Expanded reproduction, perinatal centers to improve patient service

By Nicole Fawcett
UMHS Public Relations

The Board of Regents on Feb. 19 approved the expansion of the Reproductive Endocrinology and Infertility (REI) Program and the Perinatal Assessment Center (PAC) at the U-M Health System (UMHS), which will make it possible for even more couples who are struggling to conceive or facing high-risk pregnancies to give birth to healthy babies.

UMHS has been on the cutting edge of offering many advanced programs and services for these couples. But as reproductive and perinatal medicine have expanded and improved, each program has outgrown its initial space.

“We’ve got a five- to six-month waiting list for new patient appointments because people can’t get in to see us, in large part because of limitations on space,” says Dr. John Randolph, professor of obstetrics and gynecology and director of reproductive endocrinology and infertility at UMHS.

Under the $5.5 million proposal, the REI Center for Reproductive Medicine will move to renovated space in the Briarwood Clinic that will nearly double its current clinical space and lab capabilities. The Perinatal Assessment Center then will expand into the vacated REI space, next to its current location in the C.S. Mott Children’s Hospital, also nearly doubling its size.

“We need the extra capacity to accommodate the demand for our services,” says Dr. Kathleen Hanlon-Lundberg, clinical associate professor of obstetrics and gynecology and medical director of PAC. “We have wonderful equipment, like a state-of-the-art, three-dimensional ultrasound machine. But we can’t make the most use of this excellent technology because we don’t have a designated space to house it. This expansion will allow us to develop the frontier that’s opened up by this technology.”

The new REI space would include 10,500 square feet, allowing for eight clinical exam rooms, two procedure rooms, three consultation rooms, an in-vitro fertilization lab and an assisted reproductive technology (ART) lab. Currently, the ART lab can harvest and fertilize 80 eggs a year. The new space will allow the lab to process up to 200 a year.

In addition, the new space will allow the department to offer additional services, including a donation and egg freezing program for women undergoing treatment for cancer. UMHS currently freezes sperm for male cancer patients. Randolph also anticipates expanding the center’s sexual dysfunction counseling. The new space at Briarwood also will facilitate patient access and parking.

New faculty also will come on board. OB/GYN will add a fifth faculty member to the Reproductive Endocrinology team, and a second Urology faculty member will be devoted to this program. Currently OB/GYN and Urology work together to allow men and women to be seen at the same clinic on the same day for reproductive testing and counseling.

For couples who have conceived and face a high-risk pregnancy, PAC offers ultrasound, fetal monitoring and genetic counseling. Services in this area increased 41 percent from fiscal year 2002 to FY2003 as services expanded and improved.

Fetal monitoring through the third trimester allows doctors to track a fetus’ progress and families to plan for their baby’s future. New technology has allowed testing for some abnormalities to occur earlier in a woman’s pregnancy, as soon as 11-14 weeks instead of 15-20 weeks.

“We sometimes find out about birth defects that are important to know about when the baby is born. In some cases, knowing ahead of time can be life or death when the baby is born,” Hanlon-Lundberg says.

The expansion also will allow PAC to grow its Maternal-Fetal Center for Evaluation and Intervention, enhancing UMHS’s capacity at the cutting edge of perinatal medicine. The program will have maternal-fetal specialists working together with pediatric cardiologists and surgeons to evaluate a baby’s condition in utero, plan for care immediately after birth and in some cases pursue laparoscopic surgery in utero.