BSc Hons I, Adelaide University
PhD, Australian National University
GD Admin, Canberra University
RESEARCH, TEACHING, or OTHER INTERESTS
Immunology and Allergy, Cell Biology, Hematology, Immunology
164
Scopus Publications
Scopus Publications
How well do women understand their menstrual cycles? Insights from 383,085 UK based women Zoya Enakshi Ali, Esther Wainwright, Sugha Murugesu, Silvia Moraru, Lucinda Lawrie, Natalie Getreu, Helen C. O’Neill Reproductive Health, 2026 Menstrual cycle awareness is a critical yet frequently overlooked component of reproductive health; it shapes an individual’s ability to recognise changes in their cycle, seek timely medical care when needed, and make informed decisions. However, many women of reproductive age lack essential understanding about their cycles, contributing to widespread misconceptions, stigma, and delays in healthcare engagement. This study explores menstrual cycle awareness, the perceptions of cycle regularity, and demographic disparities among UK-based women. This was a retrospective, cross-sectional analysis of self-reported menstrual cycle data collected through an online health assessment (OHA) between September 2020 and January 2025 from 383,085 UK-based women aged 18–50 years. Participants reported cycle regularity, cycle length, and period length, alongside demographic and reproductive characteristics. Overall, 22.2% of participants reported not knowing their cycle length, with uncertainty highest among those under 25 years (33.4%). Awareness increased with age before declining slightly after age 45. Awareness of period length was higher than cycle length awareness; however, 9.5% of participants were unable to report period length, rising to 13.8% among those under 25. Among participants who described their cycles as regular and reported a cycle length, 4.9% reported cycle lengths outside commonly referenced regular range (21–35 days), indicating discordance between perceived regularity and reported cycle length. This discordance was most pronounced among younger participants and varied modestly across ethnic groups. Participants who had previously been pregnant or were actively trying to conceive demonstrated higher cycle length awareness. These findings highlight persistent gaps in menstrual cycle awareness among UK-based women, particularly among younger individuals and those not actively engaged in fertility planning. Discordance between perceived cycle regularity and cycle length reference ranges suggests that many individuals may lack a clear framework for interpreting their menstrual patterns. Improving population-level education and clinical engagement around menstrual cycle awareness beyond fertility-focused contexts may support earlier recognition of potential menstrual health concerns and more timely healthcare engagement.
Fertility awareness in 97,414 women trying to conceive: gaps, misconceptions, and implications for reproductive education Esther Wainwright, Zoya Ali, Lucinda Lawrie, Natalie Getreu, Helen C. O’Neill Reproductive Health, 2025 BACKGROUND: Fertility rates in the UK are at an all-time low, with infertility affecting approximately 1 in 7 couples. Despite the rising demand for fertility services, fertility awareness, specifically knowledge of ovulation and the fertile window, remains low among women of reproductive age. Most existing studies offer a broad perspective, lacking focus on women actively trying to conceive (TTC). This study aims to assess the level of understanding surrounding the fertile window among women TTC, identifying factors associated with knowledge gaps. METHODS: A retrospective, cross-sectional analysis of 97,414 women actively TTC who answered an online health assessment was conducted. Participants provided information on menstrual cycle characteristics, previous pregnancies, and fertility knowledge, including the timing of the fertile window. Frequencies, percentages were calculated and chi-squared tests performed to assess differences in categorical data. Logistic regression models were used to calculate odds ratios (ORs) to better understand factors significantly associated with not knowing the fertile window. RESULTS: Out of the total respondents (97,414), over a third (33,756, 41%) could not accurately identify the fertile window, with substantial misconceptions observed across all age groups and ethnicities. Women with previous pregnancies were more likely to correctly identify the fertile window (OR = 1.45, 97.5% CI: 1.20-1.75, p < 0.001). However, knowledge was significantly lower among those with irregular cycles, non-White ethnicities, younger age groups and longer time TTC. Additionally, misconceptions about cycle regularity were apparent, of 60,322 women describing their cycles as regular 10% did not know their cycle length (66,95) and a further 2.9% fell outside of the clinically regular 21-35 day range. These misconceptions followed a similar trend with younger age groups, non-white ethnicities and longer time TTC having significantly increased rates of misidentifying regular cycles. This further increased the odds of not knowing their fertile window (OR = 2.99, 97.5% CI: 2.83-3.17, p < 0.001). CONCLUSIONS: The findings reveal gaps in fertility awareness among women actively TTC. Addressing these knowledge gaps through targeted educational interventions could potentially reduce time-to-pregnancy and the reliance on assisted reproductive technologies. Improved fertility education focusing on cycle tracking and ovulation timing is essential to assist women with accurate information during their TTC journey.
