Aaron Lazorwitz

Yale University | YU · Department of Obstetrics, Gynecology and Reproductive Sciences

Objectives: To evaluate how recent opioid, marijuana, and cannabidiol use affects pre-procedure pain-related anxiety for patients seeking abortion. Methods: We conducted a prospective, cross-sectional anonymous survey of patients seeking abortion assessing recent substance use and anxiety about pain during and after abortion. We compared substance...

Posttraumatic stress disorder (PTSD) is underdiagnosed peripartum. We administered a primary care screening tool and a pregnancy-related PTSD screening tool to postpartum patients presenting to our urban safety-net institution within 6 months of delivery, between August 2021 and February 2022. Our primary outcome was prevalence of positive PTSD scr...

Objective: To confirm that 24-hour steady-state trough measurements (C24) are high-quality proxies for gold standard pharmacokinetic measurements (area under the curve [AUC]) of a combined oral contraceptive pill (COCP). Study design: We conducted a 12-sample, 24-hour pharmacokinetic study in healthy reproductive-age females taking a COCP contai...

Objective: Rifampin, a strong CYP3A inducer, is the gold standard for evaluating CYP3A-mediated drug-drug interactions. We aimed to evaluate the pharmacokinetic and pharmacodynamic effects of a short course (2-weeks) of rifampin on serum etonogestrel (ENG) concentrations and serologic measures of ovarian activity (endogenous estradiol [E2] and pro...

Objectives To assess the pharmacokinetics and pharmacodynamics of the etonogestrel (ENG) contraceptive implant when inserted at an alternative scapular site. Methods We conducted a pilot study of healthy, reproductive-aged women who underwent subdermal insertion of an ENG implant over the inferior edge of the non-dominant scapula (scapular inserti...

Objectives Rifampin is a strong CYP3A inducer and the gold standard for evaluating CYP3A-mediated drug-drug interactions per the US Food and Drug Administration. We hypothesized that even a short course (two weeks) of exposure would lead to breakthrough ovulation-mediated changes in endogenous estradiol (E2) and progesterone (P4) concentrations amo...

Objective To address the knowledge gap surrounding herbal medicine and supplement usage patterns and supplement-prescription medication interactions among patients seeking treatment for infertility. Design Cross-sectional survey study. Setting Academic infertility practice. Patients 95 reproductive-aged patients. Interventions Not applicable....

Objective : Permanent contraception through tubal sterilization is the preferred contraceptive method for 25% of women in the United States. Laparoscopic permanent contraception has an anecdotally high cancellation rate. Cancellations affect operating room utilization and may reflect barriers to care. We aimed to identify the short-notice cancellat...

Objective: To evaluate topiramate and etonogestrel pharmacokinetic interactions in contraceptive implant users. Methods: We conducted a prospective, noninferiority study with healthy women using etonogestrel implants continuously for 12-36 months. We measured baseline serum etonogestrel concentrations and then began a 6-week titrated topiramate...

Objective To determine if concordance of contraceptive preference and uptake differ between postpartum recipients of emergency versus full scope Medicaid. Study Design We performed a historical cohort study of patients who delivered at a safety-net hospital in Denver, Colorado in 2016. In our public system, all patients had access to immediate pos...

Purpose: To evaluate if adverse childhood experiences are associated with hormonal contraception discontinuation due to mood and sexual side effects. Materials and methods: Women, ages 18-40 (N = 826), with current and/or previous hormonal contraceptive use completed surveys on demographics, contraceptive history, and the Adverse Childhood Exper...

Objective: To assess the variability of repeated measurements of serum etonogestrel concentration among contraceptive implant users. Study Design: We measured three consecutive serum etonogestrel concentrations, drawn weekly, in women using etonogestrel implants for 12 to 36 months. We used a repeated measures test to evaluate differences. Results:...

s These scientific abstracts are scheduled for presentation at the 2021 Society of Family Planning Annual Meeting. This year, 225 abstracts were submitted for consideration, of which 12 were selected for oral presentation and 84 were selected for poster presentation. The scientific abstract review was completed by the scientific reviewers and selec...

Objectives To determine the safety of etonogestrel contraceptive implant use among reproductive-age women who are solid organ transplant recipients. Study Design We conducted a retrospective cohort study with matching of reproductive-age women (14-45 years) who were solid organ transplant recipients and received care at a tertiary medical center i...

