical collection of oocytes from the ovaries.
Challenge Leads
Aleksandra Byrska
Dr. Geraldine Hartshorne
