Pediatric and Adolescent Gynecology (PAG) is uniquely qualified to meet the Eunice Kennedy Shriver National Institute of Child Health and Human Development mission: to “understand human development, improve reproductive health, enhance the lives of children and adolescents.”

Vision

To create a comprehensive and innovative pediatric and adolescent gynecology program within the NICHD which encompasses community clinical and research resources. This program integrates regional clinical care with a post-graduate training program to populate primarily human clinical studies of gynecologic disorders that begin before puberty, to understand both childhood and adult gynecologic disease and fertility.

Aims

Pediatric and adolescent gynecology (PAG) is a young clinical subspecialty that addresses significant gaps in gynecologic care in children and individuals with rare diseases. Clinical and translational research in PAG also addresses gaps regarding gynecologic health and fertility but is currently in its infancy. Given that reproductive biology and fertility intersect with many other specialties including oncology, endocrinology, urology, genetics, and psychology, clinical care is often provided in multidisciplinary settings and research is inherently collaborative. In July 2019, Dr. Veronica Gomez-Lobo was recruited to lead a new and innovative Pediatric and Adolescent Gynecology Program within the Division of Intramural Research at NICHD to address these gaps. Upon her arrival, Dr. Gomez Lobo, and her team focused their efforts on three critical areas/aims that will synergistically grow research in reproductive health and improve gynecologic care and fertility for individuals with rare conditions:

Aim 1: Create a robust infrastructure to study rare PAG conditions which will enhance clinical care and the understanding of human diseases. Future research will involve deep phenotyping and genotyping of individuals with rare PAG conditions which will help inform clinical guidelines and allow for the discovery of biologic processes that will generate hypotheses regarding disease mechanisms.

Aim 2: Establish a translational research program with a laboratory focusing on fertility preservation and ovarian tissue research. We established three IRB-approved protocols that allow us to perform ovarian tissue cryopreservation and have contributed to a large human ovarian tissue repository. In collaboration with multiple fertility preservation research sites in the United States, we have created a large human ovary tissue digital image bank. Through these resources and national multidisciplinary collaborations, we have defined a new ovarian anatomy nomenclature and begun to elucidate possible mechanisms of follicle loss in individuals with classic galactosemia.  Future research will begin to explore the role of the immune system in ovarian biology. We hypothesize that the immune system is integrally involved in premature ovarian insufficiency.

Aim 3: Establish one of the premier clinical and research fellowships in PAG, to allow for improved care of children and adolescents with gynecologic conditions and continuation of research efforts in these critical areas through mentorship of the next generation of PAG leaders.

Together, these efforts in Pediatric and Adolescent Gynecology (PAG) are essential to achieve the Eunice Kennedy Shriver National Institute of Child Health and Human Development’s Mission: “to lead research and training to understand human development, improve reproductive health, enhance the lives of children and adolescents, and optimize abilities for all.”