The effect of myeloablative radiation on urinary bladder mast cells Jessica Smith, Jonathan Kah Huat Tan, Christie Short, Helen O’Neill, Christian Moro Scientific Reports, 2024 Radiation-induced cystitis is an inflammatory condition affecting the urinary bladder, which can develop as a side effect of abdominopelvic radiotherapy, specifically external-beam radiation therapy or myeloablative radiotherapy. A possible involvement of mast cells in the pathophysiology of radiation-induced cystitis has been indicated in cases of external-beam radiation therapy; however, there is no evidence that these findings apply to the myeloablative aetiology. As such, this study investigated potential changes to urinary bladder mast cell prevalence when exposed to myeloablative radiation. Lethally irradiated C57BL/6J mice that received donor rescue bone marrow cells exhibited an increased mast cell frequency amongst host leukocytes 1 week following irradiation. By 4 weeks, no significant difference in either frequency or cell density was observed. However mast cell diameter was smaller, and a significant increase in mast cell number in the adventitia was observed. This study highlights that mast cells constitute a significant portion of the remaining host leukocyte population following radiation exposure, with changes to mast cell distribution and decreased cell diameter four weeks following radiation-induced injury.
Role, benefits, and risks of AMH testing for non-ART related indications Zoya Enakshi Ali, Claudia Massarotti, George Liperis, Mina Mincheva, Omar F Ammar, Julia Uraji, Antonio La Marca, Raj Mathur, Helen C O’Neill, Mariana Moura-Ramos, Juan J Fraire-Zamora Human Reproduction, 2024 The March ESHRE Journal Club discussion focused on a study by Copp et al. (2023) on the advantages and disadvantages of AMH testing, the misinterpretation of AMH levels outside an infertility treatment, the variability of AMH levels in different populations, and the impact of misleading media portrayal of DTC AMH tests on consumers.AMH, Anti-M ullerian hormone; DTC, direct-to-consumer.
Genome-wide association analyses of ovarian cancer patients undergoing primary debulking surgery identify candidate genes for residual disease Dhanya Ramachandran, Jonathan P. Tyrer, Stefan Kommoss, Anna DeFazio, Marjorie J. Riggan, , David Bowtell, Sian Fereday, Nadia Traficante, Jillian Hung, Penelope M. Webb, Peter A. Fasching, Diether Lambrechts, María J. García, Cristina Rodríguez-Antona, Marc T. Goodman, Francesmary Modugno, Kirsten B. Moysich, Beth Y. Karlan, Jenny Lester, Susanne K. Kjaer, Allan Jensen, Estrid Høgdall, Ellen L. Goode, William A. Cliby, Amanika Kumar, Chen Wang, Julie M. Cunningham, Stacey J. Winham, Alvaro N. Monteiro, Joellen M. Schildkraut, Daniel W. Cramer, Kathryn L. Terry, Linda Titus, Line Bjorge, Liv Cecilie Vestrheim Thomsen, , Michael Friedlander, Andreas Obermair, Peter Grant, Vanessa Beesley, Penelope Blomfield, Alison Brand, Alison Davis, Yee Leung, James Nicklin, Michael Quinn, Karen Livingstone, Helen O’Neill, Merran Williams, Tanja Pejovic, Claus K. Høgdall, Iain A. McNeish, Taymaa May, David G. Huntsman, Jacobus Pfisterer, Ulrich Canzler, Tjoung-Won Park-Simon, Willibald Schröder, Antje Belau, Lars Hanker, Philipp Harter, Jalid Sehouli, Rainer Kimmig, Nikolaus de Gregorio, Barbara Schmalfeldt, Klaus Baumann, Felix Hilpert, Alexander Burges, Boris Winterhoff, Peter Schürmann, Lisa-Marie Speith, Peter Hillemanns, Andrew Berchuck, Sharon E. Johnatty, Susan J. Ramus, Georgia Chenevix-Trench, Paul D. P. Pharoah, Thilo Dörk, Florian Heitz Npj Genomic Medicine, 2024 Survival from ovarian cancer depends on the resection status after primary surgery. We performed genome-wide association analyses for resection status of 7705 ovarian cancer patients, including 4954 with high-grade serous carcinoma (HGSOC), to identify variants associated with residual disease. The most significant association with resection status was observed for rs72845444, upstream of MGMT, in HGSOC (p = 3.9 × 10−8). In gene-based analyses, PPP2R5C was the most strongly associated gene in HGSOC after stage adjustment. In an independent set of 378 ovarian tumours from the AGO-OVAR 11 study, variants near MGMT and PPP2R5C correlated with methylation and transcript levels, and PPP2R5C mRNA levels predicted progression-free survival in patients with residual disease. MGMT encodes a DNA repair enzyme, and PPP2R5C encodes the B56γ subunit of the PP2A tumour suppressor. Our results link heritable variation at these two loci with resection status in HGSOC.
