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Diagnosis

Trust awarded £250,000 government funding to launch pioneering endometriosis trial

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University Hospitals of North Midlands (UHNM) has secured £250k to trial a dye-based technique in endometriosis surgery aimed at reducing pain and surgical complications.

The two-year ICE trial will compare the use of indocyanine green (ICG) dye with standard ureter stenting, aiming to better protect urinary structures during deep endometriosis procedures.

Funded by the NIHR Research for Patient Benefit Programme, the feasibility study will explore whether this method can improve outcomes, reduce complications, and support recovery.

Mr Gourab Misra, consultant gynaecologist at UHNM and chief investigator, said: “Surgery for deep endometriosis is complex and carries a risk of damaging the ureters, the delicate tubes connecting the kidneys to the bladder.

“Traditionally, surgeons use stents to identify and protect these structures, but these can cause significant pain, bleeding, and require a second procedure to remove.

“As a group of surgeons, we saw the challenges our patients faced and worked hard to design this proposal.

“Our aim is to minimise complications and improve the patient journey, reducing pain and morbidity associated with these complex procedures.”

Endometriosis is a condition where tissue similar to the womb lining grows outside the uterus, often causing chronic pelvic pain and infertility.

In severe cases, surgery may be required, which carries a risk of injuring the ureters—tubes that transport urine from the kidneys to the bladder.

Currently, surgeons often use plastic tubes called stents to protect the ureters during surgery.

These are typically left in for two to four weeks but can cause pain, blood in the urine and require removal through an additional procedure.

The new approach uses a small catheter to deliver ICG dye into the ureters, making them visible under a special light during surgery—potentially avoiding the need for stents.

The trial will recruit 70 patients across UHNM and Birmingham Women’s and Children’s NHS Foundation Trust, with participants randomly assigned to receive either the conventional stent method or the dye-based technique.

It will assess feasibility, including whether patients and surgeons are willing to participate, with the goal of informing a future full-scale trial that could lead to wider adoption across the NHS and internationally.

Professor Justin Clark, consultant gynaecologist leading the study at Birmingham Women’s and Children’s NHS Foundation Trust, said: “Deep endometriosis affects and causes significant pain adversely affecting quality of life.

“Whilst surgery is effective, it is highly complex.

“This trial uses a novel dye called ICG that identifies the ureters, which are pipes that transport urine from the kidney to the bladder.

“We hope that this study will show that using ICG can reduce complications, speed up surgery, and reduce pain following the operation, as well as enhance recovery.”

Diagnosis

WHO launches AI tool for reproductive health information

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The World Health Organization (WHO) has launched an AI tool in beta to help policymakers, experts and healthcare professionals access sexual and reproductive health information faster.

Called ChatHRP, the tool was created by WHO’s Human Reproduction Programme and draws only on verified research and guidance collected by HRP and WHO.

It uses natural language processing and retrieval-augmented generation to produce referenced content and cut the time spent searching through documents across different platforms and databases.

WHO said ChatHRP also has multilingual capabilities and low-bandwidth functionality to support use in a wide range of settings.

The beta-testing phase is aimed at a broad professional audience, including policymakers, healthcare workers, researchers and civil society groups.

WHO said the tool can help users quickly access up-to-date evidence, find sources for academic work and verify information on sexual and reproductive health and rights.

Examples of questions it can answer include the latest violence against women data in Oceania for women aged 15 to 49, recommendations on managing diabetes during pregnancy, and whether PrEP and contraception can be used at the same time. PrEP is medicine used to reduce the risk of getting HIV.

WHO added that the system will be updated regularly as new HRP materials are published and includes a feedback loop so users can flag gaps in the information provided.

The launch comes amid wider concern about misinformation in sexual and reproductive health.

A 2025 scoping review found that misinformation in digital spaces is a systemic issue that can undermine human rights, reinforce discriminatory social norms and exclude marginalised voices.

The review also said misinformation can affect health systems by shaping provider knowledge and practice, disrupting service delivery and creating barriers to equitable care.

WHO said ChatHRP is intended to give users streamlined access to reliable information as a counter to “algorithms, opinions, or misinformation”.

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Menopause

AI maps how reproductive organs age differently during menopause

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An AI atlas has mapped how reproductive organs age through menopause, with the ovaries, vagina and uterus changing on different timelines.

To better understand how this process affects health, researchers at the Barcelona Supercomputing Center developed what they describe as the first large-scale atlas of female reproductive system ageing, using artificial intelligence.

