Mohamed Bedaiwy

Professor

Research Classification

Research Interests

Endometriosis
Recurrent Pregnancy Loss
Infertility
Minimally Invasive Surgery

Relevant Degree Programs

Affiliations to Research Centres, Institutes & Clusters

 
 

Biography

My primary focus is in exploring molecular and genetic mechanisms explaining the cause of endometriosis. Endometriosis is a disease where the lining of the uterus is implanted in the abdomen. The exact cause of this disease is unknown. We are looking into specific changes in the genome of those patients that may explain the disease. As a result, specific targeted treatment could be developed for this devastating disease.

The other focus of our research is to look into mechanisms to improve on the in vitro conditions of human embryo development. We are also looking to optimize the current techniques used for embryo freezing.

In addition, we are looking into the safety aspects of doing minimally invasive surgery using robotics.

Research Methodology

Goal 3: Good Health and Wellbeing

Recruitment

Master's students
Doctoral students
Postdoctoral Fellows
2021

Endometriosis

Recurrent Pregnancy Loss

Infertility

Minimally Invasive Surgery

I am open to hosting Visiting International Research Students (non-degree, up to 12 months).
I am interested in hiring Co-op students for research placements.
I am interested in supervising students to conduct interdisciplinary research.

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Great Supervisor Week Mentions

Each year graduate students are encouraged to give kudos to their supervisors through social media and our website as part of #GreatSupervisorWeek. Below are students who mentioned this supervisor since the initiative was started in 2017.

 

I am so grateful to have Dr.Mohamed Bedaiwy as my supervisor. He is like a candle who has lit up my career path, so I can achieve my goals. He is my role model. He appreciates me on my every little progress/achievement. He does the best he can to make learning easier for me from his own experiences as a clinician. This is my last year but I really wish if I could get this wonderful opportunity to thank him every year for all the hard work he does not only for his students but also for his patients. My success is your blessing, Dr.Bedaiwy. I would always be thankful to you.

Sunaina Sharma (2019)

 

Graduate Student Supervision

Doctoral Student Supervision (Jan 2008 - May 2021)
The impact of lifestyle on the reproductive, metabolic, and psychological well-being of women with polycystic ovary syndrome (PCOS) (2019)

Introduction: Polycystic ovary syndrome (PCOS) affects the reproductive, metabolic, and psychological health of 6 to 18% of women worldwide. The impact of lifestyle is poorly understood in research and practice. This dissertation aims to elucidate how dietary intake, physical activity, and psychological well-being relate to the array of symptoms and characteristics of PCOS.Methods:Women diagnosed with PCOS were compared to women without PCOS with subfertility in four observational studies. Data collected included: dietary intake, physical activity, psychological well-being symptoms (depression, anxiety, stress, and quality of life), anthropometrics, metabolic and reproductive hormonal assays. A protocol for a randomized controlled trial involving a lifestyle intervention is presented.Results:Women with PCOS had similar caloric intake and physical activity as women without PCOS, despite being more overweight (P
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Master's Student Supervision (2010 - 2020)
Outcomes following surgical management of pelvic pain: a prospective cohort study (2020)

Endometriosis is a chronic, estrogen-mediated inflammatory condition associated with chronic pelvic pain and infertility. The condition affects up to 10% of reproductive aged women and is associated with significant impacts on quality of life, loss of productivity, and social isolation. Surgical intervention has been identified as an important tool in treatment of endometriosis, but the factors associated with treatment response are not clearly defined. Our current study aimed to address these issues by determining the impact of type of surgery, histology, and stage of endometriosis on surgical outcomes. We then evaluated whether conservative surgery for superficial peritoneal endometriosis resulted in positive impacts on pain and quality of life. Finally, we determined whether the characteristics of women undergoing hysterectomies before the age of 40 were different from those of women undergoing hysterectomies at age 40 or older and compared their surgical outcomes by age category. The first part of the thesis demonstrated that surgery was associated with improvement in all surgical outcomes regardless of type of surgery. Women undergoing hysterectomies demonstrated worse baseline quality of life scores but showed greater improvement in outcomes compared to conservative surgery. Stage and histology had little influence on outcomes. For the second part of our study, we found that surgery for superficial peritoneal endometriosis was associated with improvement in all outcomes except for superficial dyspareunia. Finally, the third part of study demonstrated that younger women undergoing hysterectomies tended to have earlier experiences of pain and increased likelihood of having comorbid conditions associated with central sensitization. Women
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Unexplained recurrent pregnancy loss: demographic and clinical features (2020)

Unexplained recurrent pregnancy (uRPL) loss is a devastating and challenging condition for couples as well as clinicians. One of the greatest challenges is not being able to identify the baseline etiology of recurrent pregnancy losses (RPL) when all the routine and recommended investigations return normal or negative. Pregnancy losses that are not seen on the ultrasound or are confirmed only based on decreasing urine or serum beta-hCG’s are termed as non-visualized pregnancy losses (NVPLs). Routine evaluation of NVPLs is not recommended by the American Society for Reproductive Medicine (ASRM) guidelines. The first objective of my thesis was to evaluate how different types of miscarriages affect the rates of a successful pregnancy (ongoing pregnancy at or beyond 10 weeks gestation) among the uRPL group. The three different types of miscarriages include visualized pregnancy losses (VPL), NVPL, and a combination of both (mixed). The second objective was to assess the idea of stratifying uRPL women into Type 1 (age ≥35, NVPL) and Type 2 (age
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Effects of gonadotropin-releasing hormone receptor antagonists on ectopic human trophoblast cell invasion (2019)

