The Division of General Obstetrics and Gynecology provides family-centered care, from pregnancy to gynecological health, from adolescent through the post-menopausal age groups. We offer unique clinical programs to treat more complicated issues and concerns including pelvic pain, heavy menstrual bleeding endometriosis, vulvar disorders, sexuality, menopause, infertility evaluation, fibroids and many other OB-GYN concerns.

• Section of Family Planning – Our family planning program includes not only the provision of specialized clinical care but also a fellowship training program, ‘bench to bedside’ research activities, global clinical care and technical consulting, and policy and advocacy activities with the state of Oregon, the CDC and the World Health Organization. Our providers are leading specialists and researchers in the field of contraceptive and abortion medicine. Our nationally recognized program provides both routine and complicated family planning care to the women of Oregon but also directly at other clinical sites such as Downtown Women’s Center, Lovejoy Surgicenter and Planned Parenthood of the Columbia-Willamette.
• Program in Vulvar Health- this specialty clinic is one of the largest programs of its type in the United States and sees women from all over the west coast with complicated vulvovaginal disorders. It is one of the only clinics running trials in acupuncture, post-menopausal dyspareunia and therapy for psychosexual distress associated with painful intercourse. Our multidisciplinary team includes physicians, physical therapists, women’s health mental health providers and researchers devoted to these complicated disorders.
• Menopause & Sexual Medicine Program- This clinic specializes in sexual health care for menopausal women, using evidence-based allopathic and alternative medicine options. This unique model offers patients same day appointment with both a gynecologist and a psychiatrist and offers comprehensive treatment options including hormonal and non-hormonal treatments; sex therapy and group mindfulness-based therapy for low-libido
• Transgender medicine- This evolving program brings together a variety of surgical and medical disciplines to care for the transgender population of Oregon. This program is a multidisciplinary clinic that combines gynecology, family medicine, plastic surgery, urology and other supportive services.
• Spots, Dots and Clots- This clinic is a specialty clinic for the adolescent girl and pairs a contraceptive expert with a hematologist to care for young women with menstrual bleeding and clotting disorders.
• Fibroid Program-This multidisciplinary clinic provides care for women with fibroids, providing expertise in both surgical and non-surgical treatments. Along with interventional radiology and gynecology, patients have access to other related specialties such as reproductive endocrinology and infertility, oncology and complementary medicine. This clinic is the only one of its kind in Oregon and provides innovation in treatment using Minimally Invasive Surgery techniques, medication clinical trials, and non-surgical radiologic procedures such as high-intensity focused ultrasound (HIFU).

The Division of Gynecologic Oncology offers all aspects of care including diagnostic work-up, pre-treatment counseling and evaluation, surgical intervention, chemotherapy and long term follow-up care. Our oncology team is comprised of physicians, nurses, social workers, dieticians, physical therapists and counselors, all trained and committed to the total care of women with gynecologic cancers. Future efforts include a potential fellowship in gynecologic oncology and to continue to build the Division overall.

Some of the ways we are helping women throughout the community include:

• Leading HPV vaccination and cervical cancer screening efforts
• Genetic testing for women with ovarian-type cancers
• Laparoscopic assessment of resectability in ovarian cancer
• HIPEC: Hyperthermic IP chemotherapy
• Pelvic sentinel lymph nodes in endometrial cancer
• Intraoperative Radiation therapy
• West Coast Molecular Tumor Board
• Ovarian Cancer Registry
• Regional clinics in Salem, Medford, Warm Springs

OHSU’s Maternal-Fetal Medicine Division is committed to providing world-class high-risk obstetrical care in a patient-centered environment, educating future leaders and performing cutting-edge research.  Our group works closely with OHSU’s generalist OB-GYN team and midwives to together develop protocols and provide perinatal services when necessary. We also partner with regional providers, including organizations in Southwest Washington, Salem, and The Dalles to provide high-risk co-management.

• Fetal therapy program: OHSU’s Doernbecher Fetal Therapy Program is one of the nation’s most comprehensive fetal therapy programs and the only one of its kind in the Pacific Northwest. It provides multidisciplinary care, advanced prenatal diagnosis and treatment of birth defects. The program brings together a coordinated approach to address fetal abnormalities, from pregnancy through delivery. Within a single visit, a patient receives coordinated care from a team of obstetric, neonatal, and pediatric subspecialty providers, including experts in maternal-fetal medicine, pediatric cardiology, neonatology, neurology, fetal imaging, interventional radiology, genetics and bioethics.
• Maternal cardiac program:  The first and only program in the state to focus on the unique challenges of managing heart conditions and pregnancy, this clinic provides coordinated care from MFM and Cardiology experts to pregnant women with cardiac disorders.  We offer collaborative care from pre-pregnancy counseling to past-partum follow-through.
• Diabetes program: This comprehensive program involves coordinated care with Endocrinologists, nutritionists and MFM experts to aid patients through high risk diabetic pregnancies.  New endeavors include expanded use of continuous glucose monitors and a revised diet menu for hospitalized patients.

