The test involves detecting a protein called PEP (progesterone endometrial
associated protein), produced by glandular cells in the endometrium, the
lining of the uterus. Gedis Grudzinskas and his colleagues at the Royal
London Hospital have been studying PEP and believe it to be an indicator
of endometrial function.

According to Tony Parsons, an obstetrician at the University of Warwick,
doctors currently carry out a sensitive pregnancy test and use ultrasound
if they suspect an ectopic pregnancy. However, the test does not indicate
the location of the embryo. Ultrasound images are often unclear, leaving
surgery as the only option, he says.

‘Ectopic pregnancies are potentially life-threatening,’ says Parsons.
‘Anything that lets us have a nonsurgical way of picking up ectopic pregnancy
early has to be good.’

Recently Grudzinskas and his colleagues measured the level of PEP in
205 women with symptoms suggestive of ectopic pregnancy. They found that
the concentration of the protein was markedly lower in these women than
in women used as ‘controls’. About 98 per cent of the women who eventually
turned out to have ectopic pregnancies had abnormally low levels of PEP.
In 60 per cent of these cases, the researchers described the level of PEP
as ‘extremely low’.

Grudzinskas and his colleagues also found that women who turned out
not to have an ectopic pregnancy but had some other pregnancy complication
tended to have a higher than average level of PEP. The results will appear
in a forthcoming issue of the journal Clinical Reproduction and Fertility.

Grudzinskas believes that his team’s findings are particularly important
because, for some unknown reason, ectopic pregnancy is becoming more common.
Fifteen years ago, less than 0.5 per cent of pregnancies were ectopic. Also,
women who undergo fertility treatments, such as in vitro fertilisation and
artificial insemination, run an increased risk of suffering from the condition.
Between 3 and 5 per cent are affected.

Now all women who are undergoing fertility treatment at Grudzinskas’s
clinic and who then become pregnant have their PEP levels measured. The
aim is to see whether problems can be picked up earlier than by other means,
such as ultrasound scans and the measurement of the levels of other hormones.

‘Complete loss of smell is quite rare,’ Hawkes says, ‘but difficulty
in perceiving things which are thought of as an odour is common.’ He believes
that the machine could provide a noninvasive, diagnostic test for multiple
sclerosis and other neurological conditions such as Parkinson’s disease.

Hawkes used a series of 40 ‘scratch and sniff’ cards. He found that
healthy individuals identify 35 or more of these smells, but people with
multiple sclerosis are not as good. When he tested 67 patients, they scored
between 25 and 30 only.

Now Hawkes wants to determine when in the disease the olfactory nerve
gets damaged. If it is early, the machine could be used for screening. Hawkes
hopes to present these results at the Association of British Neurology meeting
in April.