Reproductive Endocrinology and Infertility

Division Director

James M. Goldfarb, MD, MBA; Clinical Professor, Medical Director of IVF Program


The Division of Reproductive Endocrinology and Infertility (REI) offers a full-range of services for women with infertility and other reproductive problems. The University Hospitals Fertility Program is comprised of an internationally recognized team of three board-certified fertility specialists, a dedicated team embryologists and a team of seasoned and compassionate RNs, as well as medical assistants and patient access representatives.  The clinical team is augmented by a nationally recognized basic research team. The dedication, compassion and expertise of all members of the team result in patients  truly feeling our offices are a special place for them. 

Our IVF and Andrology Laboratory has a dedicated staff of  expert embryologists and andrologists. Our laboratory staff has direct contact with our patients who are very pleased with their compassion and expertise. The laboratory is accredited by the College of American Pathology (CAP). Our high quality facility is able to offer a wide variety of services including intracytoplasmic sperm injection, assisted hatching, Preimplantation genetic diagnosis and cryopreservation of embryos, sperm, and oocytes. Most recently the laboratory has been involved with a study assessing the efficacy of evaluating embryos with time lapse photography.

Our Reproductive Endocrinologists are active nationally.  Dr. Goldfarb is past president of the Society for Assisted Reproductive Technologies (SART), the primary organization of US professionals dedicated to the practice of IVF.  Dr. Liu is a member of editorial board for Obstetrics and Gynecology, the FDA Advisory Committee for Reproductive Health Drugs and the NIH Advisory Committee for the Study of Women’s Health Across the Nation (SWAN).  Dr. Rossi is beginning her national involvement by being an active member of the SART website committee.

Dr. Mesiano is a nationally recognized researcher. Despite the current difficulties with obtaining research funding, Dr. Mesiano has obtained diverse, prestigious funding.

Research Program, Dr. Sam Mesiano, Director

Research in the Mesiano Lab addresses the problem of preterm birth by elucidating the hormonal mechanism that control the contractile state of the gravid uterus.  The research focuses on the role and mechanism of action of progesterone in the physiology of human pregnancy and parturition, with the long term goal of developing progesterone-based therapies to prevent preterm birth.   

Although the core focus is preterm birth, the research is applicable to all areas or uterine pathophysiology that involve PR-mediated progesterone action.  Recently the lab has established that progesterone exerts anti-inflammatory actions in myometrial cells via its interaction with the type-B progesterone receptor (PR-B) and that this effect is inhibited by the type-A PR isoform (PR-A) in a dose-dependent manner.  That work represented an important step forward in understanding how progesterone promotes uterine quiescence for most of pregnancy and how it's withdrawal occurs to trigger parturition.  Importantly, the work highlights the importance of PR-B expression and signaling in myometrial cells for the maintenance of pregnancy and shows that increased PR-A expression and/or activity may trigger parturition by mediating the functional withdrawal of PR-B signaling.  

Fellows in the Division of Reproductive Endocrinology and Infertility working in the Mesiano Lab use state of the art techniques in molecular biology to examine the role of PRs in the uterine pathophysiology.  Studies to date include the exploration of PR function in endometriosis, leiomyoma disease and preterm birth.  Other studies are focused on the development of selective progesterone receptor modulators (SPRMs) that specifically affect the transcriptional activity of PR-A.  SPRMs that specifically affect PR-A may be effect therapeutics for the treatment of endometriosis, leiomyoma and preterm labor.  

Dr. Mesiano's laboratory is supported by the National Institutes of Health, the March of Dimes and the Gates Foundation.

Clinical Program

University Hospitals Fertility Center offers patients the most sophisticated technology in a very caring atmosphere by an experienced, compassionate team.   Members of the infertility team have been responsible for many firsts including Ohio’s first IVF birth in 1983 and the world’s first IVF Surrogate birth in 1986.  For patient convenience, patients can be seen in one of three locations:  The Risman Pavilion in Beachwood, MacDonald Hospital in University Circle and Westlake immediately across from the Crocker Park Shopping  Center.  Since expanding the program in 2011, In Vitro Fertilization volumes have more than tripled. 

Fellowship Program

An accredited Fellowship program in Reproductive Endocrinology and Infertility was created in 2009 at the University Hospitals Case Medical Center with the goal of preparing fellows for productive careers in academic and clinical medicine.  The program takes advantage of the breadth of research interests of the Department of Reproductive Biology as well as the rest of Case Western Reserve University.  The program provides clinical experience taught by experienced clinicians who are on the cutting edge of the practice of Reproductive Endocrinology and Infertility.  Attesting to the strength of the Fellowship, the three fellows who have thus far graduated from the program have all attained prestigious positions. 

Additional Information.