In today's podcast, we listen to Dr. Mark Trolice, the leading fertility expert in central Florida. He's gone through infertility challenge personally, ultimately adopting 5 children and openly discusses the fear and psychological pain that accompanies so many women as they go on their pregnancy journey and yet the challenge that it's still not out in the open today. He gives good advice putting an individual in control when experiencing fertility challenges, what fertility challenge really means and giving us all listeners permission to expect your doctor to care and to leave if that doctor is not living up to your expectations.

Dr. Mark Trolice. Director of Fertility Care the IVF Center in Orlando, Florida. Been in service since 2003 and offers all aspects of reproductive medicine, including in vitro fertilization.

He was a medical student for a week on the OB-GYN rotation, where they are to complete 8 weeks rotation when they were asked if anybody was interested to spend a week in the infertility service - to which he volunteered. At that time he was still unsure as to what area he wants to go to; however, only after a week of feeling the devastation of all the emotions that couples go through, it had a profound effect on him which made him want to learn everything about it.

He mentions that it encompasses a lot of areas - emergency medicine, psychology, surgery, endocrinology, gynecology, obstetrics - which satisfied all of his desires. The following year that he finally chose the medical school where he wants to pursue his career he met his wife and they got married. In the middle of his residency, they decided to have a child and they had a difficulty.

Dr. Trolice mentioned that they went to infertility for 10 years. They've been through all the diagnostic testing, surgeries, multiple IVF cycles, miscarriages, ectopic pregnancy, hyperstimulation syndrome, pretty much all possible complications. So after 10 years they finally adopt. They adopted their 5 children as babies, where his wife has been in the delivery room with all 5. He considers
himself completely blessed. The difficulties he and his wife have been through made him understand and be more closer to his patients and they know he understands the heartache, despair, and all the emotions couples go through.

He continues his practice to empower his patients with education for them to have hope and at the same time realistic expectations.

He considers adoption as a miracle to love another person for the sake of love - The bond is so profound and it's a beautiful thing.

Challenges. The two points in a woman's life is when she decides to have a baby and the second time is when she says "Hey, I think there's a problem". Once they think that they can't conceive, it's literally 24/7 thoughts of "Am I going to be a mom?', "What am I gonna do if I'm not a mom?", "Is my partner still going to love me?",etc. which is an unbelievable impact in a woman's life.

When Dr. Trolice sees them he tries to allay their anxiety, listen to their story and allow them to share their story. The first visit patients are scared to hear that they're not going to be a mom.

There are different options that parents can pursue.The simplest thing is using an over the counter ovulation predictor kit which detects the brains pituitary hormone called LH which is excreted in the urine. When the kit detects that hormone, within 24-36 hours a woman would be ovulating. The key for fertility patients is you don't save up until ovulation to have intercourse. You would want to increase the frequency of intercourse from the day after that hormone is detected then count back 6 days. So if a woman has a regular menstrual period then they can do that during those 6 days.

It involves a lot of psychology, a lot of listening, understanding their fears and knowing the physical, emotional and financial investment.

He made mention that the essentials are: are the tubes open?; are you ovulating?; and is there a good amount of sperm?

Decision Making. He never tells them what to do, he does the evaluation and discusses realistic expectations for different options. He thinks it is a big mistake if a fertility doctor tells a couple what to do. He instead works with the couple and walks with them hand in hand on their journey.

IVF. It involves stimulating a woman's ovaries with injectable fertility medication to superovulate their ovaries.

The steps involved in the IVF process include:

Stimulating the ovaries
Collecting the eggs
Embryo transfer

It is unusual for a couple not to be appropriate candidates. it is the most aggressive and expensive treatment but it's also the most successful.

Infertility, in general, is very unique. it's a disease but there are so much shame and stigma where sometimes for the patient/couple, the treatment is as big of an obstacle emotionally and psychologically as the disease.

The acceptance of infertility is a huge process because once they accept that they're having difficulty and that they need help, the stress gets reduced.

Acceptance. Our culture does not embrace infertility.

There is a pride issue as well. People like to know that they can get pregnant easily. If not, there's a shame.

1 in 8 people experience infertility. 1 in 3 for people 40 above.

Let people know that sensitivity and awareness is so important in the infertility field. Flippant comments without discretion are so damaging.

Studies show that the faster you go to a fertility specialist the shorter the time to pregnancy.

Expectations. The age of a woman is the predictor usually of pregnancy rate.

If you join artificial insemination, the success rate is usually 10 to 20 percent for women less than 35. As a woman gets older egg quality and number diminishes.

If you wanna do IVF, do it sooner. Other proactive things you can do is egg freezing if you're on your late 20's or early 30's and you don't feel that there's any prospect for fertility for years - it's somewhat of an insurance policy but there's no guarantee.

if you feel they're not getting what you are expecting from the specialist then you should leave and find someone that would take ownership of the problem. That's why Dr. Trolice always tells his patients, "Now that you're here, your problem is my problem".

Book Recommendations:

Watch out for Dr. Trolice's book that would be out this 2018 entitled Get Pregnant!

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