To compare etonogestrel pharmacokinetic and pharmacodynamic outcomes by both self‐reported race/ethnicity and genetically‐determined ancestry among contraceptive implant users. We conducted a secondary analysis of our parent pharmacogenomic study of 350 implant users. We genotyped these reproductive‐aged (18‐45 years) women for 88 ancestry‐informat...

Purpose To explore how diet and exercise habits associate with serum etonogestrel concentrations among contraceptive implant users. Materials and methods We conducted a secondary analysis of healthy, reproductive-age women using etonogestrel implants. This study was registered on ClinicalTrials.gov, NCT03092037. We assessed diet and exercise habit...

Objective To identify genetic variants associated with weight gain related to etonogestrel contraceptive implant use. Study Design We conducted a retrospective analysis from a parent pharmacogenomic study of healthy, reproductive-aged women using etonogestrel implants. We reviewed medical records to calculate objective weight changes from implant...

Objectives This exploratory study compared self-reported satisfaction rates and pain scores between patients who used marijuana during their medication abortion versus non-users. Study Design We recruited medication abortion patients at a University-affiliated abortion clinic in Denver, Colorado. Participants completed a pre-abortion questionnaire...

Objective To explore the pharmacokinetic interaction between isotretinoin, a cytochrome P-450 (CYP) inducer and potent teratogen, and the etonogestrel contraceptive implant. Study Design We enrolled healthy reproductive-age women initiating isotretinoin and using an etonogestrel implant. We compared serum etonogestrel concentrations at baseline and...

Sugammadex is a steroid binder and can potentially bind the estrogens and progestins contained within hormonal contraception. Therefore, the FDA label for sugammadex contains a drug-drug interaction warning between this medication and hormonal contraception, advising that women taking hormonal contraception use a backup contraceptive method or abst...

Objective: To estimate whether serum etonogestrel concentrations influence bleeding patterns and related side effects in contraceptive implant users. Methods: We conducted a prospective cross-sectional study with healthy, reproductive-aged women using etonogestrel implants for 12-36 months. Participants completed a brief questionnaire to assess...

Objective: To determine whether serum etonogestrel concentrations in contraceptive implant users are associated with certain individual patient characteristics. Study design: We enrolled reproductive-age women using etonogestrel contraceptive implants between 12-36 months duration and measured a single serum etonogestrel concentration. Participa...

Objective: To identify genetic variants that influence steady-state etonogestrel concentrations among contraceptive implant users. Methods: We enrolled healthy, reproductive-age women in our pharmacogenomic study using etonogestrel implants for 12-36 months without concomitant use of hepatic enzyme inducers or inhibitors. We collected participan...

Case reports of pregnancies with inadvertent etonogestrel contraceptive implant exposure in the first-trimester have not demonstrated teratogenic risks or adverse pregnancy outcomes. We report the clinical observations of a 15-year-old nulligravida who continued her etonogestrel contraceptive implant throughout pregnancy and delivery, without any a...

Nickel-titanium sterilization microinserts are surgically removed for various indications, including persistent pain. Previously described removal techniques include salpingostomy and cornuectomy with judicious use of electrocautery to avoid potential injury to adjacent structures or fracturing the micoinsert. This case series presents our techniqu...

Objective The objective was to determine the impact of carbamazepine on the pharmacokinetics and pharmacodynamics of the etonogestrel contraceptive implant. Study design We enrolled healthy, reproductive-age women using an etonogestrel implant for 1–3 years. We measured etonogestrel levels at baseline and following 3 weeks of coadministered carbama...

Continuation rates of short-acting contraception among young women are low; we attempted to determine if continuation is higher when women expect noncontraceptive benefits at initiation or perceive benefits six months later. 243 young women ages 13-24 initiating short-acting methods in an adolescent-only family planning clinic completed post-visit...

Background: Random periareolar fine-needle aspiration (RP-FNA) is increasingly used in trials of breast cancer prevention for biomarker assessments. DNA methylation markers may have value as surrogate endpoint biomarkers, but this requires identification of biologically relevant markers suitable for paucicellular, lymphocyte-contaminated clinical s...

Background: Silencing of tumor suppressor gene expression by promoter methylation occurs frequently in breast cancer and can affect the expression of >100 genes per tumor. Since tumorigenesis is a multistep process and occurs over a large period of time, promoter methylation of some genes may occur very early in this process and can be used for ris...