Researchers from the Victor Chang Cardiac Research Institute, in collaboration with the University of Sydney and the Royal Hospital for Women, have made significant strides in understanding the biological factors behind recurrent miscarriage. This condition affects up to one in fifty couples attempting to conceive and can lead to profound emotional distress.
Led by Dr. Hartmut Cuny and Professor Sally Dunwoodie, the study examined how variations in the body’s processing of vitamin B3 (niacin) and NAD—a crucial molecule for cell health—may contribute to pregnancy loss. The researchers analyzed blood, plasma, and urine samples from 88 women, both with and without a history of recurrent miscarriage, defined as two or more consecutive losses.
The team identified notable changes in three NAD-related metabolites among those who had experienced repeated miscarriages. Importantly, these alterations occurred regardless of whether the women were taking vitamin B3 supplements, indicating a potential metabolic imbalance that warrants further investigation. The findings were published in the journal Human Reproduction.
Dr. Hartmut Cuny emphasized the emotional weight of miscarriage, stating, “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 research builds on Professor Dunwoodie’s earlier work from 2017, which linked low NAD levels to birth defects and miscarriages in mouse models.
The complexity of the situation is underscored by the new study’s findings. Rather than solely attributing miscarriages to insufficient NAD levels, it suggests that variations in how vitamin B3 is metabolized may also play a critical role. This challenges previous assumptions and opens the door to a more nuanced understanding of the relationship between NAD metabolism and reproductive health.
Future Research and Potential Impact
Building on these findings, the research team has secured funding from the Australian Government Medical Research Future Fund for a new three-year project set to begin in February 2026. This study will continue to explore the dynamics of NAD levels and related metabolites among women with varying histories of miscarriage.
The upcoming research aims to identify NAD-related biomarkers that may indicate an elevated risk of miscarriage. It will also examine how the timing and frequency of miscarriages correspond to NAD metabolite levels, assess the impact of diet and nutritional supplements, and investigate other clinical factors that may interact with NAD metabolism.
Participants will be recruited from the Royal Hospital for Women and Nepean Hospital, comprising three groups: those with recurrent miscarriage, those currently experiencing recurrent miscarriage, and those with no history of miscarriage. Each participant will provide blood and urine samples and complete a comprehensive health and lifestyle questionnaire.
The ultimate goal of this research is to develop a diagnostic test that identifies women at risk of recurrent miscarriage, enhancing understanding of the biological mechanisms involved and potentially preventing future losses.
The ongoing work by researchers at the Victor Chang Cardiac Research Institute is a significant step towards alleviating the heartache associated with miscarriage and improving reproductive health outcomes for women worldwide.
