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Diabetes Drug Sitagliptin May Decrease Risk of Miscarriage

— January 27, 2020

Women find hope in trial that shows sitagliptin may decrease the risk of having a miscarriage.

Sitagliptin, a diabetes drug, can help prepared the womb for pregnancy and reduce the chances of having a miscarriage, new research shows.  Results of a trial on the drug (which is commonly known by its brand name as Januvia) showed sitagliptin increased the amount of stem cells in the womb lining by 68 percent, according to Warwick University researchers. Thirty-eight women between 18 and 42 years old were asked to participate and each had suffered an average of five miscarriages in the past.  Half of the sixteen women who opted into the study and were administered the drug ended up delivering a child, while seven of the seventeen women who were given a placebo had a baby.  In addition to these findings, the overall number of miscarriages experienced by those receiving sitagliptin was cut in half.

If the drug is successful in clinical trials, it would be one of few treatment options for women who have miscarried and tried other routes to conceive without success.  Co-author Professor Siobhan Quenby said, ‘We have improved the environment that an embryo develops in and in doing so we hope to improve the chances of a successful pregnancy.  Although this research was specifically designed to test whether we could increase the presence of stem cells in the womb, follow-up of participants found that there were no further losses of normal pregnancies in those who took sitagliptin.”

Diabetes Drug Sitagliptin May Decrease Risk of Miscarriage
Photo by Kelly Sikkema on Unsplash

One in six pregnancies in women who know they are pregnant end in miscarriage, according to experts.  This occurs when the pregnancy is lost within the first 23 weeks after conception.  The main symptoms, according to WebMD, are bleeding from the vagina and lower abdominal pain.  If a miscarriage happens in the second trimester it can be a sign of an underlying problem and additional testing should be performed if she wishes to continue trying to conceive.  Only an estimated five percent of women experience two consecutive miscarriages and one percent have three or more.  Many go on to delivery a baby after one miscarriage.

Womb biopsies were taken at the start of the trial and at the end to monitor the number of stem cells present before and after the study.  The women taking sitagliptin had around “two thirds more stem cells in their wombs at the end of the treatment.  The placebo group had no increase in stem cells,” according to researchers.  They stated further, “Excessive stress on these key cells can lead to the breakdown of the womb lining, placental bleeding and miscarriage.  The numbers of ‘stressed’ decidual cells in the womb lining was twice as low in the sitagliptin group.”

Co-author Professor Jan Brosens, of Warwick Medical School, said, “There are currently very few effective treatments for miscarriage, and this is the first that aims at normalizing the womb before pregnancy.  Although miscarriages can be caused by genetic errors in the embryo, an abnormal womb lining causes the loss of chromosomal normal pregnancies.  We hope that this new treatment will prevent such losses and reduce both the physical and psychological burden of recurrent miscarriage.”

Jane Brewin, chief executive at Tommy’s National Miscarriage Research Center, said, “For far too long it has often been said by many health professionals that miscarriage is not preventable, and parents have been left with little hope given the paucity of treatment options available.  A large-scale trial is needed to verify the findings and we hope that this will get underway quickly.”


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