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Professor Nicky Hudson

Job: Professor of Medical Sociology

Faculty: Health and Life Sciences

School/department: School of Applied Social Sciences

Research group(s): Centre for Reproduction Research - Centre Director

Address: De Montfort, University, The Gateway, Leicester, LE1 9BH.

T: +44 (0)116 207 8766

E: nhudson@dmu.ac.uk

W: /hls

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Personal profile

Nicky Hudson is a medical sociologist with particular expertise in social and cultural significance of reproduction, infertility and assisted reproductive technologies. Her work also focuses on the sociology of chronic illness. Uniting these themes is an emphasis on intersectionalities and questions of individual-biomedicine-society relations. She has received funding for her work from the Economic and Social Research Council, the Wellcome Trust, Foundation for Sociology of Health and Illness and the National Institute for Health Research. Her research is characterised by a strong commitment to interdisciplinary collaboration, social translation and impact.

She leads the Centre for Reproduction Research, an interdisciplinary centre of expertise dedicated to the production of scholarship on the social, cultural and political aspects of human reproduction based in the Faculty of Health and Life Sciences. The Centre has representation from sociology, psychology, anthropology, science and technology studies, nursing, midwifery, health policy and health sciences.

Research group affiliations

Publications and outputs


  • dc.title: The emergence and use of expanded carrier screening in gamete donation: a new form of repro-genetic selection dc.contributor.author: Hudson, Nicky; Herbrand, C.; Culley, Lorraine dc.description.abstract: With the continued expansion and commercialisation of fertility treatments, the selection and matching of donors has become more sophisticated and technologised. As part of this landscape, new form of genetic screening: ‘expanded carrier screening’ (ECS) is being offered as a technique to avoid the risk of donors passing on genetic conditions to future offspring. Allowing donors to be tested for hundreds of genetic conditions simultaneously, ECS marks a considerable departure from traditional ‘family history’ models of screening, which rely on individual’s knowledge of family health. There is growing evidence of a drive towards the use of ECS within the fertility sector and a growing number of clinics are offering it for a fee, as part of an egg or sperm donation cycle or as an add-on to IVF treatment. In this paper we use methods of critical reflection to synthesise data from two studies to explore how ECS is being used to avoid genetic risk in IVF treatment using donor gametes. We suggest that ECS is a new form of repro-genetic selection – a selective reproductive technology - with specific and important implications for donors, recipients and clinicians, and with the potential to reconfigure the scope and application of gamete donation. We examine these implications and conclude that the existing policy blind spot relating to this development in fertility treatment practice needs to be urgently addressed.

  • dc.title: Artificial intelligence and assisted reproductive technology: Applying a reproductive justice lens dc.contributor.author: Homanen, Riikka; McBride, Neil; Hudson, Nicky dc.description.abstract: In recent years, health-data-driven artificial intelligence and machine learning applications have been introduced to many areas of medicine. In the field of assisted reproduction, artificial intelligence and machine learning applications and related technologies have been hailed as (potentially) significant and ground-breaking, not least because they promise standardisation and automation in in-vitro fertilisation clinics – a precondition for scaling up and branching out in the fertility bioindustry. Artificial intelligence data-driven algorithms promise time- and cost-effective selection of ‘high-quality’ reproductive cells and successful personalised treatments. In this essay, we aim to critically discuss artificial intelligence as a technological clinical practice, which is currently moving from bench to bedside internationally. Through an analytic framework of reproductive justice, we propose that introducing artificial intelligence into this already stratified context threatens to black-box health disparities and to generate what we refer to as ‘hyper-stratifications’ of reproduction in the context of rising health and social disparities in the European context. As feminist, social science and bioethics scholars, we are all too aware of how reproductive technologies reinforce normativities rather than unravel them. We cannot presume that artificial intelligence is an ethical technological agent or user of health data but, instead, need to keep a critical eye on the moral ambivalence of emerging and evolving artificial intelligence-assisted reproduction technologies practices and their gendered consequences. Given the current hype around artificial intelligence, but also with concerns around the fast development and deployment of artificial intelligence generally and in artificial intelligence-assisted reproduction technologies particularly in mind, there is an urgent need to engage in critical feminist discussion of such developments. dc.description: open access article

