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Review documents about Tubal Reversal, HSG's, semen analysis, postcoital tests, and more. Click here!

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Learn more about the causes of and treatment for infertility as well as many related issues. Click here!

Autumn, God has really blessed us and your kindness, attention, and professional group helped make it happen! R.H. Knoxville, TN
~ R.H. Knoxville, TN
Dr. Jeffrey KeenanAutumn Galbraith, Nurse Practitioner

Dr. Keenan and Autumn Galbraith, Board Certified Women's Health Nurse Practitioner, work collaboratively to provide you with holistic care and multidisciplinary treatment. You will receive compassionate care and the most up to date treatments available. Click here or call today to schedule an appointment.

Frozen More Than 24 Years, Born Perfectly Healthy!

What once sounded like science fiction became reality when a 26-year-old gave birth to an embryo frozen for more than 24 years, and it happened right here in East Tennessee! In fact, she was our patient! In late 2017, Tina Gibson gave birth to baby Emma Wren, delivering the world's longest-frozen embryo to successfully come to birth. Tina and her husband Benjamin were embryo-receiving parents through the National Embryo Donation Center and had their frozen embryo transfer (FET) performed through us. This story made global headlines! Click here to view the coverage on Good Morning America. We're so happy for the entire Gibson family!

Fall Update 2018

Welcome Fall! The cooler temperatures are a nice relief from the hot summer days. Now that schedules have normalized with the resumption of school and end of summer vacations, call today to schedule an appointment! (865) 777-0088

Breast Cancer Awareness Month

October is breast cancer awareness month! According to the National Breast Cancer Foundation, breast cancer is the most commonly diagnosed cancer in women with 1 in 8 women being diagnosed with breast cancer in their lifetime. Behind heart disease, breast cancer is the 2nd leading cause of death among women. According to the National Cancer Institute, when breast cancer is detected early, in the localized stage, the 5-year survival rate is 98%. The best way to fight breast cancer is to have a plan that helps you detect the disease in its early stages. Give us a call to schedule your breast exam and allow us to explain current recommendations to you!

Fall Health Observances

Literature Review

IVF and Cancer?!!?

A large observational study found no increased risk for uterine cancer, but small increases in risk of some breast and ovarian cancers in women treated for infertility. Increased risks of ovarian tumors were limited to women with endometriosis, no or low number of births, or both. This study found no increased risk of any ovarian tumor in women treated because of only male-factor or unexplained infertility. Women who had previously given birth and did not have a diagnosis of endometriosis had no increase in risk for ovarian cancer. Instead, increased risk appeared to be limited to women with endometriosis, few or no births, or both.

What’s the bottom line? If this is correct, and that is a big if, the risk of in situ (not metastatic) breast cancer is increased by 2 cases per 100,000 person-years, and invasive ovarian cancer increased by 3 cases per 100,000 person-years.

Osterweil, N. (2018). IVF linked to slight increase in risk of some cancers. OB.GYN. News. Retrieved from MDEdge.com

EDCs and Sperm

Endocrine disrupting chemicals (EDCs) have been know to adversely affect the endocrine system leading to compromised functions of hormones. EDCs are substances that change the course of the endocrine system in a way that adversely affects the organism itself or its offspring. These chemicals can be found in a variety of everyday products and goods, such as foods, water, plastics, shampoos, clothes, toothpastes, soaps, fertilizers, paper, textiles, carpets, utensils, bedding, toys, cosmetics, deodorant, etcetera. There is some evidence that these chemicals can decrease sperm quality, increase the risk for testicular cancer, and be responsible for conditions such as cryptorchidism (undescended testicles) and hypospadias (incorrect position of the uretheral opening on the penis) in young males. Avoidance of these chemicals is key, especially in the face of male factor infertility.

Rheman, S., Usman, Z., Rehman, S., AlDraihem, M., Rehman, N., Rehman, I., & Ahmad, G. (2018). Endocrine disrupting chemicals and impact on male reproductive health. Transl Androl Urol., 7(3), 490-503.

PCOS and Metformin

A recent article publish in Fertility and Sterility confirmed that the use of Metformin in women with PCOS increases the rate of ovulation, but indicated that it should not be used first line for anovulation because oral ovulation induction medications such as Clomid and Femara are much more effective in increasing ovulation, pregnancy, and live-birth rates in women with PCOS. They also found that the combination of oral ovulation induction medications with Metformin increases live birth rate.

Practice Committee of the American Society for Reproductive Medicine. (2017). Role of metformin for ovulation induction in infertile patients with polycystic ovary syndrome (PCOS): a guideline. Fertility and Sterility, 108(3), 426-441.

Low Egg Supply? Don’t Panic!

Anti-mullerian hormone (AMH) is a blood test that is often used to measure a women’s ovarian reserve. The correlation has been, the lower the AMH, the lower a woman’s egg supply. A recent analysis of 750 women found that women with low AMH values (< 0.7 ng/mL) did not have a significantly different predicted probability of conceiving by 6 cycles of attempt compared with women with normal values or by 12 cycles of attempt. Among women aged 30 to 44 years, without a history of infertility, who had been trying to conceive for 3 months or less, biomarkers indicating diminished ovarian reserve compared with normal ovarian reserve were not associated with reduced fertility. So, a low AMH does not necessarily mean that you won’t be able to conceive. Now, take a deep breath, and relax!  

Steiner, A., Pritchard, M., Stanczyk, F., Kesner, J., Meadows, J., Herring, A., & Baird, D. (2017). Association between biomarkers of ovarian reserve and infertility among older women of reproductive age. JAMA, 318(14), 1367-1376.

I am trying to get pregnant. I just have a question. I think I am haivng hormonal problems. I am having irregular cycles. I think I need IVF I think I need surgery. I am having pelvic pain. I am having miscarriages.