- Obstetrics and Gynecology
- Fertility Preservation
Clinical Assistant Professor, Obstetrics & Gynecology - Reproductive Endocrinology & Infertility
Board Certification, American Board of Obstetrics and Gynecology, Reproductive Endocrinology and Infertility (2021)
Fellowship: Hospital of the University of Pennsylvania REI Fellowship (2019) PA
Board Certification: American Board of Obstetrics and Gynecology, Obstetrics and Gynecology (2017)
Residency: Hospital of the University of Pennsylvania Obstetrics and Gynecology Residency (2016) PA
Medical Education: Poznan University of Medical Sciences (1999) Poland
- Editorial: Uterine factors associated with fertility impairment. Frontiers in endocrinology 2023; 14: 1307237
Non-tubal ectopic pregnancies: Overview of diagnosis and treatment.
Fertility and sterility
Non-tubal ectopic pregnancies occur as a result of embryo implantation outside the uterine cavity and fallopian tubes. Sites include ovary, cervix, abdominal cavity, interstitial portion of fallopian tube, and cesarean scar. Non-tubal pregnancies are uncommon. Nonspecific signs and symptoms of non-tubal ectopic pregnancies make diagnosis challenging and in many cases significantly delayed, resulting in a high rate of morbidity. While surgical management remains the mainstay of treatment there is growing evidence that some of these can be managed medically or with the utilization of a combined medical and surgical approaches with good outcome. This review summarizes the current diagnostic modalities, therapeutic options, and outcomes for non-tubal ectopic pregnancies. Diagnostic and management options may be limited especially in resource-restricted settings. Therefore, an understanding of the available options is critical. It needs to be emphasized that the rarity of cases and the difficulties in organizing ethically justified randomized trials result in the lack of well-established management guidelines for non-tubal ectopic pregnancies.
View details for DOI 10.1016/j.fertnstert.2023.07.014
View details for PubMedID 37495011
- Timing of endometrial biopsy: Are we one step closer to the definition of chronic endometritis? Fertility and sterility 2022
Fertility Preservation for Transgender Males: Counseling and Timing of Treatment.
Obstetrics and gynecology
2022; 139 (6): 1012-1017
Fertility-preservation counseling in the transgender patient population is recommended by multiple organizations, including the American Society for Reproductive Medicine, the World Professional Association for Transgender Health, and the Endocrine Society. The optimal time to pursue fertility preservation has not been established, and data on potential effects of testosterone therapy on future reproductive potential are limited. This Current Commentary seeks to elucidate the most appropriate time to perform oocyte cryopreservation in relation to time on and off testosterone therapy, age of the individual, and emotional effect of treatment. Although there have been multiple studies that have demonstrated successful oocyte cryopreservation regardless of testosterone exposure, the data on live-birth rates after oocyte cryopreservation are limited. Moreover, the process of oocyte cryopreservation may have a significant negative emotional effect on the transgender male given the feminizing effects of gonadotropin stimulation, as well as the invasiveness of pelvic ultrasonograms and the oocyte-retrieval procedure. With our review, we demonstrate that a comprehensive, individualized approach to fertility-preservation counseling and timing to pursue treatment are essential. Postponing fertility-preservation procedures until patients have reached early adulthood might be considered to avoid the potential effect on mental health, without compromising outcomes.
View details for DOI 10.1097/AOG.0000000000004751
View details for PubMedID 35675598
Natural vs. programmed cycles for frozen embryo transfer: study protocol for an investigator-initiated, randomized, controlled, multicenter clinical trial.
2021; 22 (1): 660
Randomized trials of assisted reproductive technology (ART) have been designed for outcomes of clinical pregnancy or live birth and have not been powered for obstetric outcomes such as preeclampsia, critical for maternal and fetal health. ART increasingly involves frozen embryo transfer (FET). Although there are advantages of FET, multiple studies have shown that risk of preeclampsia is increased with FET compared with fresh embryo transfer, and the reason for this difference is not clear. NatPro will compare the proportion of preeclampsia between two commonly used protocols for FET,modified natural and programmed cycle.In this two-arm, parallel-group, multi-center randomized trial, NatPro will randomize 788 women to either modified natural or programmed FET and follow them for up to three FET cycles. Primary outcome will be the proportion of preeclampsia in women with a viable pregnancy assigned to a modified natural cycle FET (corpus luteum present) protocol compared to the proportion of preeclampsia in pregnant women assigned to a programmed FET (corpus luteum absent) protocol. Secondary outcomes will compare the proportion of live births and the proportion of preeclampsia with severe features between the protocols.This study has a potential significant impact on millions of women who pursue ART to build their families. NatPro is designed to provide clinically relevant guidance to inform patients and clinicians regarding maternal risk with programmed and modified natural cycle FET protocols. This study will also provide accurate point estimates regarding the likelihood of live birth with programmed and modified natural cycle FET.ClinicalTrials.gov NCT04551807 . Registered on September 16, 2020.
View details for DOI 10.1186/s13063-021-05637-3
View details for PubMedID 34579768
THE PREDICTIVE VALUE OF ESTRADIOL LEVEL IN EUPLOID NATURAL CYCLE FROZEN EMBRYO TRANSFER PREGNANCY OUTCOMES.
ELSEVIER SCIENCE INC. 2020: E286
View details for Web of Science ID 000579355300689