  • dc.title: Enabling Adults With Severe Asthma to Exercise: A Qualitative Examination of the Challenges for Patients and Health Care Professionals dc.contributor.author: Apps, Lindsay D.; Chantrell, Stacey; Majd, Sally; Eglinton, Elizabeth; Singh, Sally J.; Murphy, Anna C.; Green, Ruth H.; Hudson, Nicky; Bradding, Peter; Evans, Rachael A. dc.description.abstract: Background Adults living with severe asthma have lower physical activity levels, particularly high-intensity physical activity, compared with their healthy peers. Physical inactivity is associated with increased morbidity and mortality. Objective To understand patient and health care professional attitudes toward exercise and physical activity to inform future strategies for the improvement of healthy lifestyle behaviors, including exercise. Methods Participants recruited from a specialist difficult asthma service were interviewed individually, and health care professionals (HCPs) from primary care, secondary care, and a tertiary center were invited to attend focus groups. Interviews and focus groups were transcribed verbatim. We performed thematic analysis on interviews and focus groups separately, followed by an adapted framework analysis to analyze datasets together. Results Twenty-nine people with severe asthma participated in a semi-structured interview. A total of 51 HCPs took part in eight focus groups across the East Midlands, United Kingdom. Final analysis resulted in three major themes: barriers to exercise and exercise counseling - in which patients and HCPs identified disease and non-disease factors affecting those living with severe asthma; attitudes toward HCP support for exercise - highlighting education needs for HCPs and preference for supervised exercise programs; and areas for system improvement in supporting patients and HCPs - challenges exist across health sectors that limit patient support are described. Conclusions Patients identified the important role of HCPs in supporting and advising on lifestyle change. Despite a preference for supervised exercise programs, both patient and HCP barriers existed. To meet patients’ varied support needs, improved integration of services is required and HCP skills need extending. dc.description: open access article

  • dc.title: 'You feel like you’re drifting apart’: a qualitative study of impacts of endometriosis on sex and intimacy amongst heterosexual couples dc.contributor.author: Law, Caroline; Hudson, Nicky; Culley, Lorraine; Mitchell, Helene; Norton, Wendy dc.description.abstract: While a wide body of research reports the considerable impact endometriosis can have on sex for women with the condition, studies commonly use a quantitative design and often focus on dyspareunia. There has been a limited amount of qualitative research which includes partners and explores the broader impact on not only sex, but also intimacy and the couple relationship. This paper utilizes findings from the UK-based ENDOPART study which examined the impact of endometriosis on heterosexual couples, via in-depth interviews (n=44). The paper reports the complex ways in which endometriosis symptoms, including but not only dyspareunia, can impact upon sex, intimacy and the couple relationship, as well as partners’ emotional responses and the strategies they employed. It discusses specific and gendered ways in which heterosexual women and couples experience, navigate and manage these impacts in relation to conventions of menstrual etiquette, discourses of male sex drive and practices of emotion work. In demonstrating the range of impacts on women, partners and the couple relationship, and the importance of taking a couple-focused, relational and gendered approach, the paper will be of benefit to practitioners in healthcare and sex- and relationship-focused therapy working with women and couples living with endometriosis. dc.description: open access article

  • dc.title: Direct-to-consumer genetic testing and the changing landscape of gamete donor conception: key issues for practitioners and stakeholders dc.contributor.author: Gilman, Leah; Redhead, Caroline; Hudson, Nicky; Fox, Marie; Nordqvist, Peta; MacCallum, Fiona; Kirkman-Brown, Jackson; Frith, Lucy dc.description.abstract: Research question What impact does direct-to-consumer genetic testing (DTCGT) have on information sharing in relation to gamete donor conception? Design This study used in-depth qualitative interviews with parents through donor conception, donors, donors’ relatives and donor-conceived people who have used, or considered using, DTCGT. Interviews were conducted between September 2021 and February 2023. We interviewed 60 people who defined themselves as having been impacted by both donor conception and DTCGT. Fifty-seven of these were resident in the UK at the time of interview. The final sample included 19 (sperm, egg or embryo) donors, 25 donor-conceived people, 20 parents through donor conception and two relatives of donors. Five participants occupied more than one of these roles (hence the numbers do not total 60). Results Our research shows that the rise of DTCGT is affecting how information about donor conception is managed. DTCGT: 1) shifts patterns of knowledge about donor conception; 2) increases flexibility regarding the age of access to information about donor relatives; 3) can lead to a growing role for non-professionals, including wider family members, in gatekeeping information about donor conception; 4) accentuates the impact of donor conception for donors’ and donor-conceived people's relatives; and 5) shapes and is shaped by the formal regulatory donor information management systems. Conclusion Fertility professionals should inform people using, or considering, donor conception, or (potential) donors, about the different ways DTCGT can impact on sharing information about donor conception. Support is needed for those affected by these changes. dc.description: open access article

