Research Programs
Gynecologic Oncology
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, with the hope of expanding our knowledge as well as offering our patients unique treatments not offered elsewhere. Finally, our department is also investigating novel MUC1 vaccine agents in the attempt to prevent recurrence of ovarian cancer with some promising results.
Minimally Invasive Gynecologic Surgery and Benign Gynecology
The Section of Minimally Invasive Gynecologic Surgery and Benign Gynecology encompasses several specialty areas, including the Center for Menstrual Disorders, Fibroids and Hysteroscopic Services, the Center for Vulvar and Vaginal Health and the Chronic Pelvic Pain Program. Researchers in the Section of Minimally Invasive Gynecologic Surgery engage in a wide spectrum of clinical research to improve the care of patients with conditions such as abnormal uterine bleeding, pelvic pain and chronic vaginal conditions. Our research also focuses on predictors of surgical and postoperative complications and the prevention of surgical morbidity and mortality. Researchers collaborate with experts in interventional radiology, pathology and other related specialties to advance our knowledge of these conditions.
The Center for Menstrual Disorders, Fibroids and Hysteroscopic Services has internationally recognized gynecologic surgeons whose patient care and research is helping to change the field through collaborative research efforts in abnormal uterine bleeding, fibroids, endometriosis, adenomyosis and endometrial polyps.
The Center for Vulvar and Vaginal Health is dedicated to research that has the goal of improving the quality of life our patients who experience recurrent or chronic discharge, discomfort or other related symptoms. The research focus of this group is on the vaginal microbiome and recurrent vaginitis and is aimed at finding ways to prevent and manage these conditions.
The Chronic Pelvic Pain Program is dedicated to clinical and translational research focused on improving the lives of our patients. This research program emphasizes an interdisciplinary approach to the study of pelvic pain. Our clinician investigators collaborate with medical and surgical specialists from across the country and within Cleveland Clinic to increase our understanding and to optimize treatments for female pelvic pain disorders. Ongoing areas of study and interest include:
- A clinical trial that investigates the efficacy of an experimental electrical device for the treatment of chronic pelvic pain.
- A prospective clinical study evaluating the impact of novel surgical instruments for patients suffering from chronic pelvic pain
- A study evaluating the use of patient-reported outcome questionnaires in assessing chronic pelvic pain improvement
- Pelvic sensory discrimination mapping
- Mucosal sensitivity in Vulvar Vestibulitis Syndrome
Urogynecology and Reconstructive Pelvic Surgery
The Center for Urogynecology and Reconstructive Pelvic Surgery at 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, in addition to vulvovaginal disorders, such as genitourinary syndrome of menopause and perineal disorders. Highlights of current research activities include:
- Clinical trials evaluating the surgical and non-surgical management of stress urinary incontinence and pelvic organ prolapse. The Center strives to study innovative devices and procedures that will advance the care for women who suffer from pelvic floor disorders.
- Clinical studies evaluating minimally invasive treatments for pelvic floor disorders, including laparoscopic, robotic, and vaginal surgery with or without graft implantation.
- Clinical studies to evaluate medium and long-term outcomes of surgery for pelvic floor disorders, including complex surgery for combined vaginal and rectal prolapse.
- Studies to improve the classification and treatment of complications of transvaginal mesh procedures.
- Cleveland Clinic has recruited patients and served as the data coordinating center for a national multi-center study evaluating two minimally invasive procedures that allow women undergoing surgery for uterovaginal prolapse to avoid hysterectomy. Our center continues to study pelvic organ prolapse surgery for uterine preservation.
- Cleveland Clinic has participated in and is currently participating in multiple 522 studies for surgical treatment of urinary incontinence and pelvic organ prolapse, the Pelvic Floor Disorders Registry, and the Pelvic Floor Disorders Network.
- Clinical studies to evaluate postoperative opiate use after surgery for urinary incontinence and pelvic organ prolapse.
- Clinical studies evaluating methods to decrease urinary tract infections and decrease catheter use after surgery for urinary incontinence.
- Studies evaluating ways to measure and improve surgical competency and judgment among pelvic surgeons in training.
- Studies evaluating use of CO2 fractional laser surgery for genitourinary syndrome of menopause and other vulvar and vaginal disorders.
- Basic and translational research in pelvic floor disorders (www.lerner.ccf.org/bme/damaser).
