Profile

Margarett Shnorhavorian, MD, MPH

Margarett Shnorhavorian, MD, MPH

Urology, Disorders of Sex Development

On staff since July 2006

Children's Title: Surgical Director, DSD Program

Academic Title: Assistant Professor of Urology, University of Washington; Director, Clinical Research

Research Center: Center for Clinical and Translational Research

Making A Difference

  • It's a Boy! Or Is It a Girl?

    The Disorders of Sex Development program offers patients the most innovative treatments and guides families as they face some of the most difficult decisions imaginable. ... cont.

Overview

Board Certification(s)

Urology
Pediatric Urology

Medical/Professional School

University of California San Francisco School of Medicine, San Francisco
University of California Berkeley, Berkeley

Residency

Urology, Yale New Haven Hospital, New Haven

Fellowship

Pediatric Urology, University of Washington School of Medicine, Seattle

Clinical Interests

Crytorchidism; prenatal hydronephrosis; urogenital reconstruction

Research Description

Ifosfamide, an alkalating agent structurally related to cyclophosphamide, is a newer chemotherapeutic agent whose toxicity profile has not been well studied. The hypothesis is that ifosfamide impairs fertility.

The main study airs include:

a) determine the toxicity profile by identifying the doses which increase risk of infertility;

b) identifying protective germ cell line polymorphisms in patients exposed to ifosfamide;

c) potential intermediate biomarkers of infertility in this group.

I will gather questionnaire data (regarding erectile dysfunction and infertility), biochemical evaluation, DNA analysis, and semen samples.

Research Focus Area

Epidemiology, Cancer

Awards and Honors

Award Name Award Description Awarded By Award Date
Prize Abstract Session Prize Abstract Session presentation American Urological Association National Meeting, Society of Pediatric Urology, "Fertility Preservation among Adolescent and Young Adult Cancer Survivors in the AYA HOPE Study," San Diego, California American Urological Association National Meeting, Society of Pediatric Urology May 13, 2013
First Place Clinical Research Award Section on Urology, National Conference & Exhibition American Academy of Pediatrics 2012
Southwest Oncology Group Young Investigator Award 2010
COG-AFLAC Young Investigator Award in Adolescent and Young Adult Oncology 2009
Male Reproductive Health Research Award NIH K-award 2008 - 2013
Third Prize Award "Pediatric Vaginal Trauma: Variability in Evaluation and Management Across Free-standing Pediatric Hospitals in the United States" American Urological Association, Western Section 2008