  • dc.title: The missed disease? Endometriosis as an example of ‘undone science’ dc.contributor.author: Hudson, Nicky dc.description.abstract: Endometriosis is a chronic gynaecological condition which has been referred to as the ‘missed disease’ due to its unclear aetiology and inconsistencies in its diagnosis and management. Unlike other long-term conditions such as diabetes and asthma, endometriosis has remained largely ignored in government policy and research funding globally. Drawing on scholarship from the growing field of ‘ignorance studies’, this paper considers how ambiguity around endometriosis is part of a wider constellation of discursive, material and political factors which enrol certain forms of knowledge whilst silencing, ignoring or marginalizing other forms of knowledge. It uses concepts of ‘undone science’ and ‘wilful ignorance’ to explore how an absence of knowledge on endometriosis is a result of structural, cultural and political processes and forces which privilege certain voices and communities. This paper suggests that the association of endometriosis with historically specific constructions of menstruation and women’s pain has informed contemporary imaginaries around the condition, including ideas about women being somehow accountable for their own illnesses. Applying an ignorance lens demonstrates how the legacy of invisibility of endometriosis shapes its place in the present political and social arena, and is reflective of a process of undone science. The paper concludes by arguing that the social and political significance of endometriosis as a chronic, life-limiting condition which affects millions of women globally continues to need attention, illumination and critique. dc.description: open access article

  • dc.title: Chronic Uncertainty and Modest Expectations: Navigating Fertility Desires in the Context of Life With Endometriosis dc.contributor.author: Hudson, Nicky; Law, Caroline dc.description.abstract: For the millions of women living with endometriosis, significant disruption to normative life expectations and a considerable impact on everyday life are common. Whilst for many women concerns about and experiences of infertility may be a central feature of life with the condition, little work has considered the impact that chronic illness has on reproductive decision-making or on the ways in which a medical condition is managed in relation to plans for conception. This chapter considers how heterosexual women with endometriosis and their male partners experience the intersection of fertility desires with the use of reproductive technologies (contraceptive and conceptive) and how these experiences intersect with the medical and surgical management of endometriosis. Three themes drawn from interview data are presented: the first considers how the uncertain and indeterminate character of endometriosis shapes imaginaries about future fertility, conception and childbearing. The second focuses on how endometriosis mediates expectations about the success of fertility treatments and technologies; exploring in particular the manifestation of low expectations in relation to possible success. The third theme considers how endometriosis and fertility pathways intersect, creating specific disruptions whereby fertility treatment may be delayed by endometriosis care, and where endometriosis care may be interrupted or paused by fertility desires. Our data show how endometriosis shapes reproductive desires, decision-making and experiences and has important implications for understanding how for those living with a chronic illness, plans for having children are made within a context of biographical and biomedical contingency.

  • dc.title: The experience of counselling for UK egg providers dc.contributor.author: Loyal, Sasha; Hudson, Nicky; Culley, lorraine; Weis, Christina dc.description.abstract: Objective The aim of this study was to address current gaps in knowledge regarding the appropriateness and quality of counselling provided to egg donors in the UK. Methods The present study used a cross-sectional, qualitative design. Semi-structured interviews were carried out with 29 UK egg donors to explore their experiences of egg donation and the counselling received. Results Of the 29 participants, 24 had received counselling. The remaining five did not receive counselling because they were either not accepted as a donor (n = 4) or were offered, but chose not to take up the session (n = 1). The findings are presented in relation to five themes: feeling supported via counselling; feeling well-informed; welcoming an individualised approach; the counselling setting; and thinking about the future. Conclusion Egg donors in this study had varying experiences of counselling offered to them as part of the egg donation process in the UK. Implications The findings indicate that there are some aspects of counselling in the UK that could be improved, including the routine offering of counselling throughout the egg donation process and the tailoring of counselling to meet egg donors' individual needs. dc.description: open access article

