Expanded reproduction, perinatal centers to improve patient service
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
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
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.