Publications

  • Keegan TH, Tao L, Derouen MC, Wu XC, Prasad P, Lynch CF, Shnorhavorian M, Zebrack BJ, Chu R, Harlan LC, Smith AW, Parsons HM, AYA HOPE Study Collaborative Group
    Medical care in adolescents and young adult cancer survivors: what are the biggest access-related barriers?
    Journal of cancer survivorship : research and practice , 2014 Jan. 10
  • Keegan TH, Tao L, Derouen MC, Wu XC, Prasad P, Lynch CF, Shnorhavorian M, Zebrack BJ, Chu R, Harlan LC, Smith AW, Parsons HM, AYA HOPE Study Collaborative Group
    Medical care in adolescents and young adult cancer survivors: what are the biggest access-related barriers?
    Journal of cancer survivorship : research and practice , 2014 Jan. 10
  • Akhavan A, Merguerian PA, Grady RW, Disandro M, Shnorhavorian M
    Digital photographic measurement in hypospadias: Validation and comparison to intraoperative measurement.
    Journal of pediatric urology , 2013 Nov. 7
  • Akhavan A, Merguerian PA, Grady RW, Disandro M, Shnorhavorian M
    Digital photographic measurement in hypospadias: Validation and comparison to intraoperative measurement.
    Journal of pediatric urology , 2013 Nov. 7
  • Margarett Shnorhavorian, MD, MPH
    Fertility Preservation Among Adolescent and Young Adult Cancer Survivors in the AYA HOPE Study
    American Urological Association National Meeting, Society of Pediatric Urology , 2013 May 3 : San Diego, California
  • Margarett Shnorhavorian, MD, MPH
    Long-Term Adverse Genito-Urinary (GU) Outcomes in Survivors of Childhood Cancer: A report from the Childhood Cancer Survivor Study (CCSS)
    American Urological Association National Meeting, Society of Pediatric Urology , 2013 May 3 : San Diego, California
  • Wilson CL, Ness KK, Neglia JP, Hammond S, Shnorhavorian M, Leisenring WL, Stovall M, Robison LL, Armstrong GT
    Renal carcinoma after childhood cancer: a report from the childhood cancer survivor study.
    Journal of the National Cancer Institute , 2013 Apr, 3 : 105(7)504-8
  • Margarett Shnorhavorian, MD, MPH
    External Masculinization Score (EMS) and the Success of Genetic Testing in a Cohort of 46, XY DSD Patients
    Podium, 1st Annual GME Research Day, Top Ten finalist research presentation , 2013 Apr,
  • Margarett Shnorhavorian, MD, MPH
    Health-related Quality of Life of Adolescent and Young Adult Cancer Patients in the United States: the AYA HOPE study
    J Clinical Oncology , 2013 Feb. 21
  • Margarett Shnorhavorian, MD, MPH
    Disorders of Sex Development
    In "Urological Emergencies: A Practical Approach, 2nd Edition." H Wessells (ed.) , 2013 : Springer, New York, New York
  • Margarett Shnorhavorian, MD, MPH
    Renal carcinoma following therapy for childhood cancer: A report from the Childhood Cancer Survivor Study
    J Natl Cancer Inst , 2012 Oct. 17
  • Margarett Shnorhavorian, MD, MPH
    Long-term Lower Urinary Tract Outcomes in Boys After Early Treatment of Posterior Urethral Valves
    Poster, American Academy of Pediatrics, New Orleans, Louisiana , 2012 Oct.
  • Margarett Shnorhavorian, MD, MPH
    Male Reproductive Health after Childhood, Adolsecent, and Young Adult Cancer: A Report from the Childrens Oncology Group
    J of Clinical Oncology , 2012 Sept. 20 : 30(27)3408-16
  • Margarett Shnorhavorian, MD, MPH
    Creating a Standardized Process to Offer the Standard of Care: Continuous Process Improvement Methodology is Associated With Increased Rates of Sperm Cryopreservation Among Adolescent and Young Adult Males With Cancer
    J of Pediatr Hematol Oncol , 2012 Sept. 13
  • Margarett Shnorhavorian, MD, MPH
    Positive and negative psychosocial impact of being diagnosed with cancer as an adolescent or young adult
    Cancer , 2012 Mar. 13 : doi: 0.1002/cncr.27512
  • Margarett Shnorhavorian, MD, MPH
    Evaluation and Management of Disorders of Sex Development: Multidisciplinary Approach to a Complex Diagnosis
    RadioGraphics , 2012 11 : 32(6)1599-618
  • Margarett Shnorhavorian, MD, MPH
    Transitioning patients with Disorders of Sex Development to Adult Care: The Role of The Pediatric Urologist
    J Urol , 2012 9 : 188(3)700-1
  • Margarett Shnorhavorian, MD, MPH