  • dc.title: Egg donation in the age of vitrification: A study of egg providers’ perceptions and experiences in the UK, Belgium and Spain dc.contributor.author: Lafuente - Funes, Sara; Weis, Christina; Hudson, Nicky; Provoost, Veerle dc.description.abstract: IVF treatment involving donated eggs increases yearly. Numerous technical and commercial transformations have reshaped how eggs are retrieved, stored and managed. A key transformation is vitrification; a ‘fast freezing’ method that allows efficient preservation of eggs, and therefore more flexibility in use, giving rise to new commercial possibilities. There has been limited focus on egg providers’ experiences in the context of vitrification and related commercialisation. We report findings from a study in the UK, Spain and Belgium, where we interviewed 75 egg providers. Comparing experiences within different donation ‘regimes’ allows an exploration of how varying national practices and policies shape information-giving and women’s experiences. In the UK, a system of ‘informed gift-giving’ was described, where egg providers saw their actions as not-for-profit and felt relatively well informed. In Belgium, the system was presented as ‘trusted tissue exchange’: with less information-giving than in the UK, but clinics were trusted to act responsibly. In Spain, a ‘closed-door, market-driven’ system was described, whereby egg providers received little information and expressed concerns about generation of excess profit. Our findings extend understandings of how egg donation is managed at the national level and how donation regimes produce specific experiences, expectations and subjectivities amongst tissue providers. dc.description: open access article

  • dc.title: Using Normalisation Process Theory (NPT) to develop an intervention to improve referral and uptake rates for self-management education for patients with type 2 diabetes in UK primary care dc.contributor.author: Turner, Jessica; Martin, Graham; Hudson, Nicky; Shaw, Liz; Huddlestone, Lisa; Weis, Christina; Northern, Alison; Schreder, Sally; Davies, Melanie; Eborall, Helen dc.description.abstract: Background Referral and uptake rates of structured self-management education (SSME) for Type 2 diabetes (T2DM) in the UK are variable and relatively low. Research has documented contributing factors at patient, practitioner and organisational levels. We report a project to develop an intervention to improve referral to and uptake of SSME, involving an integrative synthesis of existing datasets and stakeholder consultation and using Normalisation Process Theory (NPT) as a flexible framework to inform the development process. Methods A three-phase mixed-methods development process involved: (1) synthesis of existing evidence; (2) stakeholder consultation; and (3) intervention design. The first phase included a secondary analysis of data from existing studies of T2DM SSME programmes and a systematic review of the literature on application of NPT in primary care. Influences on referral and uptake of diabetes SSME were identified, along with insights into implementation processes, using NPT constructs to inform analysis. This gave rise to desirable attributes for an intervention to improve uptake of SSME. The second phase involved engaging with stakeholders to prioritise and then rank these attributes, and develop a list of associated resources needed for delivery. The third phase addressed intervention design. It involved translating the ranked attributes into essential components of a complex intervention, and then further refinement of components and associated resources. Results In phase 1, synthesised analysis of 64 transcripts and 23 articles generated a longlist of 46 attributes of an embedded SSME, mapped into four overarching domains: valued, integrated, permeable and effectively delivered. Stakeholder engagement in phase 2 progressed this to a priority ranked list of 11. In phase 3, four essential components attending to the prioritised attributes and forming the basis of the intervention were identified: 1) a clear marketing strategy for SSME; 2) a user friendly and effective referral pathway; 3) new/amended professional roles; and 4) a toolkit of resources. Conclusions NPT provides a flexible framework for synthesising evidence for the purpose of developing a complex intervention designed to increase and reduce variation in uptake to SSME programmes in primary care settings. dc.description: open access article


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Research interests/expertise

  • Sociology of reproduction, especially infertility, assisted reproductive technologies, gamete donation and freezing, surrogacy and cross border reproduction
  • Sociology of medicine
  • Chronic illness
  • Qualitative research methods

Areas of teaching

  • Gender, health and healthcare
  • Social Research Methods

Membership of external committees

 

