Fertility

Lead Researcher : Dr Edouard Mills

Supported by the Metabolic & Endocrine Theme

Fertility problems are very common in the UK, with 1 in 7 couples having difficulty conceiving. This may be due to male factors, female factors, a combination of both factors, or may be unexplained. For both women and men, obesity can be associated with higher chances of difficulty conceiving. However, current treatments are limited by their effectiveness, side effects, cost, and difficulty to access through the NHS. Therefore, there is a major need to develop new, safe and effective treatments to help people having difficulty conceiving.

Kisspeptin is a naturally-occurring hormone that stimulates the release of other reproductive hormones inside the body. Because of this, there has been significant research interest in using kisspeptin-based medicines to treat common fertility problems, including difficulty conceiving due to obesity. However, currently, kisspeptin can only be administered by injections, meaning that alternative delivery routes need to be developed.

Therefore, I will investigate the potential benefit of kisspeptin administered as a nasal spray. To do this, I will recruit 12 healthy women, 12 healthy men, 12 women with obesity-related hypogonadism (i.e., when the body’s sex glands [gonads] produce little or no sex hormones) and 12 men with obesity-related hypogonadism. Each participant will attend for five study visits each and will receive 0.9% saline as a placebo (i.e., a false treatment), or kisspeptin-54 (at doses 3.2, 6.4, 12.8, and 25.6 nmol/kg) via the nasal route. This will be followed by blood sampling for reproductive hormones via a venous cannula every 15-minutes for 4-hours. This will allow me to conclude whether nasally delivered kisspeptin is viable and the most effective dose.

Determining whether nasally delivered kisspeptin can stimulate reproductive hormones could potentially change future practice by providing a patient self-administered nasal medicine that would be far preferable to current invasive methods (injection) for patients and clinicians alike.

Lead Researcher: Dr Sabrina Rodrigues

Supported by the Social, Genetic & Environmental Determinants of Health (SGE) Theme

The World Health Organization (WHO) describes infertility as a global health problem affecting millions of men and women of reproductive age around the world. Infertility is defined as the inability to achieve pregnancy after 12 months or more of regular, unprotected sex.  As infertility rates rise worldwide, there is a need for more research to identify the specific factors contributing to infertility, which could help in its prevention and management.

So far, researchers have found that infertility may be influenced by several types of factors:

• Biological factors, for example, poor-quality semen in men or endometriosis and pelvic function problems that prevent ovulation in women.
• Social factors include fertility awareness (how much people know about fertility and its risk factors), willingness to talk about infertility, time spent at a computer or working long hours, and stress.
• Environmental factors, such as living near high-voltage power lines or busy roads or being exposed to certain pollutants.

However, these factors have mostly been studied separately, and little is known about how they might work together to contribute to infertility.

The goal of this pilot study is to combine expert clinical knowledge with advanced statistical and machine learning methods to analyse a large dataset for the identification of potential novel determinants of infertility, and to investigate how these contribute jointly to a higher risk of infertility. We will also explore how these exposures may affect reproductive health. We will use data from the UK Biobank, which includes information on around 500,000 people in the UK and will focus on social, biological, and environmental factors.