Cytocompatibility of electrospun poly-L-lactic acid membranes for Bruch's membrane regeneration using human embryonic stem cell-derived retinal pigment epithelial cells Naghmeh Abbasi, Helen O'Neill Journal of Biomedical Materials Research Part A, 2024 Cell replacement therapy is under development for dry age‐related macular degeneration (AMD). A thin membrane resembling the Bruch's membrane is required to form a cell‐on‐membrane construct with retinal pigment epithelial (RPE) cells. These cells have been differentiated from human embryonic stem cells (hESCs) in vitro. A carrier membrane is required for cell implantation, which is biocompatible for cell growth and has dimensions and physical properties resembling the Bruch's membrane. Here a nanofiber electrospun poly‐L‐lactic acid (PLLA) membrane is tested for capacity to support cell growth and maturation. The requirements for laminin coating of the membrane are identified here. A porous electrospun nanofibrous PLLA membrane of ∼50 nm fiber diameter was developed as a prototype support for functional RPE cells grown as a monolayer. The need for laminin coating applied to the membrane following treatment with poly‐L‐ornithine (PLO), was identified in terms of cell growth and survival. Test membranes were compared in terms of hydrophilicity after laminin coating, mechanical properties of surface roughness and Young's modulus, porosity and ability to promote the attachment and proliferation of hESC‐RPE cells in culture for up to 8 weeks. Over this time, RPE cell proliferation, morphology, and marker and gene expression, were monitored. The functional capacity of cell monolayers was identified in terms of transepithelial electrical resistance (TEER), phagocytosis of cells, as well as expression of the cytokines, vascular endothelial growth factor (VEGF) and pigment epithelium‐derived factor (PEDF). PLLA polymer fibers are naturally hydrophobic, so their hydrophilicity was improved by pretreatment with PLO for subsequent coating with the bioactive protein laminin. They were then assessed for amount of laminin adsorbed, contact angle and uniformity of coating using scanning electron microscopy (SEM). Pretreatment with 100% PLO gave the best result over 10% PLO treatment or no treatment prior to laminin adsorption with significantly greater surface stiffness and modulus. By 6 weeks after cell plating, the coated membranes could support a mature RPE monolayer showing a dense apical microvillus structure and pigmented 3D polygonal cell morphology. After 8 weeks, PLO (100%)‐Lam coated membranes exhibited the highest cell number, cell proliferation, and RPE barrier function measured as TEER. RPE cells showed the higher levels of specific surface marker and gene expression. Microphthalmia‐associated transcription factor expression was highly upregulated indicating maturation of cells. Functionality of cells was indicated by expression of VEGF and PEDF genes as well as phagocytic capacity. In conclusion, electrospun PLLA membranes coated with PLO‐Lam have the physical and biological properties to support the distribution and migration of hESC‐RPE cells throughout the whole structure. They represent a good membrane candidate for preparation of hESC‐RPE cells as a monolayer for implantation into the subretinal space of AMD patients.
