The missing piece of the miscarriage puzzle could be hiding in plain sight

On the second day of her period, Alicia Graham uses a menstrual cup to collect blood that could help researchers unlock the mysteries of pregnancy complications.

After decanting her period blood into a small specimen jar, she carefully packs the sample into a parcel alongside an icepack, and a courier transports it to a laboratory.

“It took me a while to get started because I was a little nervous about using the cup,” said the 39-year-old mother of two from Ferntree Gully in Melbourne’s east.

“But if there’s something that can be identified in the menstrual blood that helps stop recurrent miscarriages and other complications, that would be amazing.”

Graham is among hundreds of women involved in two new studies looking at how menstruation affects a woman’s likelihood of developing complications during pregnancy, including unexplained stillbirths, pre-eclampsia, fetal growth restriction and preterm birth.

While menstrual blood has long been perceived as inconvenient, dirty and taboo, researchers at Monash University and the Hudson Institute of Medical Research are now studying the potential of the long-stigmatised bodily fluid.

“Girls hide their periods from the moment that they get them,” said Associate Professor Miranda Davies-Tuck, the lead researcher of the two studies.

“We don’t talk about our periods at all, and so it’s meant that nobody’s really considered them.”

The researchers believe that menstrual blood, which is made up of uterine lining, blood, tissue and immune cells, sheds important biological clues about women’s reproductive health before they conceive.

For the first study, Davies-Tuck and her colleagues are recruiting 1100 pregnant women in the hope of identifying menstrual characteristics – including first onset, frequency, pain, and whether the flow is heavy or light – that could be used as a risk assessment tool during pregnancy.

Davies-Tuck said early onset of periods, often between the ages of eight and 12, was linked to a higher risk or preeclampsia, a serious pregnancy complication in which women develop high blood pressure.

But she said this was not part of current screening tools for preeclampsia risk, which determines who might benefit from aspirin treatment.

Abnormal uterine bleeding can also point to undiagnosed disorders such as endometriosis which are associated with infertility and adverse pregnancy outcomes.

Davies-Tuck said she was inspired to look into the link between menstruation and pregnancy complications after hearing about her friend’s heavy and painful periods, pregnancy complications and then stillbir