# Evaluating the intersection between sexually transmitted infections, inflammation and reproductive success

> **NIH NIH R01** · UNIVERSITY OF TEXAS MED BR GALVESTON · 2022 · $455,589

## Abstract

PROJECT SUMMARY ABSTRACT
Pregnancy loss occurs in ~20% of women with a clinically recognized pregnancy. Couples with histories of
pregnancy loss represent a large portion of those trying to conceive, but treatment is limited to widely
inaccessible fertility services. Data from the Effects of Aspirin in Gestation and Reproduction (EAGeR) Trial has
shown that preconception low-dose Aspirin therapy increases birth rates in women with histories of pregnancy
loss when preconception chronic low-grade inflammation, determined by C-reactive protein, is present. There is
a critical need to understand pathways that result in preconception chronic low-grade inflammation. This would
help to identify a broader group of women whom would benefit from aspirin therapy and inform the use of aspirin
in reproductive medicine. We hypothesize that prior exposure to common sexually transmitted infections (STIs)
can lead to long-term immune dysregulation and defective tissue repair. Among women with histories of
pregnancy loss, STI serology may indicate subsequent risk of adverse events or represent a group of women
who would benefit from preconception anti-inflammatory therapy. Prevalent and mostly asymptomatic STIs such
as Chlamydia trachomatis and Mycoplasma genitalium can ascend to the upper genital tract causing endometrial
inflammation, tissue damage and scarring. Unfortunately, most women acquire these STIs as young adults, but
do not know they were ever infected. The concept of “trained innate immunity” posits that innate immune cells
can develop a long-term proinflammatory phenotype following infectious stimuli induced through epigenetic
changes to immune and epithelial cells. Indeed, these STIs are linked to tubal infertility but associations with
other measures of impaired fecundity are limited. The specific aims of this proposal will: 1) determine if
seropositivity to Chlamydia trachomatis and Mycoplasma genitalium influences time-to-pregnancy, pregnancy
loss and birth rates in women with histories of pregnancy loss while adjusting for other STIs known to infect the
upper genital tract. 2) Determine if STI seropositive women have a unique blood immune and angiogenic profile
compared to seronegative women. 3) Determine if STI seropositive women previously randomized to Aspirin
therapy as part of the EAGeR trial (results described above) have improved birth outcomes. This study will
include 1078 women from the EAGeR trial. All women have histories of pregnancy loss but no history of infertility.
Access to preconception data from a study with extremely detailed reproductive outcomes is unique. Additionally,
our team includes a world-leader in STI diagnostics, which allows for robust serological measurements. We will
also leverage the expertise of our team members, currently funded to develop methods to address
generalizability, to transport our results to our target population of US women with histories of pregnancy loss
using the National Survey of Family Grow...

## Key facts

- **NIH application ID:** 10338181
- **Project number:** 5R01AI143653-04
- **Recipient organization:** UNIVERSITY OF TEXAS MED BR GALVESTON
- **Principal Investigator:** Brandie DePaoli Taylor
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $455,589
- **Award type:** 5
- **Project period:** 2020-03-01 → 2024-02-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10338181

## Citation

> US National Institutes of Health, RePORTER application 10338181, Evaluating the intersection between sexually transmitted infections, inflammation and reproductive success (5R01AI143653-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10338181. Licensed CC0.

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