About

Natalie E. Roche, MD, is an Associate Professor and Division Chief of Obstetrics, Gynecology, and Reproductive Health at Rutgers New Jersey Medical School. She completed her Obstetrics and Gynecology training at Beth Israel Medical Center in New York City. Dr. Roche's practice encompasses all areas of general obstetrics and gynecology, with a special interest in GYN care related to HIV infection, substance abuse disorders, and lower genital tract dysplasia. She is board certified in Obstetrics and Gynecology as well as Addiction Medicine. Her educational background includes a MD degree from Mount Sinai School of Medicine of New York, earned in 1980, and a BA from Barnard College obtained in 1976. Dr. Roche is actively involved in clinical care at University Hospital in Newark and participates in various insurance networks.

Research topics

• Medicine
• Internal medicine
• Genetics
• Gynecology
• Obstetrics
• Computational biology
• Biology
• Immunology
• Cell biology
• Radiology

Selected publications

• Cervical Secretions from Women After Depot Medroxyprogesterone Acetate (Depo-Provera) Administration Promote HIV Infectivity Ex Vivo

  Viruses · 2025-09-22

  articleOpen access

  T cells but decreases the levels of most immune mediators at vaginal and cervical mucosa. In this study, we determined the effect of cervicovaginal secretions from women before (visit 1), one month (visit 2) and three months (visit 3) after Depo-Provera treatment on HIV infectivity ex vivo. The effect of supernatants from vaginal, endocervical, and rectal swabs and from cervical cytobrush on HIV infectivity were assessed by a single-cycle infection assay using CCR5-using HIV-luciferase reporter viruses. We found that endocervical secretions from women after Depo-Provera treatment promoted HIV infectivity. When analyzing the association between endocervical mediator changes in response to Depo-Provera, available in our previous study, and the changes in HIV infectivity pre- and post-treatment, we found that changes in IL-17 and VEGF were positively associated with changes in HIV infectivity at visit 2 compared with visit 1, whereas changes in RANTES and IL-4 were negatively associated with HIV infectivity. The negative association between RANTES and HIV infectivity was also observed at visit 3 compared with visit 1. Additionally, changes in IL-1α at visit 3 were positively associated with changes in HIV infectivity compared with visit 1. These findings suggest that Depo-Provera may increase the HIV risk by shifting the mucosal milieu that promotes HIV infectivity.

  PublisherOA PDFDOI

• Routine prenatal and postpartum care

  Elsevier eBooks · 2024-11-01

  book-chapterSenior author
  PublisherDOI

• Contributors

  Elsevier eBooks · 2024-11-01

  book-chapterOpen access

  https://doi.org/10.1016/b978-0-323-90263-2.01002-8

  PublisherDOI

• Macrophage scavenger receptor 1, a suppressor of HIV infection, is down-regulated in transgender females

  The Journal of Immunology · 2023-05-01

  articleOpen accessSenior author

  Abstract Transgender people are at greater risk than cisgender people of acquiring HIV and other sexually transmitted infections. Globally, the risk of acquiring HIV infection is nearly 49 times higher in transgender women than in other populations. Although behavioral and psychosocial factors contribute to the higher HIV risk in transgender people, gender-affirming hormone (GAH) (i.e., testosterone for transgender individuals assigned female at birth or estrogen/antiandrogen for transgender individuals assigned male at birth) may alter immune cell functions, resulting in increased HIV transmission. We have profiled gene expression of PBMCs from transgender females and males and have identified four specific genes (MTND1P23, IGSF10, MSR1, and DUXAP9) that were differentially expressed in transgender females. Among these genes, macrophage scavenger receptor 1 was down-regulated 0.5- or 0.4-fold compared to cis females and cis males, respectively. Transient expression of MSR1 suppressed in vitro HIV infection, suggesting that MSR1 protects cells against HIV. The data indicate that down-regulation of MSR1 in transgender women may play a role in their increased HIV risk. Future studies on the mechanisms by which MRS1 inhibits HIV infection may offer new strategies for HIV prevention in transgender women. NIH R21AI55322

