An Interview With Dr. Mark Trolice

mark troliceGet to know Dr. Mark Trolice in the following interview, where you’ll learn about his his views on reproductive medicine. Feel free to contact us if you have with any questions about our services or to schedule an appointment to meet with a Fertility CARE doctor to discuss your personal fertility issues.

After graduating from Columbia University with undergraduate degree Psychology, I enrolled at the University of Medicine and Dentistry-. During my rotation in Obstetrics and Gynecology (Ob/Gyn),(REI)

Following residency training in New Jersey, I began my fellowship in REI at the University of Connecticut School of Medicine. The satisfaction and fulfillment I experienced during this time of patient care has never abated. My next home became Charlotte, NC where I was named Assistant Director in REI at Carolinas Medical Center, a teaching hospital for residents and medical students. During this time, I successfully completed board certification in both the fields of Ob/Gyn and REI. Additionally, I maintain voluntary annual Board recertification in both areas.

Desiring to advance professionally, I accepted the position of Medical Director of the Reproductive Health Institute (RHI), part of Arnold Palmer Hospital for Children and Women here in Orlando. I was also named Director of the Division of REI, responsible for the medical education of residents and medical students in Ob/Gyn, a position I am still proud to hold. While honored to have a high degree of patient satisfaction, an excellent support staff and above average pregnancy rates at RHI, my goal was to open a non-hospital based center and expand “to provide the most comprehensive reproductive healthcare in a compassionate setting.”

With the above “mission statement,” I established Fertility C.A.R.E. (Center of Assisted Reproduction and Endocrinology) in Winter Park, Florida in March 2003. Due to continued growth, we opened Fertility C.A.R.E. IVF Division in March 2004 Additionally, we added Judith Burnett, PhD, a Reproductive Health Psychologist, to our team.

It is my pleasure to serve the reproductive needs of Florida patients as well as to serve as a consultant to my colleagues. I am excited about the plans to expand our services in the near future.

Polycystic Ovarian Syndrome (PCOS) affects 5-10 percent of women during their reproductive years resulting in ovulation dysfunction and is the most common hormonal problem. In couples with infertility 40 percent of the cause is female (usually tubal blockage or ovulation dysfunction) and 40 percent is a male cause (usually low sperm count) while 20 percent is unexplained and 30 percent is a combination of factors.

Reproductive Endocrinologists are board certified subspecialists in the field of Obstetrics and Gynecology who also have advanced education, and professional skills capable of managing complex problems relating to reproductive endocrinology and infertility. These highly trained and qualified physicians treat a wide variety of reproductive disorders that affect women, men and children.

The initials, F.A.C.O.G. represent induction as a fellow in the American College of Obstetricians and Gynecologists. This distinction is achieved after meeting all of the College’s requirements, including Board certification in Obstetrics and Gynocology. F.A.C.S. signifies a physician is a fellow in the American College of Surgeon. Approximately5% of REI physicians are accepted as fellows in the American College of Surgeons.

Since a woman is born with all the eggs in her lifetime (1-2 million), pregnancy rates begin to decline at age 30 due to decreasing egg quality and number also resulting in increasing miscarriage and chromosomal abnormalities.
Ovulation dysfunction is a common problem for which we have success with medications. However, if she is no longer ovulating due to ovarian failure/menopause, she will be able to carry a pregnancy with the use of egg donation (eggs received from a known or anonymous female donor).
Fertility in the 40s is markedly reduced due to declining egg number and quality. Women conceiving in their mid 40s, especially with multiple gestation, are more than likely using egg donation.
We offer a unique program called “Care Free IVF” in which the patient receives a dramatic discount following her first cycle of fresh and, if available, frozen IVF. When all embryos from her first egg retrieval are utilized, she will have the significant discount for every subsequent IVF cycle until a live birth is achieved.
When the female patient has a partner, his evaluation is vital to determining a cause.

Since I was a child, I have been in awe at the responsibility of a physician. My belief is there is no greater privilege than that of entering into the sacredness of the doctor-patient relationship. Because of this belief, our approach to patient care at Fertility CARE is all about quality of service. We continually strive to establish and maintain our patients’ confidence and trust. This bond is never assumed. Our staff always work to strengthen their efforts to meet patients’ individual needs as best possible.