OHSU is a national leader in fertility research and clinical care. As part of a teaching and research university, our program offers leading-edge reproductive endocrinology and fertility treatments, such as in vitro fertilization (IVF), fertility preservation services, preimplantation genetic screening and an extensive clinical research program.  We serve patients both nationally and internationally.

The division’s mission is to provide outstanding, compassionate patient care to create families and supply cost-effective comprehensive reproductive services, all via a collaborative, team approach. Advancements in fertility are ongoing at OHSU, and our expertise ensures patients receive personalized, equitable, state-of-the-art-care. We offer among the highest success rates in the Pacific Northwest.

A key part of our program is its integration with related areas throughout OHSU, including genetics, psychology, maternal-fetal medicine, oncology, and internal medicine.

Services include:

• Egg donation
• Preimplantation genetic screening
• Gestational surrogacy
• Midlife women’s care
• Pediatric gynecology
• Fertility preservation
• Oocyte freezing
• Stem cell research
• Recurrent pregnancy loss evaluation and treatment
• Reproductive surgery, minimally invasive and robotic surgery
• Single embryo transfer
• Transgender medicine/transition services
• Wellness programs
• Complementary and alternative medicine

OHSU’S Urogynecology and Reconstructive Pelvic Surgery team provides the highest level of medical expertise for pelvic floor disorders. For more than 20 years, we have been dedicated to advancing the care, treatment and research for women’s pelvic floor disorders.

Our services include:

• Management of overactive bladder and urinary incontinence
• Evaluation and treatment of accidental bowel leakage
• Postpartum injury treatment
• Nonsurgical and surgical management of pelvic organ prolapse
• Dynamic pelvic floor imaging
• Neurophysiologic evaluations of the pelvic floor
• Robotic assisted laparoscopic sacrocolpopexy

We offer one of the top residency programs in the country, with more than 700 applicants vying for seven spots in each residency class. Residents are actively involved in the selection of the next class, for an emphasis on the right fit as well as skills and technical abilities.

Many graduates continue on to sub-specialty fellowships, with an overall acceptance rate of 95 percent or practice as general OB-GYN physicians—with a large number staying in Oregon. Future plans include adding curricular emphasis on advocacy, leadership and physician wellness and adding fellowships in reproductive endocrinology and gynecologic oncology.

OHSU requires a five-week clerkship in obstetrics and gynecology for all third-year medical students. ObGyn faculty is also involved in women’s health education throughout the four-year medical school curriculum. Our goal is that every student graduate from OHSU with the basic knowledge and understanding of women’s health to enable them to provide outstanding care for their women patients.

Rotations and electives include:

• Advanced gynecology obstetrics
• Family planning
• Gynecologic oncology
• Gynecology research
• Maternal-fetal medicine
• Reproductive endocrine infertility

OHSU is one of 31 leading universities in the United States offering a fellowship in family planning. The objective of the program is to develop specialists focused on research, teaching and clinical practice in contraceptive and abortion medicine.

We offer the only maternal-fetal medicine fellowship in Oregon. The fellowship is designed to introduce fellows to basic and clinical research as well as provide a strong basic background in clinical maternal-fetal medicine.  This is a 3 year program and there are currently 4 total fellows in training.

It provides ample research opportunities and inpatient and outpatient experience for those desiring a track in clinical perinatology, clinical, or translational research programs in infectious diseases, hypertension in pregnancy, ultrasonography, prematurity prevention and clinical proteomics.

We offer the only Urogynecology fellowship in the Pacific Northwest, and work with resident researchers in female pelvic medicine and reproductive surgery. Fellows interact with attending physicians at OHSU and Kaiser, both in the outpatient clinical setting and in the operating room.

OHSU was among the first to recognize the need for robotic surgery. Our robotic training curriculum is the only one of its kind in Oregon.

Developed to help guide uro-gynecology, oncology and general OB-GYN residents through rotation, the program currently provides “dry lab” training experiences, an online curriculum, a simulator available 24/7 and partnerships with community hospitals. The program also offers a dual-console operating machine, allowing for side-by-side teaching experiences. Future plans include the ability for residents to graduate with enough robotic surgeries to be “certified” (by Intuitive Surgical) by the time residency is completed.

