Research

The EPT has supported research into biological processes that may be connected to ectopic pregnancy. The Trust sponsored Heather Flanagan, a PhD student at The University of Edinburgh, who is researching the causes of ectopic pregnancy.

This involves examining cellular changes in the lining the Fallopian tube with may result in ectopic embryo implantation. This work was supported by a joint Medical Research Council/Ectopic Pregnancy Trust PhD Fellowship.

Ectopic pregnancy and epithelial to mesenchymal transition

The EPT has assisted Monash University with research in ectopic pregnancy with the “aim of standardising core outcomes in published papers.”

The EPT has assisted with seeking lived-experience views on combining gefitinib with methotrexate to improve effectiveness of medical management

One of the key things that we believe at the Ectopic Pregnancy Trust is the importance of treatment choice. When someone is, sadly, diagnosed with an ectopic pregnancy, we believe that there should be as many options as possible available for treatment and that a woman should have a right to choose which method she thinks will be most suitable for her.

Methotrexate is one such form of treatment where the medicine is injected into the muscle and works to remove folate from the body to stop the ectopic pregnancy cells from dividing. This method of treatment, as opposed to surgery where the tube is typically removed, preserves the Fallopian tube and enables a faster physical recovery time. The downside of methotrexate is it can have temporary side effects where the woman feels very ill. Methotrexate sometimes requires a second injection and is successful in 66-95% of cases depending upon the study.

A group of researchers, led by Professor Andrew Horne of the University of Edinburgh, are running the GEM3 trial which is a multi-centre, double-blind, placebo-controlled randomised trial. This trial is seeking to establish whether medical treatment of ectopic pregnancy with the drug methotrexate is more effective when used in combination with the drug gefitinib. The study will be available at up to 50 centres across the UK.

Eligible patients will be offered the opportunity to be randomised to either the gefitinib or the placebo to be used in combination with the methotrexate. This involves taking one tablet a day for 7 days starting from the day the methotrexate is given, which is usually a single injection. Sites are now starting to open across the UK.

Currently open are:

• Chelsea and Westminster Hospital NHS Foundation Trust
• University Hospitals Bristol NHS Foundation Trust
• Dartford and Gravesham NHS Trust
• North Cumbria University Hospitals NHS Trust
• Nottingham University Hospitals NHS Trust
• Guy’s and St Thomas’s NHS Foundation Trust
• Hampshire Hospitals NHS Trust
• Hinchingbrooke Health Care NHS Trust
• University Hospitals of North Midlands NHS Trust
• Liverpool Women’s NHS Foundation Trust
• NHS Fife
• Surrey and Sussex Healthcare Trust
• Northumbria Healthcare NHS Trust
• Frimley Health NHS Foundation Trust
• Warrington and Halton Hospitals NHS Foundation Trust
• University Hospitals Coventry and Warwickshire NHS Trust
• Plymouth Hospitals NHS Trust
• Royal Wolverhampton NHS Trust
• The Princess Alexandra Hospital in Harlow
• Cambridge University NHS Foundation Trust
• NHS Forth Valley
• Buckinghamshire Hospitals NHS Trust
• Bedford Hospital NHS Trust
• Central Manchester University Hospitals NHS Foundation trust
• Heart Of England NHS Foundation Trust
• Countess of Chester Hospital NHS Foundation Trust
• Norwich and Norfolk University Hospitals NHS Foundation Trust
• Borders General Hospital in Melrose
• South Tyneside District Hospital
• The Royal Infirmary of Edinburgh
• Aberdeen Royal Infirmary
• Ninewells Hospital, Dundee
• Glasgow Royal Infirmary
• Crosshouse Hospital, Kilmarnock
• East Lancashire Hospitals NHS Trust
• West Suffolk NHS Foundation Trust
• Chesterfield Royal Hospital NHS Foundation Trust
• South Tees NHS Foundation Trust
• Walsall Healthcare NHS Trust