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How A Blood Test Could Save Women From Infertility
photo - Sascha Kohlmann
A groundbreaking study looking at the function of platelets in the blood, or other disorders of blood clotting, could offer new hope to hundreds of women resorting to surgical measures to control menorrhagia, or excessively heavy menstrual bleeding.

Each year 30,000 women in England and Wales aged 30 to 50 have a hysterectomy - surgical removal of the womb - or a procedure called endometrial ablation, which burns away parts of the lining of the womb in order to end debilitating heavy monthly bleeding.

Although ablation does not always leave a woman infertile, it is not recommended for those who wish to have children in future. Both ablation and hysterectomy are considered a last resort.

But new research being carried out by specialists at the Royal Hallamshire's Haemophilia and Thrombosis Centre and the Jessop Maternity Wing, and funded by the Platelet Charity, suggests nearly 20 per cent of these patients may suffer from blood-clotting disorders.

These patients may lack a blood protein which acts like glue to help cells clump together and form a clot, or the cells themselves (called platelets) may not be working properly.

In women, this can affect the monthly cycle as tiny blood vessels in the womb bleed profusely and for a longer than normal time.

If a blood disorder is known about, appropriate interventions can be put in place for those still needing surgery, helping to reduce the risk of serious complications and side effects of surgery.

The research is believed to be the first of its kind in the world.

Dr Clare Samuelson, a specialist registrar at the Royal Hallamshire's Haemophilia and Thrombosis Centre who is leading the study, said:

"This is a really important study as bleeding disorders can often be associated with heavy menstrual bleeding, yet there are currently no routine tests for platelet function and deficiencies or dysfunction of blood clotting proteins for women suffering with these problems. There are particular treatments we can only access when we know that a woman has an underlying problem with her blood clotting, and we hope that our study will prove that a bleeding disorder diagnosis should be considered in women such as these with severe heavy bleeding in order to reduce the likelihood of major surgery and optimise patient care and safety.

"This particular area of research has not been carried out anywhere in the world before, to the best of our knowledge, and we are delighted to be working in partnership with The Platelet Charity so that we can better inform clinical practice and improve patient care. I think the profile of women with bleeding disorders needs to be raised. That is why we set up this study, because we think all women with heavy bleeding need to be tested appropriately before they go through surgery."

Ria Peake, 23, from Manchester, has lived with the debilitating effects of heavy and prolonged periods since she was very young.

"I missed a lot of school because of it. One year I missed 50% of school. When you have had an awkward experience you don't want to go back. If I was bleeding, going out would not even be a consideration. I was housebound. It can be quite isolating."

Despite trying hormonal contraception such as the Pill and a progesterone coil, Ria's condition worsened and at one point she developed anaemia, fainting and lethargy. She was then referred to the Royal Hallamshire Hospital, where a simple test found she had von Willebrand disease - the most common inherited bleeding disorder. She hopes the study will lead to more women with platelet function defects and other bleeding disorders being diagnosed earlier and treated sooner. "Prevention is always best because otherwise you are always trying to play catch up. If it is diagnosed early you can avoid a lot of potentially embarrassing situations."

Janet Richards, CEO of The Platelet Charity, said:

"Heavy monthly bleeding has a huge impact on many women's lives, to the point where some of them are housebound and many face drastic surgery.

"However some women could be treated for undiagnosed platelet disorders, which is why this study could change so many women's lives."

The study has been funded by a £16,000 grant from The Platelet Charity and is being supported by the National Institute for Health Research.

Patients currently due to have surgery for heavy menstrual bleeding at Sheffield Teaching Hospitals NHS Foundation Trust are eligible to take part in the study, which is being run in partnership with Sheffield's NIHR Clinical Research Facility.
How A Blood Test Could Save Women From Infertility, 10th December 2016, 10:33 AM