J. Kresowik
University of Iowa Hospitals and Clinics
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Featured researches published by J. Kresowik.
Fertility and Sterility | 2011
J. Kresowik; Barbara J. Stegmann; Amy E.T. Sparks; Ginny L. Ryan; Bradley J. Van Voorhis
OBJECTIVE To report the outcomes of a program policy instituted in 2004 mandating single-embryo transfer (mSET) for all women aged <38 years, with at least seven zygotes, no prior failed fresh cycle at our center, and at least one good-quality blastocyst. DESIGN Retrospective cohort study. SETTING Academic medical center. PATIENT(S) All women <38 years old undergoing a fresh cycle with autologous oocytes and all women undergoing a fresh cycle with donor oocytes from June 1, 1999, to May 31, 2004 (before mSET) and from June 1, 2004, to May 31, 2009 (after mSET). INTERVENTION(S) mSET policy implementation. MAIN OUTCOME MEASURE(S) Live-birth rate, multiple pregnancy rate, clinical volume, and outcomes of all mSET fresh IVF transfers were analyzed. RESULT(S) Clinical volume was unchanged between the two time groups. After implementation of mSET, live-birth rates improved from 51.1% to 55.9% and multiple-birth rates dropped from 34.8% to 17.5%. A total of 364 mSET fresh transfers were performed with a live-birth rate of 64.6% and a multiple-birth rate of 3.4%. CONCLUSION(S) A mandatory SET policy based on prognostic factors can be instituted with no drop in clinical volume and no negative effect on delivery rates. Multiple gestation rates can be dramatically lowered.
Obstetrics & Gynecology | 2008
J. Kresowik; Ginny L. Ryan; Bradley J. Van Voorhis
BACKGROUND: Intrauterine progesterone therapy has been proposed as a potential uterine-sparing treatment for atypical endometrial hyperplasia and adenocarcinoma. CASE: We present a case of an infertility patient with atypical endometrial hyperplasia who was treated with the levonorgestrel-releasing intrauterine system for 6 months. At follow-up, she was noted to have an increasing endometrial thickness on ultrasonography, and biopsy revealed progression of her lesion to adenocarcinoma. CONCLUSION: Although there is a need for uterine-sparing treatment for atypical endometrial hyperplasia and early adenocarcinoma, especially in the setting of desired fertility, caution should be exercised. We do not recommend using the levonorgestrel-releasing intrauterine system as a treatment for atypical hyperplasia or adenocarcinoma until further studies demonstrate the efficacy of this treatment.
Biology of Reproduction | 2008
Stephanie L. Pierce; J. Kresowik; Kathryn G. Lamping; Sarah K. England
The mechanisms that control the timing of labor have yet to be fully characterized. In a previous study, the overexpression of small conductance calcium-activated K(+) channel isoform 3 in transgenic mice, Kcnn3(tm1Jpad)/Kcnn3(tm1Jpad) (also known as SK3(T/T)), led to compromised parturition, which indicates that KCNN3 (also known as SK3) plays an important role in the delivery process. Based on these findings, we hypothesized that SK3 channel expression must be downregulated late in pregnancy to enable the uterus to produce the forceful contractions required for parturition. Thus, we investigated the effects of SK3 channel expression on gestation and parturition, comparing SK3(T/T) mice to wild type (WT) mice. Here, we show in WT mice that SK3 transcript and protein are significantly reduced during pregnancy. We also found the force produced by uterine strips from Pregnancy Day 19 (P19) SK3(T/T) mice was significantly less than that measured in WT or SK3 knockout control (SK3(DOX)) uterine strips, and this effect was reversed by application of the SK3 channel inhibitor apamin. Moreover, two treatments that induce labor in mice failed to result in complete delivery in SK3(T/T) mice within 48 h after injection. Thus, stimuli that initiate parturition under normal circumstances are insufficient to coordinate the uterine contractions needed for the completion of delivery when SK3 channel activity is in excess. Our data indicate that SK3 channels must be downregulated for the gravid uterus to generate labor contractions sufficient for delivery in both term and preterm mice.
Ultrasound in Obstetrics & Gynecology | 2012
J. Kresowik; Craig H. Syrop; B.J. Van Voorhis; Ginny L. Ryan
To compare costs and complications associated with ultrasound‐guided hysteroscopy vs laparoscopy‐guided hysteroscopy vs hysteroscopy alone for the surgical repair of intrauterine septa and synechiae.
