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Margarett Shnorhavorian, MD, MPH

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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 NameAward DescriptionAwarded ByAward Date
Prize Abstract SessionPrize 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, CaliforniaAmerican Urological Association National Meeting, Society of Pediatric UrologyMay 13, 2013
First Place Clinical Research AwardSection on Urology, National Conference & ExhibitionAmerican Academy of Pediatrics 2012
Southwest Oncology Group Young Investigator Award 2010
COG-AFLAC Young Investigator Award in Adolescent and Young Adult Oncology 2009
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
Male Reproductive Health Research AwardNIH K-award 2008 - 2013

Publications

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
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
Digital photographic measurement in hypospadias: Validation and comparison to intraoperative measurement.
Journal of pediatric urology , 2013 Nov 7
Digital photographic measurement in hypospadias: Validation and comparison to intraoperative measurement.
Journal of pediatric urology , 2013 Nov 7
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 , May 3, 2013: San Diego, California
Fertility Preservation Among Adolescent and Young Adult Cancer Survivors in the AYA HOPE Study
American Urological Association National Meeting, Society of Pediatric Urology , May 3, 2013: San Diego, California
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 , April 2013
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
Health-related Quality of Life of Adolescent and Young Adult Cancer Patients in the United States: the AYA HOPE study
J Clinical Oncology , Feb. 21, 2013
Disorders of Sex Development
In "Urological Emergencies: A Practical Approach, 2nd Edition." H Wessells (ed.) , 2013: Springer, New York, New York
Renal carcinoma following therapy for childhood cancer: A report from the Childhood Cancer Survivor Study
J Natl Cancer Inst , Oct. 17, 2012
Long-term Lower Urinary Tract Outcomes in Boys After Early Treatment of Posterior Urethral Valves
Poster, American Academy of Pediatrics, New Orleans, Louisiana , Oct. 2012
Male Reproductive Health after Childhood, Adolsecent, and Young Adult Cancer: A Report from the Childrens Oncology Group
J of Clinical Oncology , Sept. 20, 2012: 30(27)3408-16
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 , Sept. 13, 2012
Positive and negative psychosocial impact of being diagnosed with cancer as an adolescent or young adult
Cancer , March 13, 2012: doi: 0.1002/cncr.27512
Evaluation and Management of Disorders of Sex Development: Multidisciplinary Approach to a Complex Diagnosis
RadioGraphics , 2012: 32(6)1599-618
Transitioning patients with Disorders of Sex Development to Adult Care: The Role of The Pediatric Urologist
J Urol , 2012: 188(3)700-1
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: 80(2)417-22
Ambiguous Genitalia: What Prenatal Genetic Testing is Practical?
Am J of Med Genet A , 2012: 158A(6)1337-43
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: 28(6)635-639
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: 1(3)
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: 185(6 Suppl)2536-41
Survivors of Childhood Cancer Have Increased Risk of Gastrointestinal Complications Later in Life
Gastroenterology , 2011: 140(5)1464-7
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 , Aug. 2010: 669-73
Injection volumes of dextranomer/hyaluronic acid are increasing in the endoscopic management of vesicoureteral reflux.
Pediatric surgery international , May 2010: 509-13
A rewarding experience for a pediatric urologist.
Cancer treatment and research , 2010: 485
Oncofertility: Ethical, Legal, Social, and Medical Perspectives edited by Teresa K. Woodruff, Laurie Zoloth, Lisa Campo-Engelstein, and Sarah Rodriguez
Springer , 2010
"Open" minimally invasive surgery in pediatric urology.
Journal of pediatric urology , June 2009: 221-7
Genitourinary long-term outcomes for childhood cancer survivors.
Current urology reports , March 2009: 134-7
Long-term followup of complete primary repair of exstrophy: the Seattle experience.
The Journal of urology , Oct. 2008: 1615-9; discussion 1619-20
Metastatic adenocarcinoma after augmentation gastrocystoplasty.
The Journal of urology , March 2008: 1094-6; discussion 1097
Maternal risk factors for congenital urinary tract anomalies: Results of a population-based case - control study
J of Urology , 2008: 179(4)355
Robotic-assisted laparoscopic Mitrofanoff appendicovesicostomy and antegrade continent enema colon tube creation in a pediatric spina bifida patient
J Laparoendosc Adv Tech , 2008: 18(2)310-12
Anatomic and physiologic considerations in ureteroscopy.
The Urologic clinics of North America , Feb. 2004: 15-20
Surgical Hypospadias After Exstrophy (SHAE): Management and Outcomes
J of Urology , : Submitted May 13, 2013
Male infertility in long-term survivors of pediatric neoplasms: A report from the Childhood Cancer Survivor Study
Human Reproduction , : Submitted February 2013
Use of Appropriate Initial Treatment Among Adolescents and Young Adults with Cancer: A Population-Based Study
J Clinical Oncology , : Submitted May 13, 2013
Medical care in adolescents and young adult cancer survivors: what are the biggest access-related barriers?
J Clinical Oncology , : Submitted June 20, 2013

