Division of Reproductive Endocrinology and Infertility

The Division of Reproductive Endocrinology and Infertility at the University of Iowa is very active clinically and is proud of our highly successful IVF Program. We have one of the highest rates of single embryo transfer with IVF in the country and continue to maintain outstanding pregnancy rates while reducing multiple rates leading to safer IVF treatment. In addition to our IVF and regular Reproductive Endocrinology clinics, we have a Pediatric and Adolescent Gynecology Clinic, a Fertility Preservation Program, and a Uterine Fibroid Clinic

Division of Gynecologic Oncology

The Division of Gynecologic Oncology at the University of Iowa provides comprehensive care for women with gynecologic malignancies. The Gynecologic Oncology Division is part of the Holden Comprehensive Cancer Center with clinical services located on the third floor of the Pomerantz Family Pavilion within the Women’s Health Clinic in the Department of Obstetrics and Gynecology. Our clinicians are highly experienced in robotic, laparoscopic, and open surgical procedures and base their approach on individual considerations for each case. As a long standing full member of the Gynecologic Oncology Group and a Phase I institution we actively participate in clinical trial enrollment, which includes in-depth knowledge of the design and implementation of clinical trials research. Additionally we have a strong basic science and translational research component

Division of Reproductive Endocrinology and Infertility

The Reproductive Endocrinology Division at the University of Iowa consists of five physicians, one physician assistant and two fellows in training. We also recently partnered with Dr. Paul Figge in the Quad Cities to perform outreach to patients in that area. From the clinical side, we remain quite active with both medical and surgical treatment of the full gamut of reproductive endocrinology and infertility conditions. We have a very active and highly successful IVF Program and one of our major emphases is on single embryo transfer leading to improved safety for IVF treatments. Two other clinical initiatives are a Pediatric and Adolescent Gynecology clinic run by Dr. Ryan and a new emphasis on fertility preservation which is being led by Dr. Barbara Stegmann

Risk of Early & Late Obstetric Complications in Women with IVF- Conceived Pregnancies and Polycystic Ovary Syndrome (PCOS)

There is conflicting evidence on the association between PCOS and early and late obstetric complications. It is unclear if the reported risks are independent of BMI, preexisting hypertension and diabetes. We performed a retrospective chart review to examine the risk of early and late obstetrical complications after IVF in women with PCOS (n=130) compared to controls (n=130). The miscarriage rate was 17.7% in PCOS women and 15.4% in controls. PCOS was not associated with miscarriage independent of age and BMI. The prevalence of gestational DM (GDM) was similar in both groups (12% PCOS versus 11% controls). BMI was independently associated with GDM (p=0.01). Risk of both preeclampsia and PIH was 10% in PCOS and 5% in controls, but not statistically significant. Preexisting HTN showed a significant association with preeclampsia (

Risk of Early & Late Obstetric Complications in Women with IVF- Conceived Pregnancies and Polycystic Ovary Syndrome (PCOS)

There is conflicting evidence on the association between PCOS and early and late obstetric complications. It is unclear if the reported risks are independent of BMI, preexisting hypertension and diabetes. We performed a retrospective chart review to examine the risk of early and late obstetrical complications after IVF in women with PCOS (n=130) compared to controls (n=130). The miscarriage rate was 17.7% in PCOS women and 15.4% in controls. PCOS was not associated with miscarriage independent of age and BMI. The prevalence of gestational DM (GDM) was similar in both groups (12% PCOS versus 11% controls). BMI was independently associated with GDM (p=0.01). Risk of both preeclampsia and PIH was 10% in PCOS and 5% in controls, but not statistically significant. Preexisting HTN showed a significant association with preeclampsia (

Adnexal torsion in a patient with Müllerian agenesis undergoing ovarian stimulation: a case report

Background: As assisted reproductive technologies become increasingly available to patients, more women with Müllerian agenesis may undergo ovarian stimulation and oocyte retrieval to have genetically-related offspring. The risk of ovarian torsion is increased in patients utilizing assisted reproductive technologies compared to patients who do not undergo these treatments. Case: A 25-year-old G0 with Mayer-Rokitansky-Kuster-Hauser syndrome presented to the emergency room two days after oocyte retrieval with an acute abdomen. During laparoscopy, she was found to have torsion of her left ovary. Summary and Conclusion: As more young women with Müllerian agenesis present for fertility treatment, this anatomically unique patient cohort may be at an especially high risk for ovarian torsion. Physicians should recognize this risk and counsel their patients on this risk when discussing fertility options in patients with Müllerian agenesis

Thin endometrial lining during frozen embryo cycles: a case-control study of risk factors and natural history

Objective: To identify predictors of thin endometrial lining in the first frozen embryo transfer cycles and to characterize the natural history of this condition over subsequent cycles. Design: Retrospective case-control study Conclusions: This study shows that prognosis after a diagnosis of thin endometrial lining is favorable. Lower weight and thinner fresh cycle lining are predictors of thin endometrial lining in FET cycles. Most importantly, women with a diagnosis of thin endometrial lining have similar live birth rates as those with adequate endometrial lining, although their time to achieve live birth is slightly longer

Anti-Müllerian Hormone concentration levels in maternal plasma during the first, second and third trimester of pregnancy

Follicle-Stimulating Hormone (FSH) drops rapidly in pregnancy but Anti-Mullerian Hormone (AMH) has not been shown to drop until about 12 weeks. Since the follicles that secrete AMH are thought to be FSH independent, AMH levels should slowly decline in the absence of FSH because when the follicles reach FSH dependence, they would die off. A study has presented data that suggests a decline in AMH levels suddenly starts at 12 weeks gestation. The present study agrees with a decline in AMH after the first trimester. There is a sharp decline in AMH at 12-16 weeks gestation indicating that the follicular development is actively suppressed, not passively lost because of a drop in FSH. It appears that pregnancy may be a unique situation in regards to AMH

Anti-Müllerian Hormone concentration levels in maternal plasma during the first, second and third trimester of pregnancy

Follicle-Stimulating Hormone (FSH) drops rapidly in pregnancy but Anti-Mullerian Hormone (AMH) has not been shown to drop until about 12 weeks. Since the follicles that secrete AMH are thought to be FSH independent, AMH levels should slowly decline in the absence of FSH because when the follicles reach FSH dependence, they would die off. A study has presented data that suggests a decline in AMH levels suddenly starts at 12 weeks gestation. The present study agrees with a decline in AMH after the first trimester. There is a sharp decline in AMH at 12-16 weeks gestation indicating that the follicular development is actively suppressed, not passively lost because of a drop in FSH. It appears that pregnancy may be a unique situation in regards to AMH

Laparoscopic Management of Chemical Peritonitis Caused by Dermoid Cyst Spillage

Early recognition and prompt treatment with removal of dermoid cyst content and peritoneal lavage can be successful in the management of‘ chemical peritonitis secondary to spillage of cyst content during surgery