Periods and pregnancy research

Our research focuses on finding ways to improve health outcomes for mothers and babies affected by major complications of pregnancy (preeclampsia and fetal growth restriction).
We are also investigating fetal and placental growth and development, implantation of the embryo, factors that affect the regulation of pregnancy and parturition (birth), and gene expression and regulation in the human endometrium during the menstrual cycle.

Gestational diabetes (GDM) is a condition in which women with no history of previous diabetes exhibit glucose intolerance during pregnancy. Rates of GDM have doubled in the last 10 years as maternal age and obesity continue to increase. The incidence is 11% of all pregnancies and has reached epidemic proportions within Asian (>16%) and Indian (>20%) populations within New Zealand. GDM not only predisposes women to developing diabetes later in life, but also increases the risk of diabetes, obesity and heart disease in the offspring.

Endometriosis is the most common of all gynaecological disorders, characterised by the presence and growth of endometrium (the lining of the uterus) outside the uterus. Lesions can be found anywhere within the pelvic cavity: on the ovaries, the fallopian tubes, and on the pelvic sidewall. It is a common cause of infertility and chronic abdominal pain in reproductive age women. Similar cyclic changes to those which occur in eutopic endometrium also occur in the endometrial tissue outside of the uterus resulting in abdominal and organ bleeding, inflammation, development of scar tissue, and/or appearance of endometrioid cysts often filled with blood.

Untreated endometriosis reduces Health Related Quality of Life and contributes to outcomes such as depression, inability to work, sexual dysfunction and missed opportunity for motherhood. Annual healthcare costs in New Zealand for endometriosis are greater than that of diabetes and early clinical screening and intervention is crucial for effective treatment and prevention of disease progression. Endometriosis-related pain is serious, debilitating and episodic.  

Infertility is a common problem affecting 1 in 6 couples in NZ today. For many of infertile couples, in vitro fertilization (IVF) represents their best chance of having children. However, staggeringly, 70% of transferred embryos fail to implant into the inner lining of the uterus, endometrium. While implantation is a process that depends on both the embryo and the uterus, up to 50% of this failure could be caused by the endometrium not being adequately receptive. IVF clinics have focused on selecting high quality of embryos for transfer but the other side of side of the equation, the assessment of uterine receptivity, is lagging far behind. Endometrial receptivity now appears to be the bottleneck of the reproductive process. Basic and clinical research will help to better understand the events of uterine preparation for embryo implantation.  

Dr Anna Ponnampalam

• Epigenetic regulation of endometriosis pathophysiology of gestational diabetes
• Gene expression and regulation of the human endometrium during the menstrual cycle
• New treatment targets for endometriosis

• Investigation of endometrial microbiome Determination of the role of SIRT1 in gestational diabetes
• Epigenetic regulation of endometriosis

In these projects students may be involved in any facet of biomedical research, from cellular studies to in-vitro/ animal models.