Through its intramural and extramural organizational units, the NICHD supports and conducts a broad range of research projects on amenorrhea and conditions for which amenorrhea is a symptom. Short descriptions of this research are included below.
Institute Activities and Advances
Several NICHD organizational units support and conduct research on amenorrhea and the conditions for which it is a symptom.
The Biostatistics & Bioinformatics Branch, within the Division of Epidemiology, Statistics, and Prevention Research (DESPR), is examining the functioning of the menstrual cycle through the Modeling of Menstrual Cycle Function Project. Researchers are developing statistical models to appropriately account for the intricacies of menstrual cycle biology. Using these models, they are able to study associations between hormone levels, cycle characteristics, and various reproductive outcomes such as fertility, miscarriage, uterine fibroids, and cardiovascular disease.
DESPR's Epidemiology Branch is also studying sporadic amenorrhea among normally menstruating women to determine the connection between amenorrhea and PCOS. The BioCycle Study found that normally menstruating women may also experience the endocrine disturbances that lead to PCOS. Researchers hope to determine how the disturbances can help improve diagnoses and treatment for women with PCOS.
The NICHD Unit on Reproductive and Regenerative Medicine, part of the Program in Reproductive and Adult Endocrinology (PRAE) within the NICHD Division of Intramural Research (DIR), leads numerous studies to advance understanding of primary ovarian insufficiency (POI) and fragile X-associated ovarian insufficiency (FXPOI). In one study, researchers were able to slow an immune system attack on the ovaries of mice by "teaching" the animals' immune systems to recognize the ovarian protein MATER (a maternal antigen that embryos require) as part of its own tissues. Researchers hope to one day be able to screen and explore fertility-sparing options in women who are at risk for autoimmune FXPOI. Other studies focus on the increased risk for osteoporosis in women with FXPOI as compared to normally menstruating women. A late diagnosis of FXPOI contributes to reduced bone density by delaying proper therapy. Additional studies by this NICHD research group focus on the menstrual cycle as an indicator of overall health.
The Unit on Reproductive Endocrinology and Infertility, also within the NICHD DIR, is studying loss of ovarian function among women who receive chemotherapy for cancer. Recent studies indicate that mice pretreated with gonadotropin-releasing hormone (GnRH) therapy prior to chemotherapy had their ovarian function preserved and restored after chemotherapy ended. A clinical trial is under way to determine whether giving GnRH therapy to women prior to chemotherapy also restores ovarian function after the therapy ends. The Fertility and Infertility (FI) Branch–supported Reproductive Medicine Network (RMN) studies include examining the role of leptin in reproductive development and gene mutations resulting in puberty disruption and infertility.
Other Activities and Advances
- The Specialized Cooperative Centers Program in Reproduction and Infertility Research (SCCPIR) is a national network of research-based centers, supported through the FI Branch, that promote interactions between basic and clinical scientists, with the goal of improving reproductive health. Several SCCPIR sites study amenorrhea as a condition and as a symptom of other conditions such as polycystic ovary syndrome (PCOS).
- The FI Branch also supports a Fertility Preservation program that funds research on several areas. These include the incidence and prevalence of infertility in women who have undergone chemotherapy or radiation therapy, which can cause short- and long-term amenorrhea, and the development of biomarkers and clinical parameters to better predict ovarian reserve and thus the potential success of in vitro fertilization (IVF).
- Through the SCCPIR, the NICHD also supports the Endometrium Database Resource. The Resource supplies tools that allow easy comparison of relative RNA expression from different experimental conditions, including amenorrhea, to determine how those conditions affect gene expression in various layers of the uterus.