Clinical Care

In Vitro Fertilization (IVF)

We have a proven and consistent record of pregnancy success and program integrity in our IVF center. We pride ourselves on innovative, effective, and ethical clinical care for the >300 patients undergoing egg retrievals and >150 patients undergoing frozen embryo transfers each year. We also have active and FDA-compliant third party IVF programs, including donor gamete, donor embryo and gestational surrogacy programs.  We are particularly proud of our leading role in decreasing the number of multiple gestation IVF pregnancies through innovative work in single embryo transfer.

Our IVF and Reproductive Testing Lab Director, Amy Sparks PhD, is a recognized leader in the field of clinical embryology. Dr. Sparks is a certified High Complexity Lab Director and College of American Pathologists (CAP) inspector, and our lab has been continuously CAP certified. Our lab performs the full range of standard IVF procedures including ICSI, assisted hatching, blastocyst culture, embryo cryopreservation, and biopsy for preimplantation testing. Through our laboratory, fellows are exposed to the latest IVF and embryology techniques and to cutting edge laboratory quality control practices to maintain excellent IVF results. Dr. Sparks also actively participates in research projects in the Division, including collaborative projects with fellows that utilize follicular fluid, spent media, and donated embryos.

Gynecologic Ultrasonography

A strong experience in ultrasonography is essential for fellows to appropriately evaluate reproductive tract abnormalities and to perform high quality IVF. Our clinical resources include a fully accredited ultrasound unit which performs all of the gynecologic and early obstetrical ultrasonography for the entire University of Iowa Hospitals and Clinics. Last year this included over 4,000 ultrasounds. Our sonographers are actively engaged in teaching ultrasound skills to residents and fellows, and regularly participate in research studies investigating ultrasound methods or outcomes. Fellows are not responsible for independently performing an excessive number of ultrasound scans but instead are guided through a moderate number of studies on their way to independent practice.

We have utilized our excellent ultrasound unit for clinical investigation, including some of the initial studies on high frequency transvaginal ultrasonography and its use in detecting abnormalities of the reproductive tract. For example, we published the first series of saline infusion sonography (SIS) in the United States and the initial observations on the use of ovarian volume in predicting stimulation and pregnancy following IVF. We also published the first observation that color Doppler studies can be used to aid in the diagnosis ovarian torsion following ovarian hyperstimulation, the phenomenon of uterine diverticula from C-sections as a source of abnormal uterine bleeding, and the natural history of uterine polyps and fibroids. All of this active clinical and investigative work results in excellent training opportunities for our fellows.

Reproductive Endocrinology Surgery

Fellows in our program have superior exposure to surgical procedures in REI and in Pediatric and Adolescent Gynecology. As a referral center, we see complex surgical cases including severe endometriosis, Müllerian anomalies and uterine fibroids. In fact, our REI faculty members staff our department’s Fibroid Clinic, providing a solid experience with this disease and its surgical opportunities. Although laparoscopic surgical procedures are decreasing in our field due to improving success rates with IVF, we still perform more than an adequate number of these cases to provide fellows with excellent exposure. We have state of the art laparoscopic and hysteroscopic equipment for the performance of difficult endoscopic surgery, and all of our staff members are fully trained in endoscopic and robotic surgery. With this experience and our support for SREI-sponsored surgical training workshops, fellows are expected to become excellent endoscopic surgeons during their training.

Clinical Reproductive Endocrinology and Pediatric/Adolescent Gynecology

Fellows benefit from a large patient volume from a wide catchment area while they are on clinical rotations in REI, where we saw >1,000 new patients and  >6,000 return patients this past year. The Pediatric and Adolescent Gynecology Clinic is also administered through the REI Division, and this clinic saw >200 new patients this past year. Fellows benefit from strong collaborative partnerships with Internal Medicine, Pediatrics, and Urology, as they spend time in Medical Endocrinology, Pediatric Endocrinology and Male Infertility clinics learning pertinent subspecialty care from experts who also contribute to didactic teaching. Fellows spend approximately one day each month of their clinical rotations working with a faculty member in our outreach clinic and affiliated operating suite. This gives them invaluable experience with a blended academic / private practice model of REI care.