General Practitioners

• Osteoporosis
• Medical Weight Loss
  Patients with poorly controlled diabetes are known to have an increased risk of spontaneous miscarriage, which is reduced to normal spontaneous loss rates when women are euglycemic preconceptually. Testing for fasting insulin and glucose is simple and treatment with insulin-sensitizing agents can reduce the risk of recurrent miscarriage. More recently, determining the average load of blood glucose through testing of hemoglobin A1C has become an increasingly utilized modality to evaluate insulin resistance. Because there is strong evidence that obesity and/or insulin resistance are associated with an increased risk of miscarriage, weight reduction in obese women is a first step in the treatment. Metformin seems to improve pregnancy outcome, but the evidence for this treatment is limited to a few cohort studies. Metformin is a Category B medication in the first trimester of pregnancy and appears to be safe.
• Male Infertility
  Male infertility isn’t something you hear much about in the news, so it may be surprising to learn just how common it is. About one-third of infertility is thought to be male derived. Additionally, many couples with a normal semen analysis and a normal female evaluation (also called unexplained infertile couples) may have subtle abnormalities in sperm that a routine semen analysis simply fails to diagnose.
• Erectile Dysfunction
• Infectious Diseases
  All therapeutic donor insemination procedures at Fertility Associates of Memphis are performed under the guidelines outlined by the American Society for Reproductive Medicine and the American Academy of Tissue Banks. Prior to Therapeutic Donor Insemination (TDI), the couple will have tests to help with matching to a donor specimen as well as to screen for infectious diseases. The donor sperm is purchased through a number of commercial sperm banks. Fertility Associates of Memphis will only accept sperm from accredited banks with experience.

Gynecologists

• Gynecology
  Amelia P. Bailey, Luca Lancerotto, Chad Gridley, Dennis P. Orgill, Hiep Nguyen, Elena Pescarini, Gianluigi Lago, Antonio R. Gargiulo.  Greater surgical precision of a flexible carbon dioxide laser fiber compared to monopolar electrosurgery in porcine myometrium.  Journal of Minimally Invasive Gynecology, 21(6):1103-9, 2014.
• Female Infertility
  Serving Tennessee, Arkansas, and Mississippi communities since 2003, our fertility specialists passionately help couples and individuals overcome the most complicated male and female infertility causes.
• Obstetrics
  Antiphospholipid antibody syndrome (APS) is treated with a combination of low dose heparin (5000 to 10,000 units subcutaneously every 12 hours) and low dose aspirin (81 mg orally daily) appears to be effective and may reduce pregnancy loss by 54% in women with APS. Aspirin alone does not appear to reduce miscarriage rates. Unfractionated heparin is preferred to low molecular weight heparin (LMWH) based on available data. In 1996, the Recurrent Pregnancy Loss Center published the first study that established APS as a cause of RPL in the first trimester. This landmark paper, published in the American Journal of Obstetrics and Gynecology, also established heparin and aspirin as the treatment of choice.  The data from our study is foundation of the current recommendations for treatment by the American College of Obstetricians  and Gynecologists as well as the American Society for Reproductive Medicine.
• Endometriosis
  Many patients experience no physical symptoms. However, since pelvic pain during menstruation is the most common symptom with endometriosis, many women fail to associate it with a medical condition. This pain is often a severe cramping that occurs on one or both sides of the pelvis and may radiate to the back, rectal area, and occasionally legs. Keep in mind that while endometrial pain most often occurs at the time of menstruation, many women report endometriosis pain at other times of the month or possibly during intercourse. It is important to understand that the severity of pain varies widely between patients and does not appear to be related to the extent of the endometriosis itself. A woman can have a few very small implants and have severe pain while another woman with extensive endometriosis may have very few signs of the disorder.
• Pelvic Pain
• Pregnancy

Internists

• Internal Medicine
  Dr. Brezina completed his fellowship in Reproductive Endocrinology & Infertility at the Johns Hopkins School of Medicine in Baltimore, MD. He earned his undergraduate degree from the University of North Carolina at Chapel Hill. He has an MD/MBA degree from the Brody School of Medicine at East Carolina University in Greenville, N.C., where he also completed his residency in OB/GYN and internship in Internal Medicine.

Neurologists

• Multiple Sclerosis
  Retrograde ejaculation is a disorder that causes the semen to be released backward into the bladder during ejaculation. This condition may be congenital but also may be found in men with diabetes, multiple sclerosis, or who have had previous prostate surgery. It may be a side effect of certain medications, such as antidepressants and blood pressure medicine. Urine is collected and studied to determine if there is retrograde ejaculation present; if so, the sperm is evaluated.

