Reproductive Health/Reproductive Medicine – Kristina Gemzell Danielsson's research group

Our research develops the knowledge area of ​​sexual, reproductive and perinatal health (human reproduction and the beginning of life).

Part of the:
Photo of pregnant woman.
Photo of pregnant woman. Photo: iStock

Research

The research is translational and organized in three subgroups/areas: Experimental research, Clinical trials and Global Reproductive Health. Our main vision is to improve management and access to sexual and reproductive health in a global perspective and translate our research into clinical praxis and policy; from bench to bed to the hands of women

The WHO center is the base for the research group in Reproductive Health/Reproductive Medicine. The research at the WHO center is translational “From Bench – to – Bed - to - the Hands of Women to improve Reproductive Health”.

This includes experimental studies, clinical trials and implementation of research results. Our vision is to prevent ill health and work for evidence-based clinical practice and policy, sexual and reproductive health and women's rights to this in a global perspective.

Research activities are divided into three areas of activity:

  • Experimental research
  • Clinical trials
  • Global Reproductive Health (GRH)

Staff and contact

Group leader

All members of the group

Experimental research

Our focus is to explore the basics of female reproductive sciences at the molecular level to understand fertility and its associated disorders with the intention of translating the knowledge to clinical applications. The experimental group consists clinicians, embryologists, molecular biologists, biotechnologist and bioinformaticians.

Examples of ongoing studies:

Studies on human embryo implantation in managing infertility and fertility

Studies on endometrial receptivity – two sides of a coin: management of infertility and new strategies for fertility control. Understanding endometrial receptivity is vital in managing infertility and regulating fertility. We study the cellular and molecular aspects of endometrial function, particularly, endometrial mesenchymal cells and its niche factors on endometrial regeneration. Knowledge on the above is important in finding solution for infertility due to thin endometrium. We also have ongoing studies on embryo quality and development, with the intention to develop non-invasive methods for embryo quality assessment in assisted reproduction. We are studying different types of RNAs expressed in human embryos aa well as in the embryo spent media of healthy and compromised quality of embryos.

Understanding the aetiology of endometriosis and the link to ovarian cancer development

Endometriosis is a gynaecologic disorder with poorly understood aetiology, affecting 10-15% of women causing pelvic inflammation, chronic pain and infertility. The most widely accepted theory on the aetiology of endometriosis is Sampson’s retrograde menstruation. Endometrium consists of a variety of cells expressing markers relevant to attachment, adhesion, migration and stemness. Inappropriately shed endometrial cells during menstruation reach the peritoneal cavity, where they are able to adhere and establish endometriotic implants/lesions. We study the role of different endometrial cell types in the aetiology of endometriosis and its relation to ovarian cancer.

Bromocriptine on uterine adenomyosis

Clinical trial conducted by our group on the effect of bromocriptine on adenomyosis showed a significant reduction with the symptoms. Now, we are studying the possible molecules and the related pathways involved in improving the symptoms at endometrial level.  

 

Our research wet lab is located at BioClinicum.

Team

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Lalit Kumar Parameswaran Grace

PhD, senior researcher

Angelique Flöter-Rådestad

MD, PhD, adj senior lecturer, associate professor
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Nageswara Rao Boggavarapu

PhD, post doc

Caroline Salminen Frisendahl

PhD student

Clinical trials

The research conducted at the WHO center including the development of medical abortion, misoprostol for use in obstetrics and gynaecology and new contraceptive methods such as emergency contraception, and intrauterine contraception has had a major impact on women's heath in Sweden and globally. A translational approach from experimental research to clinical trials and public health implementation. Unsafe abortion is a major contributor to maternal mortality. Therefore, effective methods for contraception and safe and acceptable methods for termination of unwanted pregnancies and treatment of incomplete abortion are prerequisites for reproductive health.

Medical abortion that was first invented by our research group and developed in collaboration with WHO is now increasingly used worldwide with major impact on women, their families and society. A simplified medical abortion procedure may include possibility for (i) home administration of misoprostol by the woman herself and; (ii) abortion care (including the examination and ultrasound) conducted by midwives; (Task shifting) (iii) self-assessment of the outcome of treatment (iv) medical abortion carried out by women themselves using telemedicine. Our research has led to the use of misoprostol on several indications (incl. postpartum hemorrhage, post-abortion care and labor induction) to reduce maternal mortality.

Our research also focuses on the development of new contraceptive methods containing new compounds such as progesterone receptor modulator, and on male hormonal contraception. In collaboration with WHO new methods for Emergency Contraception (EC) has been developed. However, the current EC Pills are only limited effective. Therefore an important part of the research programme is to develop highly effective Emergency contraceptive methods that can be used on demand and for dual protection as well as developing and promoting long acting reversible contraception (LARCs = implants and intrauterine contraception).

Although medical abortion is increasing world-wide with major impact on society a serious limitation with mifepristone is that it is only available in about 60 countries and frequently at a high cost. Therefore, misoprostol-alone regimens (although slightly less effective than the combined method and with more side effects) are used for medical abortion where mifepristone is not available.

The implementation of misoprostol has led to reduced maternal mortality and morbidity through treatment and prevention of post-partum haemorrhage, labor induction, treatment of incomplete abortion, and making legal abortion safer and more effective and illegal abortions less dangerous. Misoprostol is safe, easy to use and can be handled by nurse/midwives or women themselves. Read more at misoprostol.org

Global Reproductive Health (GRH)

This research focuses on the development of safe, effective and accepted methods for contraception, abortion and task shifting/sharing in relation to post abortion care (PAC). In ongoing projects, experiences and access to abortion and contraceptive counseling among immigrants in Sweden are studied. Access to contraception and safe abortion care in humanitarian settings is evaluated in another project. This research takes place at the intersection of healthcare research, public health/global health and reproductive medicine/reproductive health. By integrating policy, intervention and implementation into clinical practice, we strive to increase access to evidence-based abortion care. In addition to individual significance, the research also has health economic effects.

Researchers/postdocs:
Marie Klingberg Allvin, Professor
Josaphat Byamugisha, Professor, Head of Dept Makere University, Uganda
Elin Larsson, PhD International Health, Research fellow
Kakaire Othman, MD, PhD, Post doc
Margit Endler, MD, PhD, Post doc
Rebecca Gomperts, MD, PhD

Doctoral students
Amanda Cleeve
Ulrika Loi Rehnström
Sarah De Masi
Ritha Bakesiima

Master Students
Maria Persson
Iona Tjoeng