Exploring the regenerative capacity of the spleen following irradiation Christie T. M. Short, Helen C. O’Neill, Jonathan K. H. Tan Frontiers in Hematology, 2024 IntroductionHaematopoietic stem cell transplantation (HSCT) is commonly used to treat patients with haematological disorders. Myeloablative conditioning is an important preparation for patients receiving haematopoietic stem cells (HSC) or haematopoietic stem and progenitor cells (HSPC). While widely successful, HSCT is still associated with high rates of mortality. The recovery time between complete myeloablation and haematopoietic recovery is a large factor in the recovery rate. Successful engraftment of HSC is also directly correlated with the number of HSC niches available. This highlights the importance of the haematopoietic niche and its recovery from myeloablation as an important therapeutic target.MethodsThis murine model study specifically considers changes in spleen tissue architecture and cellular composition involving stromal and vascular cells that occur following lethal irradiation.ResultsSpleen recovered fully between 4- and 8-weeks after irradiation due to reconstitution by HSPC from bone marrow. Specific temporal changes in spleen architecture were identified, and these were linked to the cell types that constitute the white pulp, red pulp and marginal zones. Mesenchymal stromal cells returned before endothelial cells, and reticular cell types recovered more quickly in spleen following irradiation. Losses in gp38+ fibroblastic reticular cells and MAdCAM-1+ marginal reticular cells were associated with loss of the white pulp in the first 4 weeks following irradiation. White pulp was restored following recovery of supporting reticular cells.DiscussionThis study tests how spleen regeneration following a lethal dose of irradiation can be influenced by co-infusion of bone marrow HSPC together with either neonatal spleen stromal cells, or cells of the stromal STX3 line. Both the infusion of neonatal spleen stromal cells and STX3 stromal cells hastened recovery of both mesenchymal and vascular compartments. Following neonatal spleen stromal cell infusion, endothelial cells increased early, but a delay in structural reformation of distinct red and white pulp areas was found. Results from this study show that spleen regeneration can be influenced and even hastened through cellular therapy. Neonatal spleen stromal cells, co-infused together with HSPC following irradiation conditioning, represent a potential therapeutic opportunity for hastening spleen regeneration.
Research ideas matter: Guidance for research students and early career researchers Keith Duncan, Adrian Gepp, Justin Craig, Helen O'Neill Pacific Basin Finance Journal, 2023 This paper draws on the collective experience of the authors as researchers, supervisors and editors spanning the fields of medical science, psychology, analytics, entrepreneurship, accounting, and finance. We provide guidance about research idea formulation for novice researchers, both Higher Degree Research students (HDRs) such as PhD students, and Early Career Researchers (ECRs). Drawing on parallels with business opportunity formulation, we break down the process into three steps: generating, refining and then evaluating research ideas. We present strategies to help generate high-quality research ideas, including five key perspectives for identifying gaps in the literature that are opportunities to be addressed with novel research ideas. We also provide advice for refining research ideas, and provide guidance on evaluating and ranking those ideas. Despite the diverse background of the authorship team, there are many commonalities because of the rigorous scientific nature of the general academic research process. Helpful research tools and templates, as well as examples and suggested readings, are also presented to assist novice researchers in the challenging process of forming research ideas.
GENOME EDITING IN HUMAN REPRODUCTION Helen C. O'Neill Textbook of Assisted Reproductive Techniques Volume 1 Laboratory Perspectives Sixth Edition, 2023 Clustered regularly interspaced short palindromic repeats (CRISPR)-based genome editing is a revolutionary technology that allows for precise and efficient manipulation of DNA sequences. Perhaps the most valuable use of genome editing will be in furthering our understanding of early human development, and the first licence was given to Niakan et al. to apply CRISPR/Cas9 to human embryos to interrogate the role of OCT4 in human embryo development. As such, in a bid to advance safe and effective electroporation-mediated genome editing protocols for humans, efforts are perhaps better focused on larger mammalian embryos. Base editing is a novel CRISPR-Cas9-based genome editing technology that allows the introduction of point mutations in the DNA without generating DSBs. Base editing is a type of genome editing that allows for precise changes to a single base in the genome without making a double-stranded break (DSB) in the DNA.
Reactions to the National Academies/Royal Society Report on Heritable Human Genome Editing Misha Angrist, Rodolphe Barrangou, Françoise Baylis, Carolyn Brokowski, Gaetan Burgio, Arthur Caplan, Carolyn Riley Chapman, George M. Church, Robert Cook-Deegan, Bryan Cwik, Jennifer A. Doudna, John H. Evans, Henry T. Greely, Laura Hercher, J. Benjamin Hurlbut, Richard O. Hynes, Tetsuya Ishii, Samira Kiani, LaTasha Hoskins Lee, Guillaume Levrier, David R. Liu, Jeantine E. Lunshof, Kerry Lynn Macintosh, Debra J.H. Mathews, Eric M. Meslin, Peter H.R. Mills, Lluis Montoliu, Kiran Musunuru, Dianne Nicol, Helen O'Neill, Renzong Qiu, Robert Ranisch, Jacob S. Sherkow, Sheetal Soni, Sharon Terry, Eric Topol, Robert Williamson, Feng Zhang, Kevin Davies Crispr Journal, 2020
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