Research in the section of gynecologic oncology has covered the gamut of gynecologic malignancies. We presently have phase 3 trials in ovarian, cervical and endometrial cancers, involving both national cooperative groups from the Gynecologic Oncology Group (GOG) as well as industry trials to assess the standard of care for these diseases. We are participating in phase 1 clinical trials nationally to evaluate cutting edge therapies for cervical and ovarian cancers, including antiangiogenic agents. Our clinical trials cover both primary therapy as well as recurrent disease in the hopes of expanding our knowledge of therapy as well as offering our patients unique treatments able to be not offered in the general community. Finally, our department is also investigating novel MUC1 vaccine agents in the attempt to prevent recurrence of ovarian cancer with some promising results.
Research activity in the section of maternal-fetal medicine primarily deals with the pathogenesis of preeclampsia. This includes the putative effects of progesterone on activation of vascular endothelial cells by TNFα, sFlt-1 and sEng, and the role of heme oxygenases and carbon monoxide system. Also, we are studying the potential impact of new insights into the natriuretic peptide system on hypertensive disease in pregnancy. On the clinical side, we continue to participate in the PCOR study (Pregnancy and Cardiovascular Outcomes Registry), which looks at the relationship between certain complications during pregnancy and the development of cardiovascular disease later in life. Finally, we continue to assess the impact of new protocols for aneuploidy screening and patient preferences.
Reproductive Endocrinology & Infertility
The Section of Reproductive Endocrinology and Infertility has an active and varied basic science and clinical research program. Residents at all levels of training are encouraged to participate in ongoing projects. We will also support studies on other topics that they may want to investigate. The following is a list of the areas of research our labs are currently pursuing.
- Development of 3-D culture models for prolonged in vitro cultivation and maturation of human preantral ovarian follicles.
- Study of extracellular matrix components and their role in folliculogenesis
- Derivation of embryonic stem cell lines using a novel feeder layer.
- Coculture models and identification of embryotrophic secretions
- Growth factor modulation of embryonic growth, blastocyst differentiation and apoptosis
- Non-invasive techniques including time-lapse photography and characterization of embryonic secretions for assessing embryo vitality and predicting clinical outcome
- Characterization of endometrial secretions during the window of implantation
- Optimizing ovarian tissue cryopreservation and transplantation.
- Development of methodology for single sperm cryopreservation
- DNA fragmentation and hyaluron binding for sperm selection for ICSI
- Role of oxidative stress in endometriosis
- Role of angiogenic stem cells on endometrial development and IVF success
For more information on andrology services at Cleveland Clinic Beachwood please visit the Andrology Laboratory Services at Cleveland Clinic Beachwood Fertility Center.
Center for Urogynecology and Reconstructive Pelvic Surgery
The Center for Urogynecology and Reconstuctive Pelvic Surgery at the Cleveland Clinic includes nationally and internationally recognized scientists and clinician-investigators performing basic, translational and clinical research dedicated to improving the understanding and treatment of pelvic floor disorders such as urinary incontinence, pelvic organ prolapse and fecal incontinence. Highlights of current research activities include:
- Our center is one of 8 clinical sites nationally in the NICHD Pelvic Floor Disorders Network (PFDN). Cleveland Clinic researchers serve as the Principal Investigator in two of the PFDN’s ongoing clinical trials. A list of PFDN studies can be found at www.pfdn.org.
- Clinical trials evaluating the surgical management of stress urinary incontinence and pelvic organ prolapse (see [link] for list of on-going clinical studies)
- Clinical studies evaluating minimally invasive treatments for pelvic floor disorders including laparoscopic and robotic surgery
- Studies to improve the classification and treatment of complications of transvaginal mesh procedures.
- The Cleveland Clinic is recruiting patients and serving as the data coordinating center for a national multi-center study evaluating two minimally invasive procedures that allow a women undergoing surgery for utervaginal prolapse to avoid a hysterectomy (add link to VAULT)
- Clinical studies evaluating methods to decrease utrinary tract infections and decrease catheter use after surgery for urinary incontinence.
- Studies evaluating ways to measure and improve surgical competency and judgement among pelvic surgeons in training.
The Center for Specialized Women’s Health encompasses holistic care of women, often with complex medical conditions, and provides cutting edge evidence based therapies. The research program emphasizes an interdisciplinary approach to the study of women’s health concerns. Collaboration between the multidisciplinary staff at the Center with a diverse group of clinicians from across the Cleveland Clinic and Case Western university allows for novel approaches and the dissemination of the latest breakthroughs in women’s health research. Our staff have worked along with the Case Western School of Dentistry to examine periodontal issues in women taking bisphosphonate therapy and with the Cleveland Clinic Department of Radiology to assess compliance with osteoporosis screening. Ongoing areas of study include treatment of osteoporosis, gynecologic concerns after bone marrow transplant, resident education, cervical cancer screening, sexual dysfunction, pelvic organ prolapse and stress incontinence. Additionally, Dr. Holly L. Thacker, MD, is the recipient of a $10,000 research grant from the Healthnetwork Foundation Service Excellence Awards, given annually to 10 top physicians who have consistently gone above and beyond for members. Dr. Thacker also is being recognized for demonstrating a long-term commitment to premium-level patient care and medical research.