Studies Address Common Disorders Causing Infertility, Pelvic Pain
Millions of Americans with reproductive health disorders stand to benefit from new research funded by the National Institutes of Health. With funds from the American Recovery and Reinvestment Act, the National Institutes of Health today announced grants totaling nearly $60 million for research into disorders that impair fertility, cut short a woman’s reproductive years, and often cause intense pain.
"Collectively, reproductive health disorders affect millions of Americans. They may cause untold pain and discomfort, may prevent couples from having families, and often require expensive medical treatments," said Alan Guttmacher, M.D., acting director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the NIH institute awarding the funds. "Recovery act funding will help to uncover new information that can be applied to the development of more effective treatments for these disorders."
Much of the research is organized around themes that seek to further research progress, which were identified by NIH Director Francis Collins, M.D.
One theme, comparative effectiveness research, seeks the most effective of several available treatments.
With an NICHD grant for roughly $1 million over the course of two years, Elizabeth Stewart, M.D., of the Mayo Clinic, will conduct a study of 220 women to compare the effectiveness of two techniques for relieving the pain associated with uterine fibroids. Uterine fibroids are the non-cancerous growths that occur in the wall of the uterus. They may cause painful menstrual periods, pain during sexual intercourse, infertility, urinary and fecal incontinence, and bowel obstruction. One study estimated that 1 of 4 American women —and up to 3 of 4 African-American women—have uterine fibroids.
Hysterectomy, or surgical removal of the uterus, is a common treatment for fibroids, but is not suitable for women who wish to retain the ability to have children. Two less-invasive surgical treatments are also available: one destroys a fibroid by cutting off its blood supply, and the other directs a high-energy ultrasound beam to heat and kill the fibroid. Although these treatments have shown promise in easing the pain women experience from fibroids, little research has been conducted to determine if one treatment is more effective than the other. In their study, Dr. Stewart and her colleagues will compare the effectiveness of the techniques in relieving pain.
Infertility is another common health problem, with some studies estimating that 10 to 15 percent of American couples are affected. Several treatments are available to women experiencing difficulties achieving pregnancy; however, many of these treatments also confer a ten- to twentyfold increase in the risk of multiple births. Infants born as one of a set of multiples are usually preterm, and often have a number of health problems due to their premature birth.
NICHD awarded a two-year $9.4 million grant to its Reproductive Medicine Network to study the comparative effectiveness of three infertility drugs. The Reproductive Medicine Network is a cooperative system of clinical research centers that conducts research on reproductive health topics. Working with women around the country, scientists in the network will determine which of the three drugs is least likely to lead to multiple births while still overcoming infertility.
"The comparative effectiveness research being conducted by studies like these is essential for controlling health care costs," said Dr. De Paolo. "These studies are essential for identifying which of the available treatments offers the greatest benefits."
Another key objective identified by Dr. Collins is research using cutting-edge genomics technologies. Genomics is the science of studying the entire genome, rather than a single gene. The NICHD awarded a two-year grant for nearly $5 million to a genetic study of polycystic ovary syndrome (PCOS). Estimated to affect from 5 to 10 percent of women of childbearing age, PCOS is a hormonal imbalance that causes tiny, fluid-filled sacs, or cysts, to form in the ovary. In addition to infertility, PCOS is also associated with obesity and type-2 diabetes.
NICHD awarded the funds to Andrea Dunaif, M.D., of Northwestern University’s Feinberg School of Medicine, to scan the genomes of thousands of volunteers with and without PCOS to pinpoint the genes associated with the disorder. Because PCOS often occurs along with other conditions, such as obesity, the researchers hope to find out if genes linked to PCOS are unique, or are involved in these other conditions. Dr. Dunaif and her collaborators hope that this knowledge will result in better treatment and prevention of PCOS.
Other research projects supported by the funds seek to understand the fundamental processes underlying human reproduction and identifying more effective strategies for diagnosing, treating, and preventing conditions that affect reproductive health.
For more information about the research funded by the NICHD’s Reproductive Sciences Branch, visit the Branch’s Web site at http://www.nichd.nih.gov/about/org/cpr/rs/. To learn more about how the NIH is involved in the American Recovery and Reinvestment Act, visit http:// www.nih.gov/recovery/.
The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit the Institute’s Web site at http://www.nichd.nih.gov/.
The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical, and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.