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. The section also supports studies on other topics that residents may want to investigate. The following is a list of the areas of research our labs are currently pursuing:
- Use of time-lapse imaging and morphokinetics in the IVF lab to improve clinical outcomes
- Non-invasive techniques for assessing embryo vitality
- Preimplantation genetic diagnosis to understand association between embryonic multinucleation and euploidy
- Development of 3-D culture models for prolonged in vitro cultivation and maturation of mouse and human preantral ovarian follicles
- Study of extracellular matrix components and their role in folliculogenesis
- Derivation and feeder-free culture of embryonic stem cell lines
- Growth factor modulation of embryonic growth, blastocyst differentiation and apoptosis
- Testicular/epididymal sperm and impact on embryo developmental dynamics
- Development of methodology for single sperm cryopreservation
- DNA fragmentation and embryo development
- Characterization of endometrial secretions during the window of implantation
- Optimizing ovarian tissue cryopreservation and transplantation
- Role of microRNAs in endometriosis
- ADAMTS and myoma extracellular matrix
- Development of an anti-adhesion product for laparoscopic surgery
For more information on IVF Research please visit the Cleveland Clinic Beachwood Fertility Center.
Obstetrics and Maternal-Fetal Medicine
Researchers in the Section of Obstetrics and Maternal Fetal Medicine are committed to research that improves the health and wellbeing of women and children through a number of different areas, including:
- Genetic testing during pregnancy is a focus of our work. We are conducting a series of studies funded by the NIH to identify how to best integrate new prenatal genetic tests into patient care, including cell-free fetal DNA screening, one of the newest tests available to patients. Our goal is to find ways to help educate patients and doctors about these tests and then, ensure that patients can have effective discussions with their doctor about what test is right for them.
- A focus of our research is cardiovascular complications of pregnancy, with an emphasis on preeclampsia and the identification of factors that cause this condition as a way to develop new approaches to early diagnosis and intervention. Current studies are looking at the 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. In addition, we are studying the potential impact of new insights into the natriuretic peptide system on hypertensive disease in pregnancy. We will also begin collaboration with Lerner Research Institute researchers investigating APO1 mutations responsible for the increased risk of preeclampsia in African American women. On the clinical side, we will soon be recruiting patients for a multi-center prospective randomized trial on treatment of chronic hypertension in pregnancy and 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.
- Another focus is on how to optimize outcomes for women and children when an obstetric complication is identified. This includes studies looking at how to best plan for labor and delivery when a baby is diagnosed with meningomyelocele, one of the different types of neural tube defects that can be diagnosed early in pregnancy. We also have studies to help improve obstetric outcomes when a mother has diabetes or is diagnosed with this during her pregnancy. These studies will look at the effect of delayed cord clamping as a way to help babies thrive in the early days of life.
Specialized Women's Health
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 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 Cleveland Clinic's 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.
Global Women’s Health
The Section of Global Health is focused on how to best deliver high-quality, evidence-based healthcare to patients across the world, particularly in areas where women experience preventable diseases such as cervical cancer. Although preventable, cervical cancer is one of the leading causes of mortality for women in low and middle income countries. Researchers in the Section of Global Health focus on developing innovative and low-cost technologies adapted to detect, prevent, and treat precancerous lesions in resource-poor settings. Other projects conducted within the Section of Global Health include the development of an HPV self-sampling screening protocols to reach underserved women in Central American and China.
Family Planning
The Section of Family Planning is deeply committed to research focused specifically on contraception and abortion that exerts a sustained and significant impact on women’s health, reproductive advocacy and clinical practice. Our research team is dedicated to improving the overall quality of women’s health care by fostering innovative research and partnering with other Cleveland Clinic departments, institutes and organizations of excellence. This important multi-disciplinary collaboration allows for extraordinarily meaningful scientific input for the national and international reproductive health communities. Our projects currently center on investigating best practices in complex contraception, the use of LARC (Long-Acting Reversible Contraception) in the immediate post-partum period and post-abortive period, improving adolescent contraception, methods of abortion training and education, effectiveness of physician advocacy in protecting the reproductive rights of women, health care providers views on abortion, innovative policies to decrease the unintended pregnancy and neonatal mortality rates and new protocols for early pregnancy failure and post-abortion follow up procedures.