    Unintentional and sexual abuse related pediatric female genital trauma: A multi-institutional study of free-standing pediatric hospitals in the United States
    Pediatric Urology , 2012 8 : 80(2)417-22
  • Margarett Shnorhavorian, MD, MPH
    Practice variation and clinical confusion regarding undescended testes and retractile testes among primary care respondents: A multi-regional survey study in the United States
    Pediatr Surg Intl , 2012 6 : 28(6)635-639
  • Margarett Shnorhavorian, MD, MPH
    Ambiguous Genitalia: What Prenatal Genetic Testing is Practical?
    Am J of Med Genet A , 2012 6 : 158A(6)1337-43
  • Margarett Shnorhavorian, MD, MPH
    Responding to Adolescents with Cancer who Refuse Sperm Banking: When "No" Should Not Be the Last Word
    J of Adolescent and Young Adult Oncology , 2012 2 : 1(3)
  • Margarett Shnorhavorian, MD, MPH
    Can we Rely on the Presence of Dextranomer-Hyaluronic Acid Copolymer Mounds on Ultrasound to Predict Vesicoureteral Reflux Resolution After Injection Therapy?
    J of Urology , 2011 6 : 185(6 Suppl)2536-41
  • Margarett Shnorhavorian, MD, MPH
    Survivors of Childhood Cancer Have Increased Risk of Gastrointestinal Complications Later in Life
    Gastroenterology , 2011 5 : 140(5)1464-7
  • Shnorhavorian M, Song K, Zamilpa I, Wiater B, Mitchell MM, Grady RW
    Spica casting compared to Bryant's traction after complete primary repair of exstrophy: safe and effective in a longitudinal cohort study.
    The Journal of urology , 2010 Aug. : 669-73
  • Sorensen MD, Koyle MA, Cowan CA, Zamilpa I, Shnorhavorian M, Lendvay TS
    Injection volumes of dextranomer/hyaluronic acid are increasing in the endoscopic management of vesicoureteral reflux.
    Pediatric surgery international , 2010 May : 509-13
  • Margarett Shnorhavorian, MD, MPH
    Oncofertility: Ethical, Legal, Social, and Medical Perspectives edited by Teresa K. Woodruff, Laurie Zoloth, Lisa Campo-Engelstein, and Sarah Rodriguez
    Springer , 2010
  • Shnorhavorian M
    A rewarding experience for a pediatric urologist.
    Cancer treatment and research , 2010 : 485
  • Hidalgo-Tamola J, Shnorhavorian M, Koyle MA
    "Open" minimally invasive surgery in pediatric urology.
    Journal of pediatric urology , 2009 June : 221-7
  • Shnorhavorian M, Friedman DL, Koyle MA
    Genitourinary long-term outcomes for childhood cancer survivors.
    Current urology reports , 2009 Mar. : 134-7
  • Shnorhavorian M, Grady RW, Andersen A, Joyner BD, Mitchell ME
    Long-term followup of complete primary repair of exstrophy: the Seattle experience.
    The Journal of urology , 2008 Oct. : 1615-9; discussion 1619-20
  • Vemulakonda VM, Lendvay TS, Shnorhavorian M, Joyner BD, Kaplan H, Mitchell ME, Grady RW
    Metastatic adenocarcinoma after augmentation gastrocystoplasty.
    The Journal of urology , 2008 Mar. : 1094-6; discussion 1097
  • Margarett Shnorhavorian, MD, MPH
    Robotic-assisted laparoscopic Mitrofanoff appendicovesicostomy and antegrade continent enema colon tube creation in a pediatric spina bifida patient
    J Laparoendosc Adv Tech , 2008 4 : 18(2)310-12
  • Margarett Shnorhavorian, MD, MPH
    Maternal risk factors for congenital urinary tract anomalies: Results of a population-based case - control study
    J of Urology , 2008 4 : 179(4)355
  • Shnorhavorian M, Anderson KR
    Anatomic and physiologic considerations in ureteroscopy.
    The Urologic clinics of North America , 2004 Feb. : 15-20
  • Margarett Shnorhavorian, MD, MPH
    Medical care in adolescents and young adult cancer survivors: what are the biggest access-related barriers?
    J Clinical Oncology : Submitted June 20, 2013
  • Margarett Shnorhavorian, MD, MPH
    Use of Appropriate Initial Treatment Among Adolescents and Young Adults with Cancer: A Population-Based Study
    J Clinical Oncology : Submitted May 13, 2013
  • Margarett Shnorhavorian, MD, MPH
    Male infertility in long-term survivors of pediatric neoplasms: A report from the Childhood Cancer Survivor Study
    Human Reproduction : Submitted February 2013
  • Margarett Shnorhavorian, MD, MPH
    Surgical Hypospadias After Exstrophy (SHAE): Management and Outcomes
    J of Urology : Submitted May 13, 2013

