Researchers at the Victor Chang Cardiac Research Institute, in collaboration with the University of Sydney and the Royal Hospital for Women, have made significant progress in understanding the biology behind recurrent miscarriage. This condition impacts approximately one in fifty couples attempting to conceive and can lead to profound emotional distress. The study, spearheaded by Dr. Hartmut Cuny and Professor Sally Dunwoodie, evaluated how variations in the body’s processing of vitamin B3 (niacin) and the essential molecule NAD might contribute to recurrent pregnancy loss.
The research team conducted an analysis involving blood, plasma, and urine samples from 88 women, some of whom had experienced two or more consecutive miscarriages. They identified distinct changes in three NAD-related metabolites in individuals with a history of recurrent miscarriage. These variations were observed regardless of whether participants were taking vitamin B3 supplements, indicating that deeper metabolic imbalances may play a crucial role in miscarriage rates.
New Findings and Future Research Directions
The findings, published in the journal Human Reproduction, shed light on the potential connections between NAD metabolism, inflammation, and pregnancy health. The research aims to enhance the understanding of why some pregnancies end in miscarriage and strives to pave the way for identifying women at risk for recurrent losses. Dr. Cuny remarked, “Every miscarriage is heartbreaking. Our goal is to understand the biology behind them, so that in time, fewer families have to go through such loss.”
This investigation builds upon previous work by Professor Dunwoodie, who, in 2017, discovered that low NAD levels were linked to birth defects and miscarriages in mouse models. Those findings suggested that insufficient NAD levels might correlate with some miscarriage cases. However, the new study indicates that the situation in women is more intricate. Changes in the metabolism of vitamin B3 appear to contribute significantly to reproductive health, suggesting a more complex interplay than previously understood.
As part of ongoing research, the team has received a grant from the Australian Government Medical Research Future Fund to explore this area further. The new project, set to commence in February 2026, will involve partnerships with women who have experienced miscarriages and their healthcare providers. The study aims to investigate NAD levels and associated metabolites among women with varying histories of miscarriage.
Objectives of the Upcoming Study
The forthcoming research will focus on identifying NAD-related biomarkers that may signal an elevated risk of miscarriage. Researchers plan to examine how the timing and number of miscarriages correspond to levels of NAD metabolites. Additionally, they will assess the influences of diet and nutritional supplements on NAD metabolism, as well as other clinical factors that might interact with this metabolic pathway.
Women participating in the study will be categorized into three groups: those with a history of recurrent miscarriage, those currently experiencing recurrent miscarriage, and those with no history of miscarriage. Participants will provide blood and urine samples and complete comprehensive health and lifestyle questionnaires. The ultimate goal is to develop a diagnostic test to identify women at risk for recurrent miscarriages and to enhance the scientific community’s understanding of the biological mechanisms involved. By doing so, researchers hope to reduce the incidence of such devastating losses in the future.