  PublisherOA PDFDOI

• Telomeres and replicative cellular aging of the human placenta and chorioamniotic membranes

  Scientific Reports · 2021 · 17 citations

  • Cell biology
  • Biology
  • Computational biology

  Abstract Recent hypotheses propose that the human placenta and chorioamniotic membranes (CAMs) experience telomere length (TL)-mediated senescence. These hypotheses are based on mean TL (mTL) measurements, but replicative senescence is triggered by short and dysfunctional telomeres, not mTL. We measured short telomeres by a vanguard method, the Telomere shortest length assay, and telomere-dysfunction-induced DNA damage foci (TIF) in placentas and CAMs between 18-week gestation and at full-term. Both the placenta and CAMs showed a buildup of short telomeres and TIFs, but not shortening of mTL from 18-weeks to full-term. In the placenta, TIFs correlated with short telomeres but not mTL. CAMs of preterm birth pregnancies with intra-amniotic infection showed shorter mTL and increased proportions of short telomeres. We conclude that the placenta and probably the CAMs undergo TL-mediated replicative aging. Further research is warranted whether TL-mediated replicative aging plays a role in all preterm births.

  PublisherOA PDFDOI

• Occupational therapy practice contexts

  2021-02-22 · 1 citations

  book-chapter

  Upon completion of this chapter, the reader will be able to describe the client groups occupational therapists work with and the role of the occupational therapist in six practice contexts. The reader should also, upon reading this chapter, be able to recognise that legislation and regulations affect access to, and provision of, occupational therapy services, and discuss a person-centred approach to working with clients on their prioritised occupational goals and potential outcomes across a range of practice contexts.

  PublisherDOI

• Depot medroxyprogesterone acetate administration increases cervical CCR5+CD4+ T cells and induces immunosuppressive milieu at the cervicovaginal mucosa

  AIDS · 2020 · 11 citations

  • Medicine
  • Gynecology
  • Immunology

  OBJECTIVES: Depot medroxyprogesterone acetate (Depo-Provera) is the most commonly used injectable hormone contraceptive in Sub-Saharan Africa where HIV incidence is high. We determined the impact of Depo-Provera on cervical immune cells and mediators in healthy women. METHODS: In this longitudinal study, vaginal, endocervical, and rectal swabs were collected at baseline (visit 1), 1 month (visit 2), and 3 months (visit 3) after Depo-Provera injection. Cervical cells were collected by cytobrush and immune markers on cervical CD4 T cells were analyzed by multicolor flow cytometry at three different visits. The levels of immune mediators in cytobrush supernatants as well as vaginal, cervical, and rectal secretions from swabs were analyzed by multiplex assays and ELISA. RESULTS: Compared with baseline levels, we found a significant increase in the frequency of cervical CCR5CD4 T cells and a significant decrease in the frequency of cervical central memory CD4 T cells. Depo-Provera treatment had little effect on expression of immune mediators in rectal mucosa but significantly suppressed numerous immune mediators at cervicovaginal mucosa. Levels of MCP-1, G-CSF, IL-6, IL-10, GM-CSF, and IP-10 were significantly decreased in both vaginal and cervical secretions after Depo-Provera injection. In cervical samples collected by cytobrush, we found reduced levels of 22 of 25 immune mediators after Depo-Provera injection. Changes in immune mediators differed between vaginal and cervical mucosa, demonstrating compartment-specific responses. CONCLUSION: Depo-Provera altered immune profiles of cervical CD4 T cells and suppressed host immune response at cervicovaginal mucosa, suggesting its likely effect on transmission of sexually transmitted infections including HIV.

