MD News Article, May 2004
Fertility C.A.R.E.: A Comprehensive, Compassionate Practice

This article may also be viewed in Adobe Acrobat PDF format. 2 MB file size.

Comprehensive Services: medical, psychological, financial
What To Expect At Fertility C.A.R.E.
IVF Program
Service and Education: A Personal and Patient Priority
Continued Growth for Fertility C.A.R.E.
A Satisfying Doctor/Patient Relationship

Couples coping with fertility issues receive comprehensive, individualized treatment from highly qualified physicians and a caring staff at Fertility C.A.R.E. (Center of Assisted Reproduction and Endocrinology).

By Margaret M. Sloane, RN, BSN

When a woman wants to have a baby and she is unable to get pregnant, it can be a devastating, "why me?" situation for both the woman and her partner. Emotions run the gamut from anger and hurt to guilt and blame. To properly diagnose and treat a couple's fertility problems, it's essential to seek the help of a physician trained in Reproductive Endocrinology, a subspecialty in Obstetrics and Gynecology (Ob/Gin).

Mark P. Trolice, M.D., FACOG, FACS, Founder and Director of Fertility C.A.R.E. in Winter Park, is board-certified in Reproductive Endocrinology and Infertility (REI) and Ob/Gyn and voluntarily recertifies for both annually. He brings the highest standards of scientific excellence to his practice and is an inductee as a fellow in both the American College of Obstetrics and Gynecology and the American College of Surgeons, the latter includes only 5% of all REI physicians nationally.

Fertility C.A.R.E. was established in March 2003 and a year later opened its own IVF Division in Winter Park to accommodate the practice's rapid growth. Dr. Trolice believes that Fertility C.A.R.E.'s multidisciplinary approach using state of the art reproductive diagnostics, treatments and programs delivered by a highly qualified and compassionate medical team has led to pregnancy rates consistently exceeding national averages and multiple births well below the national average.

Comprehensive Services: medical, psychological, financial

Fertility C.A.R.E. services incorporate all aspects of Reproductive healthcare within-office services including hysteroscopy, hysterosalpingogram (HSG), pelvic ultrasound, sperm testing and hormonal assay. Treatment plans are individualized and include ovulation induction, artificial insemination, and in-vitro fertilization (IVF). Reproductive surgery can include laser laparoscopy, hysteroscopy and myomectomy. For couples experiencing the difficult problem of recurrent pregnancy loss, a team of specialists in reproductive endocrinology and infertility, maternal fetal medicine, medical genetics, psychology and registered nurses provide a multidisciplinary approach for management.

While it is true that science-based methodologies are vital to success in treating fertility disorders, Fertility C.A.R.E. places equal importance on designing a treatment strategy that includes a strong emphasis on a couple's psychological needs. According to Dr. Trolice, studies have shown that an empathetic approach from a supportive staff may improve patient outcomes. "We take into account the emotional anxiety and disappointment a couple experiences when facing reproductive challenges," he says. "Our program is tailored to the specific needs of individuals and couples. We feel that it is important to offer our patients not only the latest treatment options, but new hope as well."

A few months ago, Judith A. Burnett, Ph.D., a licensed clinical psychologist in reproductive health, joined the Fertility C.A.R.E. staff. She points out that individuals and couples dealing with infertility often go through grief issues, communication problems, considerable stress, and financial concerns. Infertility is essentially an invisible problem and is often not perceived by the general population to be a serious illness. Well meaning friends and family can make insensitive comments. "Having a psychologist available on staff at Fertility C.A.R.E. can help couples navigate the bumpy emotional road of infertility," she says.

Couples with financial concerns can meet with an in-office financial coordinator, a recently added service for Fertility C.A.R.E. patients, to discuss fertility benefits coverage. For patients without fertility benefits, many financial options exist including payment plans with Advanced Reproductive Care and Family Fee Plan.

What To Expect At Fertility C.A.R.E.

Infertility is defined as the inability of a couple to conceive after 12 months of unprotected intercourse appropriately timed with ovulation. A summary of factors contributing to infertility include 40% attributed to the female (tubal blockage and ovulatory dysfunction), 40% to the male (decreased number and poorly functioning sperm), and 20% unexplained. In approximately 30-40% of couples, infertility is associated with more than one factor.

By the time a patient consults with Dr. Trolice for an initial appointment, she is often very anxious over her inability to get pregnant. Couples having difficulty trying to begin or expand their family find that Fertility C.A.R.E. combines sensitivity and compassion with a multidisciplinary scientific approach in the treatment of fertility disorders.

During the initial visit, Dr. Trolice allows plenty of time to explain his approach to patient care, to answer all questions, and to design an individualized treatment plan. He puts his patients at ease and reviews the importance of adopting stress reduction techniques and coping strategies. Several diagnostic tests may be performed in order to answer questions such as: Are you ovulating normally? Are your fallopian tubes and anatomy normal? Is your partner's sperm count adequate and functional? Tests for female and male infertility can include endometrial biopsy, hormonal studies, HSG, laparoscopy, hysteroscopy, semen analysis and ultrasound.

IVF Program

IVF is an assisted reproduction technology procedure whereby fertilization of the egg and sperm occur in the laboratory or "in-vitro."