Surgical competence is an essential skill for both medical students and residents training in an OB-GYN program. Most commonly, learner surgical skills are gained by observing and then performing surgeries in the operating room with training and supervision provided by a more experienced surgeon.  Yet with decreasing surgical case numbers and the need for increased surgical supervision, there is considerable variability in the acquisition of surgical skills.

OHSU has developed and implemented a formal OB-GYN surgical skills training program for medical students and residents. The curriculum uses a combination of bench exercises, realistic surgical models and animal models to teach both open and endoscopic surgical skills. The department also collaborates with VirtuOHSU, a simulation facility which provides a controlled setting and comfortable environment  for simulation and further development of technical skills and team training.

And because the practice of medicine doesn’t necessarily mean practicing on patients, the surgical skills curriculum in the OHSU Department of OB-GYN uses models to practice procedures including basic suturing and knot-tying, laparoscopy, abdominal and vaginal hysterectomy, hysteroscopy, IUD insertion, infant circumcision, cesareans, and laceration repair.

However, many models are cost-prohibitive. One-time use surgical models can cost up to $500 or more. So Meg O’Reilly, M.D., M.P.H. and OB-GYN surgical skills program director, along with her team, has developed innovative, creative models for a fraction of the cost.

For example, Dr. O’Reilly’s original cesarean model is comprised of layers of material that appropriately mimic the many layers: micro-suede for skin, quilt batting for tissue, muslin for fascia, felt for muscle, Lycra for peritoneal area, cup cozy fabric for the uterus, toile and plastic wrap for bladder.   Her innovative design has been utilized in many national teaching environments, including by the American Congress of Obstetricians and Gynecologists (ACOG) in its annual medical student surgical skills program held at the Annual Clinical Meeting.

Dr. O’Reilly works closely with medical students and residents to develop new models, such as their most recent innovative design mimicking a Bartholin cyst. Learners also serve as faculty in the instruction of simulation during American Congress of Obstetricians and Gynecologists (ACOG) meetings, and their work with Dr. O’Reilly has resulted in other presentations and publications for many of them.

Research in the Division of General Obstetrics & Gynecology includes efforts in family planning and contraceptive medicine, vulvar pain, medical education, women’s sexuality and gynecologic health.  Below are a few of our current grants and research programs:

• Contraceptive Research Center NIH U54 HD055744 P.I. Jeff Jensen, M.D.,M.P.H. This grant targets the discovery and development of novel nonhormonal contraceptive agents that act by preventing maturation and release of the oocyte, or fertilization, and the preclinical evaluation of promising candidates in the female nonhuman primate.
• Contraception Clinical Trial Network.  (Jeff Jensen, MD, MPH/Alison Edelman, MD, MPD co- PIs.  This NICHD contract provides a mechanism for the conduct of multicenter clinical trials to  evaluate investigational contraceptive agents.
• Women’s Reproductive Health Research Scholar (NIH 1K12HD085809, P.I. Aaron B. Caughey, recipient Maria I. Rodriguez, M.D., M.P.H.). “Examining the impact of health care reform on publicly funded family planning services in Oregon:” This K award investigates the effect of innovations such as pharmacist prescription of contraception, incentive metrics and the primary care home on contraceptive initiation and continuation.
• Department Mission Support Award, 20% matched FTE funding for 2016-2018. “Early clinical diagnosis in pregnancy of unknown location using uterine aspirate” P.I. Maureen K Baldwin, M.D., M.P.H. This bench research study examines potential biomarkers for use as a clinical diagnostic tool to localize very early abnormal pregnancy.
•  Medical Research Foundation of Oregon $50,000 “Mindfulness-based Group Cognitive Behavior Therapy for Women with Provoked Localized Vulvodynia-A Randomized Pilot Study” P. I. Catherine M. Leclair, M.D.  This randomized clinical trial compares two treatments for the psychosexual distress women endure who have painful sexual intercourse.

OHSU has international recognition as a frontrunner in contraceptive development and research.  We strive to make contraception more effective, easier to use, and to increase options available to all women through discovery and development of novel approaches. We are the only university in the United States that has a National Institutes of Health (NIH)-funded grant for basic research in contraceptive development as well as a NIH-funded grant supporting clinical trials for new female contraceptive methods and technologies.

