Welcome!

Welcome to the website of the HMove study! The HMove study is a medical-scientific research project that is carried out by the Radboud UMC in collaboration with the Maastricht University Medical Centre. The research focuses on women that have experienced multiple unexplained miscarriages. On this website you can find more information about the study, get to know the research team and if you would like to receive more information you can use the contact form.

Background of the study

1-2% of all couples that try to conceive face recurrent miscarriages. Recurrent miscarriage is defined as 2 or more miscarriages within 24 weeks of gestation. The causes of recurrent miscarriage can be divided into;  pregnancy-related causes, woman-related causes and man-related causes. Known causes are for example an abnormal shape of the uterus, genetic factors, clotting disorders or chronic diseases such as diabetes. Unfortunately, only in about 50% of the cases an underlying cause can be found. In the other 50%, it is speculated that the immune system might play an important role. A well-functioning immune system is pivotal for a successful pregnancy. Namely, a fetus consists for 50% of foreign DNA coming from the father. During implantation of the embryo, is it important that the endometrium does not reject the embryo. It is thought that the rate of miscarriage is higher when the maternal immune system is not functioning well. In a previous study, it has been shown that exercise improved the immune system of patients with cancer. During the menstrual cycle, these immune cells, residing in the endometrium, are shed into the blood and mucus. By analyzing these immune cells from the menstrual blood before and after an exercise intervention, we want to investigate whether exercise can improve the immune system of women suffering from unexplained recurrent miscarriages.

What to expect?

Are you participating in the study? This study will last around 1 year. The exercise intervention will last 3 months in total.

For this study, you will cycle on a home trainer at a gym at the Radboud UMC, the University Maastricht sports centre, or a local gym for 3 months. We will also call you every two weeks. We will then ask you a couple of questions regarding the training and we will download the training-data from your smartwatch. In this way, we can also personally coach you. If you participate in the study you will receive a smartwatch on loan and a reimbursement of the membership fees for 3 months at the gym where the training takes place. The first 6 weeks you will be asked to exercise 2x 1 hour a week and the second 6 weeks 3x 1 hour a week. You will receive a personalized training schedule that will be adjusted to your maximum training capacity.

For the study you will have to visit the hospital once before the intervention and once after the intervention. One visit lasts approximately one full day. We will do our best to plan all examinations on one day. The schedule and content of the examination day can differ somewhat from undermentioned example depending on if the research will be conducted either in Nijmegen or Maastricht but will always be communicated and discussed with you.

Day 1 (morning):

You will be asked to come on an empty stomach. In case this is not feasible, please let the researcher know.

• Short questionnaire about exercise
• Blood and urine examination. For that, we have to draw 8 tubes of blood. All together this is around 64 mL of blood. This amount of blood will not cause any problems in adults. In comparison: people at a blood bank donate 500 mL. We will test the following parameters:
  • Sugar levels and fat balance in your blood
  • Immune cells in your blood
  • Protein levels in your blood
• Physical examination. The researcher will weigh you, determine your height, measure your blood pressure and check your pulse.
• The reaction of your nervous system will be measured for around 30 minutes by placing a sensor band around your finger while laying down on a bench.
• A vaginal ultrasound will be performed and a vaginal swab will be taken to examine the inside of the uterus.

Day 1 (afternoon):

Exercise test. The reseacher will let you cycle on a home trainer for 10-30 minutes whereby the cycling gradually will become more difficult. During the cycling the following tests will be done to determine your stamina:  

• Maximum oxygen uptake capacity during the exercise. This is done using a gas-analysis taken from your breath.
• After the cycling, a finger-prick will be done to determine the lactate levels in your blood (only in Nijmegen).

These examinations/measurements will be carried out once more after the intervention as described above.

Next to the examinations in the hospital we kindly ask you to collect your menstrual blood using a menstrual cup during 1 menstrual cycle. You will be asked to collect the menstrual blood the first 2 days of your menstruation using the menstrual cup. This menstrual cup is made out of silicones that you can vaginally insert like a tampon. You will start collecting as soon as your menstruation starts (the very first blood loss). The menstrual blood, collected in the menstrual cup, can be poured over into special collection tubes every 12 hours. Afterwards, the cup should be inserted again. In this way, the blood will be collected during 1,5 days (3x 12 hours). After the 1,5 days you are kindly asked to send the collected menstrual blood to our laboratory where it can be processed and analyzed. In case the number of cells in the blood is not sufficient to perform the analysis, we will contact you and kindly ask you to donate a second time. If you are not willing to donate again this does not affect your participation in the study. A year after completing the cycling intervention, a short questionnaire will be sent to you. The questions are mainly focused on the course of pregnancies that have occurred after participation in the study. Filling out the questionnaire will take around 5-10 minutes. Given your medical history, the questionnaire might be emotional or confronting for you. We completely understand if you would rather not fill out the questionnaire. This is absolutely no problem. You can always let us know when you receive the questionnaire. You can also opt for only filling out the general questions and to skip the questions regarding pregnancies.