By Leigh Savage
When a couple is struggling with fertility, medical interventions often are focused on the female partner. But a new partnership between Blake Wynia, MD, a urologist with Prisma Health Regional Urology, and Lisa Green, MD, of Prisma Health’ Fertility Center of the Carolinas, is creating a more comprehensive approach that may help couples achieve their family dreams sooner.
“It’s understandable why, historically, the emphasis has been on the female aspect, considering women carry the baby,” Dr. Wynia said. “But we feel that focusing on the couple as a whole helps us comprehensively identify issues that are potentially correctable.”
About half of infertility issues stem from the female partner, while a male issue is the cause in 30 percent of cases. In 20 percent of cases, both partners have a contributing factor.
“A lot of people don’t realize that around 50 percent of couples do have some form of male factor involved, and male infertility has been an underserved need,” Dr. Wynia noted.
When the two physicians began working at Prisma Health in September 2017, they quickly realized they had a common interest in collaborating to improve patient care.
Our collaborative relationship dates back to our physician orientation,” Dr. Green explained. “And his male reproductive clinic is right across the street, so we’ve been making an intentional effort to create a one-stop shop.”
She says fertility issues have a unique dynamic, with a couple as the patient instead of one person. “You don’t have an infertile male or female, but an infertile couple,” she observed. Being able to address female and male issues together “really makes us a strong, fully functioning reproduction center.”
To the best of their knowledge, they are the only example in the upstate of interdisciplinary reproductive healthcare professionals working in close collaboration. While Prisma Health has long been known for its robust reproductive endocrinology group (the female side), there have been only a few doctors specializing in male infertility, and none in close coordination with the fertility center.
Now, when new patients call with infertility issues, appointments are scheduled for the couple to visit both doctors. The doctors ask that both partners attend each appointment, though Dr. Green focuses more on the female and Dr. Wynia the male.
“Even though I’m mostly interviewing the male partner, the female partner can fill in the gaps,” Dr. Wynia said.
A powerful collaboration
Dr. Green chose to pursue reproductive endocrinology because it offered her a chance to focus on science, clinical care and surgery. She appreciates the challenge of helping patients who may have hormonal issues or rare disorders, and using leading-edge science and research to solve the problem.
“It’s so rewarding to help a couple who wants to build their family and help them achieve their dreams,” Dr. Green said.
Dr. Wynia completed a fellowship in andrology, or male infertility and sexual dysfunction, at Albany Medical College after finishing medical school and residency. He was drawn to the field because it makes such a difference in people’s lives.
“Some people have been told they might not have a chance to have a genetically related child, and they’ve been trying for quite a while and are frustrated,” he explained. “It’s really satisfying to offer couples some sort of hope, and some sort of treatment that will increase their chance of success and make a big difference in their lives.”
Now that he and his wife have a 16-month-old son, he has a more vivid understanding of what couples are hoping to achieve.
“Having a child is not like anything else,” he said.
Numerous factors contribute to infertility on both the male and female side, and recommendations and solutions for couples vary widely. Dr. Wynia said he takes a holistic view of the male partner, who may need to consider overall health and address diet, smoking or drinking.
“All kinds of things affect fertility and the quality of sperm,” he said. “Sometimes it’s easily correctable.”
Issues that aren’t lifestyle related can often be corrected via surgery. Options include microscopic testicular sperm extraction and microscopic varicocelectomy, or the repair of varicose veins in the scrotum. Dr. Wynia is the first in the Upstate to offer the microscopic technique, which improves sperm quality. He also offers vasectomy reversals that can be done robotically, which improves accuracy.
On Dr. Green’s side, women also may have lifestyle factors, or they may need to address any number of issues, such as Turner syndrome or premature ovarian insufficiency. Focusing on the full scope of endocrinology—the endocrine glands as well as hormones—is the best approach to address infertility.
The key is using both doctors’ skills, knowledge and training to help patients on the complex journey to parenthood.
“A lot of couples feel alone, and it’s very isolating,” Dr. Green said. “But 15 percent of couples have an infertility diagnosis.”
With the collaborative power of both doctors and their teams focusing on every aspect of infertility, Green and Wynia say the chances for success are excellent.
We look at all of the options available, whether it’s improving male or female fertility,” Dr. Wynia said. “And we can help the majority of patients achieve their dream.”
This article originally appeared in the Spring 2018 issue of Prisma Health’ss Inside Health magazine. The full issue can be accessed here.