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Expert: Finding Solutions to Reproductive Health Challenges

6 min read  |  January 13, 2025  | 

In January, the UHealth Center for Reproductive Medicine, part of the University of Miami Health System, relocated to Doral, Florida. The location is new, but the center’s patient-centered approach to reproductive medicine is the same.

“We work to understand the cause of infertility in order to create personalized treatment protocols. Ours is not a cookie-cutter approach,” says Pasquale Patrizio, MD, MBE, HCLD, FACOG, the center’s director and chief of reproductive endocrinology and infertility at the University of Miami Health System and a professor of obstetrics, gynecology and reproductive sciences at the Miller School of Medicine.

Dr. Patrizio is an internationally renowned specialist in female and male reproductive medicine.  Before joining UHealth three years ago, he spent 18 years as director of the Yale School of Medicine’s fertility center and in vitro fertilization (IVF) program.

In this article, Dr. Patrizio discusses reproductive medicine research, treatments, and the importance of patient-centered care.

How is UHealth research driving new perspectives on reproductive medicine?

Dr. Patrizio: To maximize the efficiency of an IVF treatment cycle, University of Miami researchers are studying in vitro maturation (IVM). IVM is the process of maturing eggs outside of the body in the embryology laboratory. During a normal egg retrieval, 75 to 80% of the harvested eggs are mature; the other 20 to 25% are immature. In most IVF clinics, immature eggs are discarded. Our team of embryologists keeps the immature eggs in culture for an additional 24 hours to allow maturation. If they mature, these eggs can be used for fertilization, thus maximizing the efficiency of the treatment cycle.

We are at the forefront of basic research in female gametogenesis (the mechanism underlying the production of eggs) by studying with the ex vivo ovarian perfusion system what controls and contributes to egg production in human reproduction. We are also at the forefront (with work done by Dr. Attia and Dr. Strbo) of basic research in elucidating the immunological mechanisms controlling implantation after embryo transfers.

In addition to your embryology lab and IVF treatments, are there any services unique to your clinic?

Dr. Patrizio: There are several. We have a full andrology lab offering complete male infertility testing and a urologist, Dr. Pagani, who provides male fertility evaluation and treatment.

Dr. Simms-Cendan, a pediatric adolescent gynecologist, offers consultations twice a month for adolescent patients with pelvic pain, heavy, painful periods, endometriosis, polycystic ovarian syndrome (PCOS), or other gynecological adolescent conditions. It is better to diagnose these and other endocrine disorders early because they could affect not only quality of life but also future fertility.

Dr. Carugno, an expert in minimally invasive surgery, provides consultation and treatments to patients requiring optimization of their reproductive organs before undergoing IVF.

Our reproductive specialists are also experts in oncofertility (the preservation of fertility before undergoing chemotherapy/radiotherapy). They can see patients within 48 hours after a patient is referred by their oncologist.  These consultations are critical because they give patients with cancer  an opportunity to freeze their eggs, embryos, or sperm. For women who don’t have time to undergo egg or embryo freezing – if their cancer has not spread to the ovaries – we offer ovarian tissue freezing by harvesting ovarian tissue via laparoscopy.

All of this combined expertise makes our center unique in that we can see women, men, and adolescents at our center; essentially, we provide everything under one roof.

Many consumers consider “success rates” when selecting a fertility clinic. Why is this not always the best indicator of quality care since some clinics do not accept patients who are less likely to conceive due to their age or other factors?

Dr. Patrizio: One in seven couples experience infertility, and the causes of infertility are many and varied. As part of an academic university-based health system, we have access to a large network of specialists. Our first objective is to correctly identify the cause of infertility, and to this end, we may need to coordinate care with other specialists to ensure the best outcomes and the highest likelihood of a successful IVF treatment cycle.

 Success rates depend on the woman’s age, whether she has had previous pregnancies, sperm quality, and the real cause of her infertility. If a woman is younger than 35, we usually see clinical pregnancies and live births within two IVF treatment cycles. For women older than 40 years and particularly older than 42 years, the chances of a live birth are reduced.

We perform about 600 treatment cycles per year, and we see patients not accepted at other practices because of their advanced reproductive age (older than 42 to 43 years old). We have expertise in how to treat women of advanced maternal age through personalized ovarian stimulation cycles — knowing the optimal time to collect eggs and how to mature them in vitro, if necessary. It is more difficult for these patients to conceive, but they may still want to use their own genetic eggs instead of using eggs from donors. If there is the possibility of giving them an opportunity to use their own eggs, we respect their reproductive autonomy.

Many for-profit clinics offer “add-on” services to patients. What should consumers understand about “add-ons”?

Dr. Patrizio: I sit on an international committee that reviews and comments on the implementation of add-ons. Overwhelmingly, the large number of “add-ons” currently offered have not been validated with randomized, controlled clinical trials, yet they are offered to so many vulnerable couples. These days, it seems that clinics are not looking at outcomes, but rather, they are looking at income. Preimplantation Genetic Testing (PGT) on embryo biopsies – done to determine whether the embryo has the normal number of chromosomes – is an example of an add-on. The American Society for Reproductive Medicine (ASRM) has recently reaffirmed that this testing is not yet fully validated. Still, nearly 60% of IVF treatment cycles in the USA are offered with the PGT “add-on,” while only 15% of cycles in the U.K. are done with PGT.

How do you help patients establish realistic expectations regarding their ability to conceive?

Dr. Patrizio: We allow ample consulting time with patients. Particularly for patients of advanced maternal age, we are very careful in setting the right expectations and honestly explaining success rates.   

Our center is the only reproductive endocrinology infertility clinic in South Florida with a Reproductive Endocrinology and Infertility (REI) Fellowship Program and a university-based research team. Newsweek’s annual “America’s Best Fertility Clinics” listing ranked us #1 in Florida and #17 in the U.S. for three years in a row.


The UHealth Center for Reproductive Medicine is located at 2801 NW 79th Avenue, Suite 401, in Doral, Florida, 33122. To schedule an appointment, call 305-243-8642.


Q&A compiled by Nancy Moreland, a regular UHealth Collective contributor.

Tags: Dr. Pasquale Patrizio, fertility care in Miami, have children, risk of infertility

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