Presentations

Presentations Title Event Location Date
Are genetic variants that influence testicular cancer risk also involved in hypospadias and undescended testes? A case-parent study Pediatric Urology Fall Congress Las Vegas, Nevada Sept. 20, 2013
From Cancer to Wellness: Fertility Preservation Cancer Survivorship Symposium, Seattle Childrens Hospital Seattle, Washington Oct. 27, 2012
Common urologic problems in girls and adolescents North American Society of Pediatric and Adolescent Gynecology National Meeting Miami, Florida April 2012
Pediatric Urology for the primary care provider Providence Physician Group Mill Creek, Washington Jan. 31, 2012
Ups and Downs of Testes: Evaluation and Management of Undescended Testes Clinicians Guide to Pediatric Urology: A Practical Update. Seattle Childrens Hospital, CME Level I Seattle, Washington Nov. 19, 2011
Modern Surgical Management of Urogenital Sinus and Cloaca Pediatric Surgery Department Conference, Hue Central Hospital Hue, Vietnam Oct. 2011
Seattle Childrens Hospital Center for Clinical and Translational Research External Review Research Presentation Seattle, Washington Sept. 19, 2011
Outcomes in Reproduction in Childhood and Adolescent Survivors: ORCAS an update Male Reproductive Health Research Award Symposium, University of Washington Seattle, Washington April 6, 2011
Disorders of Sex development: Consensus and Controversy Pediatric Urology Conference Seattle Children's Hospital Feb. 14, 2011
Complex Hypospadias Reconstruction Modern Techniques Department of Urology Grand Rounds, Hue Central Hospital Hue, Vietnam 2011
Evaluation and Surgical Management of Ambiguous Genitalia Department of Pediatric Surgery Grand Rounds, Hue Central Hospital Hue, Vietnam 2011
DSD - Multidisciplinary Approach Department of Urology Conference University of Washington 2011
Consensus and Controversies in the Surgical Management of Patients with DSD Seattle Childrens Hospital, CME Level I and North American Society of Androgen Insensitivity Syndrome Support Group-USA Seattle, Washington 2011
Challenging DSD Cases Department of Urology Conference University of Washington 2011
DSD Department of Urology Conference University of Washington 2011
Moving Beyond Cancer to Wellness: Male Fertility Preservation Fertility Breakout Session, Lance Armstrong Foundation, Cancer Care Alliance Seattle, Washington Nov. 6, 2010
Outcomes in Reproduction in Childhood and Adolescent Survivors Seattle Childrens Hospital Grand Rounds Seattle, Washington Sept. 30, 2010
Patient Acquired Images in Pediatric Postoperative Care Results in Reduction of Unnecessary Emergency Department Visits American Academy of Pediatrics (AAP) National Conference and Exhibition Washington, DC Oct. 18, 2009
Emerging guidelines from the Childrens Oncology Group (COG) Yale Surgical Society, Division of Urology New Haven, CT June 5, 2009
LH and FSH Are Significantly Elevated in Young Men After Treatment with Ifosfamide and Cyclophosphamide in Relation to the Total Dose of Chemotherapy American Academy of Pediatrics, Section on Urology Annual Meeting Washington, DC 2009
Surgical management of intersexuality, cloacal malformation and anomalies of genitalia in girls Department of Urology Conference University of Washington 2009
Cure is not enough: Reproductive Late Effects of Ifosfamide in Survivors of Pediatric Malignancies Male Reproductive Health Research Award Symposium, University of Washington Seattle, Washington Sept. 16, 2008
Technique of Umbilical Reconstruction Using A Two-Faced Flap Technique , Northwest Urological Society (Scientific Session IV: Pediatrics) Portland, OR 2008
Late GI Effects Societe Internationale dUrologie (SIU) Santiago, Chile 2008
Testes tumors Societe Internationale dUrologie (SIU) Santiago, Chile 2008
Update in Pediatric Uro-oncology Societe Internationale dUrologie (SIU) Santiago, Chile 2008
Early Valve Ablation for Treatment of Posterior Urethral Valves Compared to Urinary Diversion: Long-term follow-up Cohort Study American Academy of Pediatrics (Society for Fetal Urology) Section on Urology 2008 National Conference and Exhibition Boston, MA 2008
Intersex Jeopardy Department of Urology Conference University of Washington 2008