At Fertility C.A.R.E., an IVF cycle involves collection of mature eggs from a woman after stimulation with injectable medication. The short procedure is performed on-site while the patient is under intravenous sedation. The partner's sperm is added to the eggs in the laboratory and fertilization occurs with the formation of embryos. After continued growth of the embryos, a select number are transferred into the woman's uterus. IVF, including the treatment of male factor infertility, has proven to be the most effective method of treating infertility regardless of the duration or the extent of infertility experienced by couples of childbearing age.

Although featured prominently in pregnancy success stories, Dr. Trolice says that IVF does not define his practice. "I've talked several patients out of IVF when it was not indicated and helped them get pregnant with less expensive, less aggressive treatment options," he says. "Our practice is about providing the most comprehensive, appropriate healthcare in a compassionate setting."

Couples who are evaluated for IVF will partner with Lorrie Bishop, RN, IVF coordinator for Fertility C.A.R.E. "I help coordinate the woman's cycles, teach her how to give injections, and assist in egg retrieval and embryo transfers," she says. "And hopefully, I get to be the person who calls to report a positive pregnancy test." Ultimately, Bishop's goal is to encourage patients to take an active role in their treatment plan and assist the couple toward a resolution. "IVF can be an exciting, frightening, exhilarating process. It really is a roller coaster ride of emotions but has played a role in many tremendous success stories" she says.

Service and Education: A Personal and Patient Priority

Fertility C.A.R.E. has built a reputation for placing its patients at the hub of the continuum of care. "Our approach to patient care is all about service and education" says Dr. Trolice. "We want to empower our patients with knowledge and put them back in the driver's seat to take control of their care."

Ginger Strazi, LPN, fertility nurse coordinator, finds it exciting to share the journey with couples who are eager to have a family and to educate them in the process. "When they arrive at our practice for their initial visit, they come with various degrees of emotion" she says. "I reassure them they are not alone in their problems, offer them literature, and answer any questions they may have about the sometimes complex treatment they decide to explore."

Maintaining privacy is an important issue for many patients, says Strazi. For example, many patients would rather not share their infertility disorder with co-workers. They need to take time off from work in order to follow a treatment schedule such as coming into the office on several days during the month for hormonal testing and several ultrasounds. "It can be difficult and stressful to try to work while going through fertility cycles," she says. For this reason, Fertility C.A.R.E. maintains flexible office hours to accommodate fertility cycles and treatments, often seeing patients on weekends.

Dr. Trolice is committed to the highest standards in education in all aspects of his specialty including the education of his Reproductive Medicine colleagues. He holds the title Division Director of REI and is a full-time faculty member at Arnold Palmer Hospital for Children and Women in Orlando, and a clinical faculty member at both the University of Florida in Gainesville and Florida State University in Tallahassee. "I give weekly lectures and work with residents every day. We have 3rd and 4th year medical students rotating with our practice," says Dr. Trolice. "Working with medical students, residents and faculty intellectually stimulates me. While I am a teacher, I am also a student continuing to learn about reproduction especially from my patients. This field and continuing medical education is very gratifying."

Continued Growth for Fertility C.A.R.E. Beginning July 2004, Milton McNichol, M.D., FACOG, also Board-certified in REI and Ob/Gyn, joins Fertility C.A.R.E. and looks forward to helping his patients achieve their dream of parenthood. He's particularly excited about the practice's mission to provide unparalleled comprehensive services. "It's easy to break patients into separate entities when we send them in many directions for care. For example, when they need blood work they go to a laboratory. When they need x-rays studies they go to another site," he says. "We are committed to providing complete care, on-site in our new facility." Fertility C.A.R.E. is expected to open its new facility in August 2004 adjacent to its current office in Winter Park.

When asked what the future holds for his fertility patients, Dr. Trolice says one word: excitement. He predicts three areas of anticipation for growth and advancements in Assisted Reproduction: egg freezing, preimplantation genetic diagnosis (PGD), and unstimulated IVF.

Egg freezing has great potential especially for cancer patients to preserve their eggs prior to chemotherapy and radiation. PGD is beneficial for genetic detection of defects and diseases such as Down's syndrome, sickle cell and cystic fibrosis prior to embryo implantation. And finally, with more research and testing on the horizon for unstimulated IVF, the high cost of injectable fertility medications might be avoided.

A Satisfying Doctor/Patient Relationship Amy and her husband from Ocala tried for many years to conceive on their own. "When we met Dr. Trolice, we were frustrated and desperate. He gave us hope as he calmly went over all our options. Infertility is such a personal issue and he and his staff were always kind and professional," says Amy. "Thanks to Dr. Trolice and his team, we now have two healthy boys."

Dr. Trolice says it was his deep empathy for patients struggling with infertility that drew him into the field of Reproductive Endocrinology. "I consider it a privilege to be invited into the most personal aspect of a couple's life and help them become parents," he says. "It's a bond that is never assumed and always strengthened by our team. It's all about offering the highest Fertility CARE to our patients."

For more information or to make an appointment, call Dr. Trolice at (407) 672-1106. To learn more about the practice, contact us

Our Hours, Location, & Directions
Our Services
Our Staff
Our History
Our Future
Fertility C.A.R.E. In The News