

In a groundbreaking study published in Nature Medicine, researchers have identified 195 genetic risk factors tied to 42 female reproductive health conditions, marking a major advance in understanding how genetics shapes women’s reproductive health. Conducted using data from nearly 300,000 women in Estonia and Finland, this research sheds light on the genetic underpinnings of conditions like polycystic ovary syndrome (PCOS), endometriosis, uterine fibroids, and intrahepatic cholestasis of pregnancy (ICP)—conditions that affect millions of women globally.
Genetics Behind Reproductive Health—Why It Matters
Female reproductive health disorders, from infertility to pregnancy complications, are often driven by complex genetic and environmental factors. However, many genetic contributors remain unknown, limiting diagnostic and treatment options. This study addresses that gap by identifying new genetic loci that could predict risk, guide early interventions, and inform personalized medicine for women.
“Many of these conditions are poorly understood, but our DNA holds vital clues that could revolutionize how we approach diagnosis and care,” say researchers from Estonian and Norwegian research teams.
Key Findings of the Study
195 Genetic Loci Identified:
- 83 novel genetic loci never before linked to female reproductive disorders.
- Genes involved in hormone signaling, organ development, and follicle maturation play critical roles.
- Population-specific variants (e.g., CHEK2, MYH11) discovered in Finnish and Estonian populations.
Notable Genes Linked to Reproductive Health:
- FSHB, GREB1, WNT4, PAX8, WT1, CHEK2, among others.
- Newly implicated genes for ovarian cysts: PDE4D, ID4, NR0B1.
Shared Genetic Risks Across Diseases:
- Strong genetic overlap between uterine fibroids and heavy menstruation, and cervical dysplasia and cervicitis.
- Surprisingly, there is a negative correlation between PCOS and preterm birth, challenging previous assumptions.
Breakthrough in Predictive Tools: Polygenic Risk Score (PRS) for ICP
The study developed a polygenic risk score for ICP, a serious pregnancy complication:
- Women in the highest PRS decile were 6.7 times more likely to develop ICP compared to those in the lowest decile.
- Validation in an independent Norwegian cohort confirmed the score’s predictive power.
- Area under curve (AUC) for ICP prediction reached 0.71, showing strong clinical potential.
PheWAS analysis also linked the ICP PRS to gallstone disease (cholelithiasis), suggesting shared genetic roots.
Implications for Women’s Health
Early Detection and Personalized Care:
- Identifying women at higher genetic risk enables targeted screening and early intervention.
- Potential to personalize treatment plans based on genetic profiles.
Guiding Public Health Strategies:
- Data could inform screening guidelines and resource allocation for women’s health.
- Potential to reduce healthcare costs by preventing advanced-stage disease.
Future Drug Development:
- Discovery of pleiotropic genes (e.g., WNT4) associated with multiple conditions opens new avenues for therapies.
The Big Picture: Women’s Health at a Turning Point
The research underscores that reproductive health issues are genetically complex—driven by many small genetic variations rather than single genes. It also highlights the importance of studying diverse populations, as some genetic risks are unique to specific groups, like Estonians and Finns.
Lead authors emphasize that while these insights are transformative, further research in more diverse populations is critical to ensuring global applicability. Additionally, integrating genetic risk with environmental and lifestyle factors will help fine-tune prevention and care strategies.
Conclusion
This landmark genetic study is poised to redefine women’s reproductive health, moving from generalized care to precision medicine. By understanding the genetic roots of reproductive disorders, clinicians may soon offer personalized solutions to millions of women worldwide—empowering women to manage their reproductive health proactively.
More Information: Pujol Gualdo, N., Džigurski, J., Rukins, V. et al. Atlas of genetic and phenotypic associations across 42 female reproductive health diagnoses. Nat Med (2025), DOI: 10.1038/s41591-025-03543-8, https://www.nature.com/articles/s41591-025-03543-8
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