Journal of Pediatric and Adolescent Gynecology | 2014
Mary B. Rysavy; J. Kresowik; Dawei Liu; Lindsay Mains; Megan Lessard; Ginny L. Ryan
STUDY OBJECTIVE To compare sexual attitudes and behaviors of young women who have received or declined the HPV vaccine. DESIGN Cross-sectional survey. SETTING Obstetrics and gynecology and pediatrics clinics at a large, Midwestern, academic health center. PARTICIPANTS 223 young women (ages 13-24): 153 who had received HPV vaccination and 70 with no prior HPV vaccination. MAIN OUTCOME MEASURES Sexual behaviors; attitudes toward sexual activity. RESULTS Vaccinated young women were slightly but significantly younger than unvaccinated (mean age 19.2 vs 20.0). Both groups showed a large percentage of participants engaging in high-risk sexual behavior (75% vs 77%). The mean age at sexual debut was not significantly different between the groups (16.8 vs 17.0) nor was the average number of sexual partners (6.6 for both). Unvaccinated participants were more likely to have been pregnant (20% vs 8.6%, P = .016), although this difference was not significant in multivariate analysis CI [0.902-5.177]. Specific questions regarding high-risk sexual behaviors and attitudes revealed no significant differences between the groups. CONCLUSION We found that sexual behaviors, including high-risk behaviors, were similar between young women who had and had not received HPV vaccination. Our findings provide no support for suggestions that the vaccine is associated with increased sexual activity. Importantly, we found that young women in our population are sexually active at a young age and are engaged in high-risk behaviors, affirming the importance of early vaccination.
Biology of Reproduction | 2014
J. Kresowik; Eric J. Devor; Bradley J. Van Voorhis; Kimberly K. Leslie
ABSTRACT The window of implantation of human embryos into the endometrium spans Cycle Days 20–24 of the 28-day menstrual cycle. However, uterine receptivity may not be reliably replicated in infertile patients throughout this span. Thus, it is of importance to be able to determine optimal receptivity through a minimally invasive measure. We screened expression of a number of candidate micro-RNAs (miRNAs) in endometrial tissues and serum collected from a panel of fertile women during both the proliferative phase and the secretory phase of a normal menstrual cycle. We found that several miRNAs were significantly elevated in endometrial tissues in the secretory phase versus the proliferative phase. One of these, miR-31, was found to be not only detectable in serum samples but also significantly elevated in the secretory phase versus the proliferative phase. MiR-31 is known to target several immunomodulatory factors, such as FOXP3 and CXCL12. We find that both of these factors are significantly downregulated in endometrial tissues during the secretory phase. Our data suggest that miR-31 is a potential biomarker for optimal endometrial receptivity, possibly operating through an immunosuppressive mechanism.
Fertility and Sterility | 2012
J. Kresowik; Amy E.T. Sparks; Bradley J. Van Voorhis
OBJECTIVE To identify patient, cycle, and retrieval characteristics associated with embryo implantation and live birth in patients undergoing single embryo transfer (SET). DESIGN Analysis of prospectively collected IVF database. SETTING Academic IVF program. PATIENT(S) All patient cycles meeting criteria for SET between June 2004 and September 2010. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Clinical pregnancy and live birth. RESULT(S) Single embryo transfer was performed in 438 cycles, resulting in a clinical pregnancy rate of 76.2% and a live birth rate of 66.8% per transfer. Clinical pregnancy was associated with younger female age, ≥ 58% mature (metaphase II) oocytes at the time of retrieval, and increasing blastocyst expansion. Ongoing pregnancy was associated with younger female age and more advanced blastocysts. A diagnosis of uterine factor was negatively associated with live birth. CONCLUSION(S) Even in a favorable prognosis population, younger female age is associated with clinical pregnancy and live birth. Although all patients underwent blastocyst transfer, expanded and hatching blastocysts were strongly associated with pregnancy and live birth. A diagnosis of uterine factor was the only infertility diagnosis found to affect live birth after SET. Obesity did not negatively affect SET outcome. These findings may assist physicians in determining the best candidates for SET.
Fertility and Sterility | 2007
J. Kresowik; Ginny L. Ryan; J. Christopher Austin; Bradley J. Van Voorhis
Journal of Reproductive Medicine | 2007
J. Kresowik; Colleen M. Kennedy; Susan Wing; Rudolph P. Galask
Fertility and Sterility | 2009
J. Kresowik; Ginny L. Ryan; Craig H. Syrop; B.J. Van Voorhis