Ectopic pregnancy (EP) is a life-threatening condition responsible for 6.5% of Canadian mothers’ death between 1993-2004. EP occurs when an embryo implants outside the uterine endometrium, commonly in the Fallopian tube (98%). Tubal EP often requires surgical intervention as a life-saving measure. Early and precise diagnosis allow many women to choose methotrexate, the only available medical option, for treatment. Methotrexate is effective in 70% of patients; however, they may require multiple treatments, suffer moderate-to-severe side effects, or experience sub-optimal responses. The remaining 30% fail to respond to the treatment.Gonadotropin-releasing hormone (GnRH) has an inducing effect on intrauterine placental cell invasion and human chorionic gonadotropin hormone (hCG) production. GnRH receptor (GnRH-R) antagonists have been used safely to treat endometriosis, chronic pelvic pain, and in the artificial fertilization techniques. For the first time, we separated primary trophoblast cells from tubal EP placentas. We validated their trophoblastic origin using trophoblast-validating markers. The preliminary findings showed that primary EP trophoblast cells express GnRH and GnRH receptor. Treating these cells with clinical GnRH-R antagonist, cetrorelix, suppressed their viability. We used primary trophoblast cells from tubal pregnancies, immortalized HTR-8/SVneo cell line, and placental villous explants established from the first-trimester human intrauterine placenta in this study. We investigated the effect of clinical GnRH-R antagonists, cetrorelix and ganirelix, on the invasion of different trophoblast models. Finding a safe, effective, and more tolerant medical treatment for tubal pregnancy will significantly improve women’s health and reduce healthcare-related costs.

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Parity and sliding sign in endometriosis-associated pain and infertility: two cross-sectional studies (2019)

Symptomatic women with endometriosis may present with chronic pelvic pain (CPP) and infertility. Endometriosis leads to CPP through chronic inflammation, continuous peripheral nerve stimulation, and enhancement of central sensitization. The relationship between pregnancy and endometriosis is complex. Pregnancy has been proposed as a possible risk for developing CPP. However, amenorrhea has been thought to be protective against endometriosis. For fertility, endometriosis causes infertility mainly through distortion of reproductive anatomy with endometrioma and pelvic adhesions. Although endometrioma can be diagnosed with transvaginal ultrasound and sliding sign can evaluate adhesions in the posterior uterine compartment, the only way to estimate the pregnancy rate is by calculating the endometriosis fertility index (EFI). EFI calculation during laparoscopy provides a score between 0 and 10 (10 is associated with the best fertility prognosis while a score of 0 associated with the poorest fertility prognosis). In this thesis, I conducted two cross-sectional studies using a prospectively collected registry. In the first study, I compared the severity of pelvic pain between three groups of women: a group of nulligravid women (n=686), a group of parous women (n=371), and a group of women with a history of miscarriage or abortion (n=129). I found a higher number of women in the parous group had severe CPP. The nulligravid group had a higher rate of severe dysmenorrhea. Ordinal regression with backward elimination methods showed a strong association between parity and severe CPP (AOR= 1.448, 95%CI=1.092–1.918, P=0.010). In the second study, I divided infertile endometriosis patients into two groups based on the sliding sign results. The sliding sign is considered negative when the sliding motion is not observed between the colon and cervix or uterus. I found that participants with a negative sliding sign (n=26) had significantly lower total EFI scores and a lower score for each surgical factor than patients with positive sliding sign (n=60). Logistic regression showed that an EFI score of
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Expression of HOXB4 in Endometrial Tissues from Women with or without Endometriosis (2016)

Endometriosis is a benign gynecological disease that affects up to 10% of women of reproductive age; however, the pathogenesis of endometriosis remains poorly understood. HOX genes encode transcription factors that play roles in regulating cell proliferation, differentiation, angiogenesis, adhesion and motility in adult tissues – key features of endometriosis. The aim of this study was to examine the localization of HOXB4, via immunohistochemistry (IHC), in both eutopic (EE) and ectopic endometrial tissues (deep infiltrating endometriosis (DIE) and endometriomas (Eoma)) from women with endometriosis and compare it to endometrial tissue from women with no history of endometriosis (EC). The localization of HOXB4 in these tissues was determined via immunohistochemistry (IHC) with a monoclonal HOXB4 antibody, where immunoreactivity was assessed by Histoscore (H-Score) method. HOXB4 protein was present in the endometrial glandular epithelial cells only. HOXB4 immunoreactivity in EC was significantly higher in the proliferative phase than in the secretory phase of the menstrual cycle; however, this difference was lost among the diseased groups (EE, Eoma and DIE). Interestingly, HOXB4 expression was significantly lower in the DIE lesions compared to matched eutopic endometrium and endometrioma /DIE lesions. After normalizing HOXB4 mRNA levels to endometrial epithelial cell content, consistent with IHC results, HOXB4 mRNA levels were significantly lower in the DIE groups when compared to EC and Eoma.On the whole, HOXB4 expression is reduced in DIE, but not endometrioma, and may be dysregulated in ectopic implants. During the menstrual cycle, the expression of HOXB4 in endometrial glandular epithelial cells is higher in the proliferative phase than the secretory phase in the normal eutopic endometrium. We here report for the first time the expression of HOXB4 localization and immunoreactivity not only in the normal eutopic endometrium but also in both eutopic and ectopic endometrial tissues in women with endometriosis.

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Publications

 
 

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