The practice of Reproductive Medicine, specifically the aspect of treating fertility issues, involves addressing patient needs from both a physical and emotional perspective. Our patients often feel a sense of being ‘out of control’ when dealing with their fertility issues so we strive to educate them extensively about their particular diagnosis. We believe that this knowledge empowers the patient and allows them to take more control of their problem while being proactive in their treatment. We always include the patient in the decision making in managing their treatment, an approach which often reduces their apprehension.

Presently, there are no definitive studies demonstrating stress as a cause of infertility. However, many studies show the benefits of stress reduction on improving pregnancy success rates. So, the difficulty with fertility does have the potential of negatively impacting a couples’ sense of mental well being. For example, stress can affect a woman’s ovulation function or reduce a man’s sperm count. While we all recognize the medical component of reproductive health care, Fertility CARE offers patients access to emotional support. In addition to our medical staff, we provide our own Fertility CARE. Support Group as well as the services of Judith Burnett, Ph.D., a clinical reproductive psychologist.

Once a patient recognizes they are experiencing a challenge in trying to conceive, the first step we recommend is education. We truly believe ‘knowledge is power’ so an informed patient will gain tremendous advantage in their pursuit of fertility. Understanding the biology of reproduction, the patient can be reassured about certain questions and directed in a more focused way to diagnosis and treatment. Additionally, an educated patient can contribute to her or his own care during a consultation with the physician, resulting in a more rewarding and less stressful experience.

Following acceptance of difficulty in conceiving, I would encourage all patients to remember the benefit of faith and hope. Our goals in life may not always be attained in the way and time frame we desire, but as long as we continue to recognize opportunity, then fulfillment and achievement are in our grasp.

My first goal during a new patient visit is to place the patient at ease. I explain our approach to patient care, our availability to answer all questions and how our treatment plans are individualized. Our program does not merely focus on the medical aspect of fertility because we realize the significant physical, emotional and financial investment a patient makes during this process. By the time a patient has a consultation with a subspecialist, she probably has already gone through a significant amount of worry. So, we begin by discussing how her (or his) fertility problem is impacting her life and we review stress reduction and coping strategies. Sometimes, the majority of a new patient visit is spent on discussing the psychological effect of fertility.

Following a thorough medical interview, I proceed with a comprehensive physical examination and pelvic ultrasound, explaining to the patient about her reproductive anatomy and determining any conditions she has that contribute to a fertility problem. The patient then reviews her evaluation and testing with one of our specialized nurses and is given patient education materials to supplement the office visit. Finally, she spends time with our Financial Counselor to determine fertility benefits coverage and then schedules her follow-up appointments.

Assisted Reproduction is an exciting field that continues to rapidly evolve. Three areas that will probably be increased in use are Egg Freezing, Pre-implantation Genetic Diagnosis (PGD), and Unstimulated IVF.

Egg and/or ovarian tissue freezing have many applications but most notable is that these procedures allow cancer patients the opportunity to preserve their eggs prior to chemotherapy and radiation. (Cancer treatments have the potential to affect a woman’s supply of eggs, placing her into severe diminished ovarian reserve or ovarian failure.) Additionally, this technology may offer women the ability to defer childbearing without diminishing the fertility of their eggs.

Genetic diagnosis (PGD) has long been a part of prenatal care, especially to detect a chromosomally abnormal fetus, such as Down’s syndrome, which generally occurs when the mother is more than 34 years of age. PGD enables the physician to make this diagnosis before implanting an embryo by n using embryo biopsy with IVF. Diseases such as sickle cell and cystic fibrosis can be screened in the laboratory. The use of PGD may also help reduce birth of multiple children at one time by transferring only a single embryo after laboratory analysis to select the most optimal embryo to transfer.

Lastly, the cost and potential risk of injectable fertility medications could be eliminated with an unstimulated IVF cycle. Currently, this type of cycle yields low pregnancy rates. Further research and testing may offer better methods of enhanced screening to maximize pregnancy rates in a greater number of patients.

We are Central Florida’s most successful IVF Program.

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