Psychiatrists

• Depression
• Anxiety

Endocrinologist

• Diabetes Care
• Endocrinology
  Memphis Fertility Laboratory, Inc. provides exclusive andrology, endocrinology, and embryology services related to assisted reproductive techniques. Drs. Ke and Kutteh are investors in Memphis Fertility Laboratory, Inc. LabCorp provides reference laboratory services and LabCorp will bill their services directly to your health insurance. For co-insurance and deductible payments that you are responsible for, you will receive a separate statement from LabCorp. While we will verify your insurance plan’s designated laboratory, we do not verify if each individual test is covered by your plan.
• Hypothyroidism
  Abnormal ovarian function with decreased progesterone production has been termed a “luteal phase deficiency” and is found in 5-8% of women with RPL. Other hormonal deficiencies that are associated with pregnancy loss include hypothyroidism, an excess in production of prolactin, and imbalances in glucose and insulin. These conditions can be treated medically.
• Thyroid

Radiologist

• Ultrasound
  We describe a new algorithm for the evaluation and treatment of RPL. Miscarriage chromosome testing is recommended with the second and all subsequent miscarriages. Miscarriage tissue obtained from early nonviable pregnancies should be sent for conventional cytogenetic analysis or 23-chromosome pair microarray evaluation. No diagnostic/therapeutic action is recommended following one miscarriage unless there was some abnormal finding as a part of the routine evaluation. These would include an abnormal shape to the uterus on ultrasound that might suggest a uterine anomaly, a high blood sugar on routine blood or urine suggesting a diabetic condition, or a false positive test for syphilis which could suggest the antiphospholipid syndrome.
• MRI
  Congenital and acquired anomalies of the uterus are a major correctable cause of RPL. Anatomic causes of RPL are typically diagnosed using hysterosalpingography  or sonohysterography.  Hysteroscopy, laparoscopy, or magnetic resonance imaging can supplement these tests as needed. Recently, transvaginal three-dimensional ultrasonography has been introduced and has allowed an accurate and non-invasive diagnosis of congenital uterine anomalies. The prevalence of congenital and acquired uterine anomalies in 904 women with RPL  was reported by our group in 2013 and published in Fertility and Sterility. The summary of the abnormalities that were found in women with RPL is detailed in the table below. Primary RPL is when there have never been any live born children. Secondary RPL is when there has been at least one live born child.
• X-Rays
• Chemotherapy
  Many oncologic treatments such as chemotherapy or radiation have been clearly linked to a profound decrease in fertility. Oocyte or embryo cryopreservation offers women with cancer the chance to preserve their fertility potential prior to being exposed to oncology therapies. Cryopreserved oocytes or embryos may be utilized once a cancer-free status is achieved if there is no residual ovarian function after therapy.
• Radiation Therapy
  Many of the strategies aimed at oncologic fertility preservation have been only marginally effective and were pioneered in large part prior to the demonstrated success of egg freezing in the setting of IVF. One such strategy is the surgical removal and freezing of part/all of an ovary prior to oncologic treatment with subsequent replacement of this tissue at the time of desired fertility. Another strategy is to suppress ovarian function with medication during the time of chemo and radiation therapy. These and other strategies may confer a modest benefit but are currently thought to be inferior to IVF when compared with oocyte/embryo cryopreservation.

Surgeons

• Minimally Invasive Surgery
  Uterine abnormalities, both those that develop from birth and those that develop later in life, are common causes of miscarriage. These include abnormally shapes of the uterus such as a septum and abnormal growths within the uterus such as fibroids or polyps. These can usually easily be corrected with minimally invasive surgery.
• Vasectomy
  However, some men may wish to have more children even after this procedure. In some cases, men may have cryopreserved a few vials of sperm in case they change their mind and desire more children. If this was not done, there are several alternatives that offer excellent fertility options after vasectomy.
• Robotic Surgery
  Dr. Bailey has authored more than 20 research publications in peer-reviewed national and international journals and delivered more than 50 lectures in the field.  She has received multiple teaching and patient satisfaction awards reflecting her focus on patient-centered care.  In addition to treating all areas of infertility, her special interests include robotic surgery and the treatment of congenital abnormalities of the reproductive tract.
• Hysterectomy
• Laparoscopy

Dermatologists

• Skin Cancer
  Wei Tan, Amelia P. Bailey, Megan Shparago, Brandi Busby, Jordan Covington, James W. Johnson, Emily Young, Jian-Wei Gu.  Chronic alcohol consumption stimulates VEGF expression, tumor angiogenesis and progression of melanoma in mice.  Cancer Biology and Therapy 6(8):1211-7, 2007.
• Cyst
• Lesions
  Every month, the endometrial implants respond to the monthly cycle just as they would in the uterus (fill with blood, thicken, break down, and bleed). Products of the endometrial process cannot shed through the vagina as menstrual blood and debris does. Instead, the implants develop into collections of blood that form cysts, spots, and patches. These lesions may grow as the cycle continues. The lesions are not cancerous, but they often develop to the point that they cause obstruction or adhesions (web-like scar tissue) that attach to nearby organs, causing pain, inflammation, and sometimes infertility.