Defining the impact of endometriosis on immune-vascular remodelling in pregnancy

Supervisors: Dr Douglas Gibson (1st) and Dr Meaghan Griffiths (2nd)

Lay abstract

Endometriosis is a chronic, hormone-dependent inflammatory condition that affects 190 million women worldwide. In patients with endometriosis, tissue similar to the lining of the womb (endometrium) grows outside of the uterus and this associated with symptoms of pelvic pain and infertility. Recent studies also suggest that women with endometriosis are more likely to have a complicated pregnancy and there is a link between endometriosis and poor pregnancy outcomes for both the mother and baby.

This project aims to understand how endometriosis can lead to poor pregnancy outcomes by studying how blood vessels in the womb adapt in pregnancy to supply the growing baby - a key feature of a healthy pregnancy. We have previously discovered that this process can be controlled by hormones called androgens which act to promote healthy blood vessels in early pregnancy. Importantly, our new research suggests that these hormones are unbalanced in endometriosis which may mean that adaptation of blood vessels in the womb for pregnancy is disrupted. This project aims to understand if unbalanced androgens might be an underlying cause of poor pregnancy outcomes in women with endometriosis.

In order to better understand how androgens might be unbalanced in endometriosis, clinical samples from patients will be profiled to measure androgen production in cells from the womb lining and the impact of altered androgens on production of factors needed for blood vessel development will be measured. This will be combined with pre-clinical models of endometriosis and early pregnancy to assess how endometriosis can affect adaptation of blood vessels in the womb in pregnancy. Together, these studies will determine how androgens regulate adaptation for pregnancy in endometriosis with the ultimate aim of finding new treatments to improve pregnancy health in endometriosis patients.