Member. British Fertility Society, Law Policy and Ethics SIG (2021-)

Membership of professional associations and societies

  • Member of British Sociological Association
  • Convener of BSA East Midlands Medical Sociology Group
  • Member Society for Social Studies of Science (2015 - 2016)
  • Member ESHRE (2014-2015)
  • Member of International Sociological Association (2010-2014)  

Current research students

I supervise students on the following subjects:

  • Reproduction
  • Assisted Reproductive Technologies
  • Medicine
  • Chronic Illness

Externally funded research grants information


  • . Herbrand, Hudson (CI), Parry, Borry, Miedzybrodzka. ESRC £595,322.74. 01/02/23 – 31/01/26
  • ESRC £766, 670. Frith (PI), Hudson (CI), Fox, Nordqvist, McCallum, Kirkman-Brown. Feb 2021-Jan 2024
  • Egg Donation in the UK, Belgium and Spain: an interdisciplinary study. Hudson (PI) with Culley, Herbrand, Pennings, Provoost, Pavone. ESRC. £494,350. April 2017-March 2021. Grant ref. ES/N010604/1.
  • Digitizing Reproduction: new technologies, intersectionality and the politics of inclusion. Research Development Grant funded by the Foundation for the Sociology of Health and Illness. Mackkintosh, N. (PI), Hudson, N. (CI), Mcintosh, T. Sandall, J. and Verdezoto, N. £5952.38. April 2018 - June 2018.
  • Understanding Klinefelters Syndrome: genetics, gender and reproduction. The Foundation For Sociology of Health and Illness. Hanna, E. (PI), Hudson, N. (CI), McEleny, K. Stevenson, E. Quinten, R. Wilkes, S. and Herbrand, C. £4,682.20. Jan 2018 - July 2018. 
  • Increasing uptake of effective self-management education programmes for type 2 diabetes in multi-ethnic primary care settings.Programme Grants for Applied Research,NIHR. Davies, M (PI) et al, Hudson, N (CI). £2m. Nov 2015 - Oct 2020.
  • A feasibility study to inform the development of a multicentre randomised controlled trial of an asthma-tailored pulmonary rehabilitation programme versus usual care for individuals with severe asthma. Research for Patient Benefit Programme, NIHR. Evans, R (PI). Eglinton, E. Singh, S. Bradding, P. Apps, L. Martin, N. Green, R. Hudson, N. (CI) Povrod, I. £340K. Nov 2013 - Oct 2017.
  • A feasibility study to inform the design of a randomised controlled trial (RCT) to evaluate an interactive internet (web) based pulmonary rehabilitation programme. Research for Patient Benefit Programme, NIHR. PB-PG-0711-25127. Williams, J. (PI), Singh, S. Pulikottil-Jacob, R. Hudson, N. (qualitative consultant). £158K. Jan 2013-Jan 2015.
  • Endometriosis: Improving the Well-being of Couples. ESRC. ES/J003662/1. Culley (PI), Denny, Hudson (CI), Mitchell, Raine-Fenning. £89,228. 2011-13.
  • Increasing Physical Activity in Chronic Kidney Disease: The Patient Perspective. British Renal Society. Dr Alice Smith, Dr James Burton (PI), Dr Jo Byrne, Prof. Nigel Brunskill, Mrs Hannah Young. Dr Nicky Hudson (CI). £45K. Sept 2012-Aug 2013. 
  • Structured Education in Diabetes. NIHR Programme Development Grant. Prof Melanie Davies (PI), Prof. Kamlesh Khunti, Dr Marian Carey, Prof. L Culley, Prof M Johnson. Dr Nicky Hudson team member and PI for ÐßÐßÊÓƵ work package. £100K. May 2012-April 2013.
  • Management and Interventions for Asthma. HSR programme, NIHR. Prof. M Lakhanpaul (PI), Prof. L Culley, Prof. M Johnson, Dr. D Bird, Prof. Jonathon Grigg, Mrs Narynder Johal, Dr Noelle Robertson, Mrs Melanie McFeeters. Dr Nicky Hudson team member and PI for ÐßÐßÊÓƵ work package. £334K. Sept 2010- Feb 13. 
