Most of the programs within the NICHD lead and support an extensive portfolio of research on women's health throughout the life cycle, from menstruation and gynecological issues and disorders to pregnancy and menopause.
Gynecological Issues and Disorders
The NICHD conducts and supports research on issues affecting women's overall gynecological health. Areas of research include menstrual irregularities, menopause, disorders such as vulvodynia and uterine fibroids, the organs and pathways of the female reproductive system, and disorders linked to the X chromosome. The following NICHD organizational units conduct or support research in this area of women's health:
- The intramural Division of Intramural Population Health Research (DIPHR) conducts research on a wide variety of topics, including the menstrual cycle, effects of fetal alcohol exposure, and gestational diabetes.
- Current research in the Fertility and Infertility (FI) Branch focuses on infertility, contraceptives, and issues affecting reproduction. Researchers are currently studying pelvic floor prolapse and incontinence, conducting clinical trials on medications for polycystic ovary syndrome, and leading etiologic studies on vulvodynia.
- The Division of Intramural Research (DIR) works to optimize the health of women through research that enhances knowledge about the biology of development and reproduction. The Unit on Integrative Reproductive Medicine, for example, is studying Fragile X–associated primary ovarian insufficiency (FXPOI). The unit recently made the discovery that women with primary ovarian insufficiency (POI) still have immature eggs in their ovaries, which could improve fertility potential.
- The Contraception Research Branch supports the Pelvic Floor Disorders Network, which conducts the Childbirth and Pelvic Symptoms (CAPS) study on women with anal sphincter tears and postpartum fecal incontinence. Other investigations include a study on stress urinary incontinence (ATLAS) and research to estimate the mean age of menopause.
- The National Center for Medical Rehabilitation Research (NCMRR) advances studies on women with disabilities. Its Spinal Cord and Musculoskeletal Disorders and Assistive Devices (SMAD) Program is studying women with spinal cord injuries who experience recurrent urinary tract infections.
Fertility, Infertility, and Contraception
NICHD research on issues in this area includes diseases related to infertility, such as polycystic ovary syndrome (PCOS), premature ovarian failure (POF), and endometriosis; and sexually transmitted diseases and infections. The following NICHD organizational units conduct or support research in this area of women's health:
- Current DIPHR research includes the role of the X chromosome in POI, the BioCycle Study for PCOS, the ENDO study on endometriosis, and LIFE, which studies the long-term effects of chemicals and lifestyle factors on fertility.
- The DIR's Unit on Integrative Reproductive Endocrinology and Infertility is studying ovarian function loss after chemotherapy for cancer.
- The Fertility and Infertility (FI) Branch Branch's Reproductive Medicine Network is currently studying the safety and efficacy of various fertility treatments in women with PCOS or unexplained infertility. In addition, the Endometrium Database Resource has discovered that statins could be a possible treatment for endometriosis. Other studies include the effects of obesity on young girls' future fertility.
- The CRH Branch's Contraceptive Clinical Trials Network includes four phases of clinical trials for new contraceptive methods, including a vaginal ring that can be used for 13 cycles. Other work includes the Contraceptive Development Research Center Program, which supports studies on nonhormonal methods to inhibit ovulation.
- The Maternal and Pediatric Infectious Disease Branch supports and collaborates on the Microbicide Trials Network. Network researchers aim to reduce the transmission of HIV by working together to develop and evaluate microbicides—products taken orally or applied topically—to prevent HIV transmission.
Pregnancy, Childbirth, and Pregnancy Outcomes
The NICHD conducts and supports research on pregnancy issues, including pre-pregnancy and prenatal care, miscarriage and stillbirth, prematurity and preterm labor, sudden infant death syndrome (SIDS), birth defects and developmental disabilities, medication use during pregnancy, and breastfeeding. The following NICHD organizational units conduct or support research in this area of women's health:
- The bulk of research in this area is through the Pregnancy and Perinatology Branch, which currently studies the effects of breastfeeding on brain development, specifically development of the medullary raphe of the brainstem and the serotonin systems, and its mechanisms for reducing the risk for SIDS. Other studies include complications of high-risk pregnancies, including medication use and adolescent pregnancy.
- Current DIPHR research includes a study on the effect of long-term aspirin therapy on blood flow to the fetus and placental health (EAGeR study), studies on preeclampsia, and research on labor and induction.
- The DIR includes studies on preeclampsia and preterm birth as well as on calibrating measurements of growth factors in blood.
- Current studies in the Pediatric Growth and Nutrition Branch include advancing knowledge of the benefits of breastfeeding for preterm and low-birth-weight infants and studying the role of breast milk in gastrointestinal immunity.
- The Intellectual and Developmental Disabilities Branch supports studies to develop prenatal screening techniques to diagnose intellectual and developmental disabilities early.
Overall Health and Wellness
General wellness topics for women's health include violence and exposure to violence and bone health. The following NICHD organizational units conduct or support research in this area of women's health:
- The Population Dynamics Branch currently studies domestic violence and relationship dynamics.
- The Pediatric Growth and Nutrition Branch is studying fibroblast growth factors and the role of physical activity in bone health.
- The DIR includes studies on osteogenesis imperfecta in its Bone and Extracellular Matrix Branch.
The promotion of women's health is at the heart of many of the networks and programs supported by the NICHD. A number of these are included below.
- Contraceptive Clinical Trials Network (CCTN)
Funded through the CRH Branch, this network supports research on contraceptive drugs and devices. Current studies include research on the efficacy of a female condom and a vaginal ring that can provide effective contraception without increasing the risk of blood clots, particularly in obese women.
- Global Network for Women's and Children's Health Research
The Global Network is a partnership committed to improving maternal and infant health outcomes and building health research capacity in resource-poor settings by testing cost-effective, sustainable interventions. The network began in 2001 as a public-private partnership between the NICHD and the Bill & Melinda Gates Foundation. It currently includes a Data Coordinating Center and seven research units around the world.
- National Child and Maternal Health Education Program (NCMHEP)
NCMHEP was created by the NICHD in 2008 to provide a forum for reviewing, translating, and disseminating new research in maternal and child health. A coalition of health care provider associations, federal agencies, nonprofit organizations, and other partners pinpoint one issue pertaining to maternal and child health on which to focus for a set period of time, typically 12 to 18 months. The first focus area is Late Preterm Birth and Elective Term Deliveries.
- Women's Interagency HIV Study (WIHS)
Funded through the PAMA Branch, the study is investigating the impact of HIV infection on women in the United States. It is the largest and longest ongoing U.S. study of HIV-infected women. The study will evaluate how the infection affects women in particular, look at effective treatments, and investigate the relationship between HIV and other diseases.
To support training and education in women's health research, the NICHD supports the following activities for career development:
- National Centers for Translational Research in Reproduction and Infertility (NCTRI)
The NCTRI (Formerly the Specialized Cooperative Centers Program in Reproduction and Infertility Research [SCCPIR]) is a national network of research-based centers promotes training and career development for research scientists in the areas of reproduction and infertility research."
- Women's Reproductive Health Research (WRHR) Career Development Program
This program offers training opportunities for obstetricians/gynecologists (OBs/GYNs) interested in pursuing women's health research. The program provides OBs/GYNs who recently completed their postgraduate clinical training with additional education and experience in basic, translational, and clinical research.
- Building Interdisciplinary Research Careers in Women's Health (BIRCWH)
This program supports physician-scientists as they move between completion of clinical or postdoctoral training and an independent research career. BIRCWH research projects span the spectrum of women's health topics, and the program is open to all types of clinicians and non-clinicians.