Presentations

Presentations TitleEventLocationDate
Are genetic variants that influence testicular cancer risk also involved in hypospadias and undescended testes? A case-parent studyPediatric Urology Fall CongressLas Vegas, NevadaSept. 20, 2013
From Cancer to Wellness: Fertility PreservationCancer Survivorship Symposium, Seattle Childrens HospitalSeattle, WashingtonOct. 27, 2012
Common urologic problems in girls and adolescentsNorth American Society of Pediatric and Adolescent Gynecology National MeetingMiami, FloridaApril 2012
Pediatric Urology for the primary care providerProvidence Physician GroupMill Creek, WashingtonJan. 31, 2012
Ups and Downs of Testes: Evaluation and Management of Undescended TestesClinicians Guide to Pediatric Urology: A Practical Update. Seattle Childrens Hospital, CME Level ISeattle, WashingtonNov. 19, 2011
Modern Surgical Management of Urogenital Sinus and CloacaPediatric Surgery Department Conference, Hue Central HospitalHue, VietnamOct. 2011
Seattle Childrens Hospital Center for Clinical and Translational Research External Review Research PresentationSeattle, WashingtonSept. 19, 2011
Outcomes in Reproduction in Childhood and Adolescent Survivors: ORCAS an updateMale Reproductive Health Research Award Symposium, University of WashingtonSeattle, WashingtonApril 6, 2011
Disorders of Sex development: Consensus and ControversyPediatric Urology ConferenceSeattle Children's HospitalFeb. 14, 2011
Evaluation and Surgical Management of Ambiguous GenitaliaDepartment of Pediatric Surgery Grand Rounds, Hue Central HospitalHue, Vietnam 2011
Complex Hypospadias Reconstruction Modern TechniquesDepartment of Urology Grand Rounds, Hue Central HospitalHue, Vietnam 2011
DSD - Multidisciplinary ApproachDepartment of Urology ConferenceUniversity of Washington 2011
Challenging DSD CasesDepartment of Urology ConferenceUniversity of Washington 2011
Consensus and Controversies in the Surgical Management of Patients with DSDSeattle Childrens Hospital, CME Level I and North American Society of Androgen Insensitivity Syndrome Support Group-USASeattle, Washington 2011
DSDDepartment of Urology ConferenceUniversity of Washington 2011
Moving Beyond Cancer to Wellness: Male Fertility PreservationFertility Breakout Session, Lance Armstrong Foundation, Cancer Care AllianceSeattle, WashingtonNov. 6, 2010
Outcomes in Reproduction in Childhood and Adolescent SurvivorsSeattle Childrens Hospital Grand RoundsSeattle, WashingtonSept. 30, 2010
Patient Acquired Images in Pediatric Postoperative Care Results in Reduction of Unnecessary Emergency Department VisitsAmerican Academy of Pediatrics (AAP) National Conference and ExhibitionWashington, DCOct. 18, 2009
Emerging guidelines from the Childrens Oncology Group (COG)Yale Surgical Society, Division of UrologyNew Haven, CTJune 5, 2009
LH and FSH Are Significantly Elevated in Young Men After Treatment with Ifosfamide and Cyclophosphamide in Relation to the Total Dose of ChemotherapyAmerican Academy of Pediatrics, Section on Urology Annual MeetingWashington, DC 2009
Surgical management of intersexuality, cloacal malformation and anomalies of genitalia in girlsDepartment of Urology ConferenceUniversity of Washington 2009
Cure is not enough: Reproductive Late Effects of Ifosfamide in Survivors of Pediatric MalignanciesMale Reproductive Health Research Award Symposium, University of WashingtonSeattle, WashingtonSept. 16, 2008
Technique of Umbilical Reconstruction Using A Two-Faced Flap Technique, Northwest Urological Society (Scientific Session IV: Pediatrics)Portland, OR 2008
Update in Pediatric Uro-oncologySociete Internationale dUrologie (SIU)Santiago, Chile 2008
Testes tumorsSociete Internationale dUrologie (SIU)Santiago, Chile 2008
Late GI EffectsSociete Internationale dUrologie (SIU)Santiago, Chile 2008
Early Valve Ablation for Treatment of Posterior Urethral Valves Compared to Urinary Diversion: Long-term follow-up Cohort StudyAmerican Academy of Pediatrics (Society for Fetal Urology) Section on Urology 2008 National Conference and ExhibitionBoston, MA 2008
Intersex JeopardyDepartment of Urology ConferenceUniversity of Washington 2008

Primary Office

Seattle Children's
OA.9.220 - Urology
4800 Sand Point Way NE
Seattle, WA 98105
206-987-2509

Additional Offices

Seattle Children's Bellevue Clinic and Surgery Center
CB-11
1500 - 116th Ave NE
Bellevue, WA 98004
425-454-4644
Seattle Children's Everett
CE - Suite 100
900 Pacific Ave
Everett, WA 98201
425-304-6080

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