  • Barriers and Motivators to Implementation of an Intradialytic Exercise Programme. British Renal Society. Dr Alice Smith (PI), Dr James Burton, Dr Jo Byrne, Dr Noelle Robertson, Dr Nicky Hudson (CI) and Prof John Feehally. £18,775. Sept 2011-Aug 2012.
  • A Systematic Review of the Literature on Asthma and South Asians. Asthma UK. Dr Monica Lakhanpaul (PI), Dr Deborah Bird, Prof Lorraine Culley, Prof Mark Johnson. Project advisor. £27K. Oct 2010-April 2011. 
  • The Educational Experiences of Muslim Students on Pre-Registration Nursing and Midwifery Programmes East Midlands Healthcare Workforce Deanery, Dr Sue Dyson (PI), Prof. Lorraine Culley, Dr Nicky Hudson. June 2010-July 2011.
  • Transnational Reproduction. An Exploratory Study of UK Residents who Travel Abroad for Fertility Treatment (TRANSREP) ESRC, RES 000-22-3390. Culley (PI), Hudson, Blyth, Pacey, Rapport, Norton. £99,844. 1 March 2009 – 30 Nov 2010.
  • Regional Evaluation of the Pacesetters Programme (PACEVAL) Leicester City Primary Care Trust. Prof. Mark Johnson (PI), Prof Lorraine Culley, Ms Jennie Fleming, Dr Nicky Hudson, Dr Fenglin Guo. £78,946.81. May 2008 – October 2009.
  • Palliative Care for Children and Young People in Leicester, Leicestershire and Rutland: An Evaluation of Parents/Carers’ and Young People’s Perspectives of Service Provision. (PALLCARE) Leicester City West Primary Care Trust, L. Culley & N Hudson. £15K. February – September 2006.
  • Evaluation of Patient Information resources on Osteomalacia in Asian Languages (ARCOST) Arthritis Research Campaign, Prof. Mark Johnson (PI), Prof. Lorraine Culley, Dr. Ash Samanta, Dr Fenglin Guo, Dr Nicky Hudson. 2005-2006. 
  • ESRC, RES-160-25-0044. Prof. Lorraine Culley (PI), Prof. Mark Johnson, Prof. Frances Rapport, Dr Adi Bharadwaj. Dr Nicky Hudson, project researcher. £46, 577. April 05 – March 06. 
  • Ethnicity Infertility and Reproductive Technologies. International Symposium funded by ESRC, Science and Society Programme. Co-convenor with Prof. Lorraine Culley & Dr. Floor van Rooij. £7K. Nottingham, September 2006.
  • Improving the Access of Ethnic Minority Visually Impaired People to Appropriate Services: Building a Supported Community Referral System (OV2) Thomas Pocklington Trust, Prof. Mark Johnson (PI) et al. Nicky Hudson, team member. 2003-2004.
  • Europe's Migrants and Human Tissue Donation - ESF Exploratory Workshop (EUMIDON) European Science Foundation. Prof Mark Johnson (PI), Prof. Lorraine Culley, Dr Nicky Hudson. September 2004.
  • A Study of the Provision of Infertility Services to South Asian Communities (ASFERT) NHS Trent Region, Prof. Lorraine Culley (PI), Prof. Mark Johnson, Prof. Frances Rapport, Dr Savita Katbamna. Dr Nicky Hudson, project researcher. £100K. January 2002 – March 2004.

Internally funded research project information

  • Visualising Reproduction in Medical, Social and Historical Contexts: An Interdisciplinary Inquiry. ÐßÐßÊÓƵ's Revolving Investment Fund. Pichel, B (PI) and Hudson, N (CI). £2,410. Nov 2017 - July 2018. 

  • ENDOPART 2: developing a knowledge exchange partnership and improving support in endometriosis. ÐßÐßÊÓƵ's Higher Education Innovation Fund. Hudson, N (PI). Oct 2015 - July 2016.

  • Egg Donation in Europe: an international workshop. ÐßÐßÊÓƵ's Revolving Investment Fund. Hudson, N (PI). Oct 2014 - July 2015.

  • European network for research on men, in/fertilities and assisted conception. ÐßÐßÊÓƵ's Revolving Investment Fund. Culley, L (PI), Hudson, N (CI), Norton, W (CI). Oct 2011 - July 2012.

Nicky Hudson