This year, Penn Fertility Care (PFC) celebrated its 50th anniversary, and as part of that, we’re reflecting on how the program has grown and how our Penn fertility experts have helped couples create and grow their families for decades.
Penn's team of reproductive endocrinologists helped pioneer the development of new approaches to the care of infertile couples and led reproductive medicine breakthroughs since opening its doors in 1964, when it became the first fertility program in the greater Philadelphia area.
“When the Penn Fertility Care practice was first established by Luigi Mastroianni, MD, and Celso Garcia, MD, Penn had a vision to develop a program that included three cornerstones that are still relevant today. They include innovation and research into technologies to help couples conceive, education of the next generation of fertility specialists, and excellence in providing patient care,” says Christos Coutifaris, MD, PhD, chief, division of Reproductive Endocrinology and Infertility.
Mastroianni came to Penn Medicine in 1964 as the chair of the department of Obstetrics and Gynecology. He recruited Garcia, one of the pioneers of fertility surgery and the oral contraceptive pill, to join him. During their tenure, they established both the research division of reproductive biology and the clinical division of human reproduction, building one of the best research and clinical programs in women’s health.
Ever since its start, PFC physicians have advanced the science, and, as a result, patients have seen promising results.
“The tools were very limited in the 60s,” says Clarisa Gracia, MD, MSCE, director of Fertility Preservation and associate chief of Clinical Operation for Penn Fertility Care. “There were a few medications to induce ovulation, treatments didn't address male factor infertility, and blocked tubes were treated only with surgery.”
Dr. Coutifaris agrees.
“The evolution of care for the infertile couple has changed tremendously. In the 1950s and 1960s, surgery and hormonal treatments were the primary approaches to infertility care, while in vitro fertilization (IVF) was just starting to be used in animal models and was considered experimental,” he said.
In 1982, Penn launched the country’s fourth IVF program. “Today, IVF is the preferred or most common infertility treatment for most, if not all, causes of infertility,” he added.
Dr. Mastroianni’s vision and leadership are acknowledged by many to have shaped obstetrics and gynecology into an academic and clinical specialty. To this day, PFC continues to be among the top National Institutes of Health (NIH)-funded programs of its kind in the nation, and has been selected to participate in landmark clinical trials, including trials to help women with polycystic ovary syndrome (POS) or endometriosis conceive, and studies associated with fertility preservation in the cancer patient. The PFC is also home to the only dedicated reproductive research laboratory in the Philadelphia region.
In addition to IVF, the PFC offers a wide range of services for both women and men. These include pre-implantation genetic diagnosis and screening, non-invasive embryo imaging, preventative and consultative services, other diagnostic imaging and testing, drug therapy, and a complete array of endoscopic and minimally invasive surgical treatment options.
“Penn Fertility Care encompasses the largest fertility group in Philadelphia consisting of a well-rounded, diverse group of experienced fertility specialists all into one practice,” says Coutifaris. “This includes a reproductive urologist, whose sole focus is the treatment of the infertile male.”
Clinicians and researchers at the PFC are constantly working towards improving success rates for IVF, growing embryos in specialized environments, and optimizing cryopreservation protocols, all in order to maximize the quality and number of embryos capable of implanting and resulting in the birth of a baby.
In addition, with a large and growing cancer center at Penn, freezing eggs for women undergoing cancer therapies has become an important clinical service at PFC for Abramson Cancer Center patients.
“There have been so many advances in cryopreservation for women’s eggs,” says Gracia. “Because we can offer this service with confidence to women, they can focus on their cancer care.”
The PFC also has services for the LGBT community looking to grow their families, and the Penn Polycystic Ovary Syndrome Center, which assists women in managing their POS—a common endocrine system disorder among women of reproductive age.
Genetic testing of embryos is also getting more sophisticated. Clinical embryologists can biopsy embryos and determine if they are chromosomally normal or they are not affected by a genetic disease that the parents may have or may be carriers of. Gracia says this level of care and diagnosis can not only help improve success rates but also decrease the chance of pregnancy loss, or avoid inherited genetic problems the parents may carry.
“We are proud of the accomplishments the practice has made over the past 50 years,” says Coutifaris, “but also look forward to what is ahead for the program in the years to come.”