  PublisherDOI

• The Effect of Forced Cough to Minimize Pain and Discomfort at the Time of Colposcopy-Guided Cervical Biopsy

  Journal of Lower Genital Tract Disease · 2020 · 3 citations

  • Medicine
  • Obstetrics
  • Radiology

  OBJECTIVE: The aim of the study was to determine whether forced cough during colposcopy-guided cervical biopsy affected pain and anxiety levels. MATERIALS AND METHODS: The study was conducted at the University Hospital (Newark, NJ) Ambulatory Care Center from December 2016 to June 2018 and evaluated 110 patients at the time of a colposcopy-guided cervical biopsy. Study patients were randomized to either cough or no cough group during the biopsy procedure. Pain level was assessed using a visual analog pain scale before, during, and immediately after a colposcopy-guided cervical biopsy. Study patients also completed a standardized anxiety survey before and after the procedure. T tests, Pearson χ, or Cochran-Mantel-Haenszel were used to compare baseline characteristics between the cough and no cough groups. Multivariate linear regression analysis was used to identify potential confounders and then compare pain levels across both groups. RESULTS: There was no statistically significant difference in pain scores between the cough and no cough group when analyzed for each demographic variable even when confounders were accounted for. The anxiety scores for both study groups before and after the procedure were similar and not significantly reduced. CONCLUSIONS: We observed a trend that cough reduced pain associated with the colposcopy-guided cervical biopsy but did not reach statistical significance. A similar outcome was observed in anxiety level, where anxiety was reduced in the cough group but was not statistically significant as compared with the no cough group. Further studies are necessary to assess various modalities in reducing pain and anxiety associated with colposcopy-guided cervical biopsy.

  PublisherDOI

• Approach to Termination of Pregnancy in a Woman with Uterine Leiomyomas

  Journal of Gynecologic Surgery · 2019-05-07

  article

  Abstract Background: Women with enlarged leiomyomatous uteri often have limited options for termination of pregnancy (TOP) and are referred to tertiary-care centers for management. This article presents a unique surgical approach to TOP in such women that has not been previously described in the literature. Case: A 35-year-old gravida 6, para 2032, at 9 weeks and 3 days of pregnancy, presented with a 30-week-sized leiomyomatous uterus displacing the pregnancy to the fundus with distortion of the cervix and endometrial cavity. This patient desired future fertility and declined medical management of her condition. She underwent a transfundal suction curettage via laparotomy at 13 weeks and 2 days of her pregnancy. Results: The patient's estimated blood loss was 300 cc. She had an uncomplicated postoperative course and underwent a myomectomy 12 weeks after a surgical abortion. Conclusions: A literature review revealed several case reports of medical management, and 1 reported use of an endotracheal tube for surgical termination. However, no other reports were found to guide surgical management in women with enlarged leiomyomatous uteri. When conventional suction curettage or dilation and extraction are not technically feasible in pregnant women, due to distortion of the cervix and endometrial cavity secondary to the leiomyomas, transfundal suction curettage via laparotomy may be considered. This approach is an alternative to medical management in women with enlarged leiomyomatous uteri who desire termination of their pregnancies.

  PublisherDOI

• Differential effects of depot medroxyprogesterone acetate administration on vaginal microbiome in hispanic white and black women

  Archives of Medicine · 2019-09-20

  articleOpen access

  The use of depot medroxyprogesterone acetate (DMPA), a 3-monthly injectable hormonal contraceptive, is associated with an increased risk of HIV acquisition possibly through alteration of the vagina...

  Publisher

Frequent coauthors

• Todd Rosen

  Rutgers, The State University of New Jersey

  10 shared

• Theresa L. Chang

  Rutgers New Jersey Medical School

  9 shared

• Nataliya Parobchak

  8 shared

• Bingbing Wang

  8 shared

• Adanna Ukazu

  University Hospital, Newark

  8 shared

• Debra S. Heller

  7 shared

• Valeria Di Stefano

  6 shared

• Amy L. Davidow

  New York University

  6 shared

Education

• M.D.

  Mount Sinai School of Medicine of New York

  1980

• B.A.

  Barnard College

  1976