• Obesity and Birth Control. Initial early work, led by OHSU’s Alison Edelman, M.D., M.P.H. and her team shows there may be a difference in the efficacy of the birth control pill for women who are at a higher weight or BMI level.
• Emergency contraception. Evaluation of the pharmacokinetics and pharmacodynamics of ulipristal acetate and levonorgestrel EC.  Our center is the only center currently evaluating the interaction of obesity and failure of EC.
• Non-hormonal contraception. The NICHD-funded U54 Contraception Development Research Center at ONPRC explores normal contraceptive mechanisms.
• New IUD studies. Following successful industry clinical trial evaluations of the LNG-IUS Mirena™, we have participated in trials of the low-dose Skyla™ system and the comparator 52 mg Liletta™ LNG IUS.  New copper IUDs are also under study.

The mission of OHSU’s Division of Gynecologic Oncology is to improve and guarantee the quality of what can be achieved in gynecologic cancer care for all women, and create opportunities to join in research that is meaningful to them. Our close connection with the Knight Cancer Institute allows us extensive research opportunities, and we are uniquely placed to bring the latest discoveries from the lab to patient care.

The key is to halt gynecologic cancers before they start, and a good deal of our research is dedicated to early detection and prevention. We are involved in extensive clinical gynecologic oncology research, including possible vaccinations for ovarian cancer and early detection programs. This involves outreach efforts to help women understand the importance of early measures that can keep them healthy. Below are a few of our current grants and research programs:

• Fanconi/BRCA DNA repair pathway and the role of hypoxia
• Hypoxia signaling pathways and targeted therapies in ovarian cancer and drug resistance
• General hypoxic signaling mechanisms in reproductive biology
• OCTRI KL2: Pilot study evaluating HPV Subtypes among AI/AN women
• Clinical Trial: Phase Ib, DPX-Survivac vaccine
• Clinical Trial: Phase I TSR-042, anti-PD-1 monoclonal AB
• Clinical Trial: Phase II TPIV200, Folate Receptor α vaccine
• Clinical Trial: Phase II/III CA 4P. Fosbretabulin, vascular disrupting agent
• Clinical Trial: 3D-Predict Registry, Ex vivo 3D cell culture

We are the largest maternal-fetal medicine group in Oregon and publish more research than any other MFM program in the United States. We provide research opportunities from basic science to translational projects, bolstered by the Oregon National Primate Research Center (ONPRC) and a broad infrastructure to support bio-statistics. We have received multiple NIH grants and our faculty members frequently lead national and international research studies. Current research efforts include laboratory studies, translational studies at the primate center, and clinical trials. Below are a few of our current grants and research programs:

• The Optimal Management of the Second Stage (OMSS) trial is a multi-center trial at Washington University, University of Alabama-Birmingham, University of Pennsylvania, and OHSU. The randomized trial is designed to ascertain the impact of timing of pushing during the second stage of labor and the long-term impact on the pelvic floor.

As part of the pelvic floor disorders network (PFDN) , a National Institutes of health (NIH)-sponsored multicenter group, we are actively involved in studying conditions such as:

• Imaging studies: How the brain and bladder communicate, behavioral neuroscience and the mind-body experience
• Treatment for overactive bladder, stress incontinence and fecal incontinence
• Pelvic floor mesh placement

The Ob/Gyn Mission Support Award (MSA) was established in 2011 and is uniquely designed to allow for protected time for faculty to participate in OHSU’s academic missions of clinical care, education, research and policy / outreach. Faculty leading an MSA effort are supported by mentors and committees who provide collaboration and feedback The MSA is designed to provide a recipient with between 10-20 percent protected time, or the budgetary equivalent, to devote to a specially designed project that contributes to the academic mission and furthers the personal academic goals of the recipient.  Any primary appointed faculty member of the Department of Obstetrics and Gynecology at OHSU is eligible to apply.

Recently funded projects have included:

• Use of EMR to Improve Contraceptive Usage among Medically Complex Women
  “Impact of Metabolic Changes across Gestation on Successful Exclusive Lactation
• Development of the OHSU CWH Menopause and Sexual Medicine Program
• A RaDefinitive non-Classical I Human Leukocyte Antigen expression and genotype of abnormal human pregnancy: HLA-F, E, G, and C in Preeclampsia, PTL and IUGR.ndomized Study of an Alternate Dosing Protocol for Magnesium Sulfate in Obese Preeclamptic Women
• Structured screening for risk stratification and targeted interventions for prevention of the main adverse obstetric outcomes and improvement in maternal and perinatal health
• A Randomized Study of an Alternate Dosing Protocol for Magnesium Sulfate in Obese Preeclamptic Women
• Functional changes in Hippocampal Synaptic Strength and Long-Term Potentiation in Survivors of Preterm Birth
• Transgender Health Program