The team combined 1,112 tissue images from 659 samples, covering 304 women aged 20 to 70, with gene expression data from thousands of genes.

This allowed them to reconstruct how seven key reproductive organs, including the uterus, ovary, vagina, cervix, breast and fallopian tubes, age over time.

The study used the supercomputing power of MareNostrum 5 together with advanced image-recognition methods to process the data.

Using deep learning techniques, the researchers detected visible tissue changes as well as the underlying molecular processes linked to ageing in each organ.

The result was a detailed, organ-by-organ map of the reproductive system’s ageing process.

The researchers found that not all organs age in the same way or at the same speed. The ovaries and vagina showed a more gradual ageing process that begins even before menopause officially starts.

By contrast, the uterus appeared to undergo more sudden changes around the time of menopause.

Even within a single organ, different tissues aged at different rates. In the uterus, for example, the mucosa, its inner lining, and the muscular layer did not change in sync. These tissues also appeared to be particularly sensitive to the hormonal and biological shifts associated with menopause.

Marta Melé, leader of the transcriptomics and functional genomics group at BSC and director of the study, said: “Our results show that it acts as a turning point that profoundly reorganises other organs and tissues of the reproductive system, and allows us to identify the genes and molecular processes that could be behind these changes.”

Building on the finding that organs age according to different patterns, co-first author Laura Ventura said the research “paves the way for personalised medicine where treatments are tailored to a woman’s specific molecular profile and the specific tissues showing the most age-related distress.”

The study also identified molecular signals linked to reproductive ageing that can be detected in blood samples from more than 21,441 women.

These biomarkers could allow doctors to monitor the condition of reproductive organs in a non-invasive way, potentially helping to anticipate risks such as pelvic floor complications without the need for biopsies.

According to the researchers, this could lead to simpler and more accessible clinical tools for tracking women’s health over time.

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Pregnancy

Early miscarriage care could prevent 10,000 pregnancy losses a year, study finds

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Early miscarriage care after a first loss could prevent about 10,000 pregnancy losses a year in the UK, according to a new study.

The study by Tommy’s National Centre for Miscarriage Research and Birmingham women’s hospital involving 406 women found a 4 per cent reduction in the risk of future miscarriage for women on the graded model of care compared with usual care.

Women in England, Wales and Northern Ireland currently become eligible for specialised NHS care for early baby loss only after they have had at least three miscarriages.

Tommy’s has called for women to become eligible after one miscarriage, saying this could reduce the risk of future miscarriages and improve health outcomes for mothers.

Researchers said that would translate to 10,075 fewer miscarriages a year across the UK.

Kath Abrahams, chief executive of Tommy’s, said women were being “left without early access to services that could help prevent future losses and reduce the debilitating feelings of isolation and hopelessness that we know affect so many who experience pregnancy loss”.

She said: “Our pilot study indicates that providing support after a first miscarriage, with escalating care after further losses, is not only effective but achievable without significant additional workload for NHS teams who are already working extremely hard to deliver good care.

“Put simply, it is the right thing to do. We will do all we can to drive that change across the UK so that more women and families are supported after every miscarriage.”

The graded model of miscarriage care proposed by Tommy’s is already available in Scotland, and the charity is calling for it to be introduced across the whole of the UK.

The graded model includes nurse-led support after one miscarriage, with advice on reducing risk factors such as low vitamin D, folic acid intake, alcohol consumption and caffeine use.

Women who received the specialised care were 47 per cent more likely to have a risk factor identified and receive relevant advice to help prevent future miscarriages than women receiving usual care, the study found.

Among women who had experienced two miscarriages and received the specialised care, one in five were found to have thyroid dysfunction or anaemia, both conditions that can affect pregnancy outcomes.

About one in four pregnancies ends in miscarriage, most often within the first 12 weeks of pregnancy.

The report comes ahead of the long-awaited final findings of the government’s investigation into maternity care in England. Interim findings uncovered a range of failures, including claims that NHS hospitals that caused harm to women and babies during childbirth often resorted to a “cover-up” of their mistakes, falsified medical records and denied bereaved parents answers.

Women’s health minister Gillian Merron said: “Pregnancy and baby loss can have a devastating impact on women and families, who too often feel they have been left without the care and support they need.

“I welcome the findings of this important report, and this will be carefully considered as part of our ongoing work to make sure women get the high-quality, compassionate NHS care they deserve.”

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