Advanced Reproductive Specialists

11/23/2025

A heartfelt message from Dr. Fox.

11/21/2025

Endometriosis and Pelvic pain are some of the most confusing and poorly managed areas in medicine.

Endometriosis is one of the most misunderstood (and mistreated) diseases in Gynecology and maybe medicine in general. Our surgical treatment method is complete excision that still, even today, is very unusual. There are fewer than 25 Gynecologists in the US that do extensive excisional surgery for endometriosis. There are many studies that demonstrated an increase in fertility after excisional treatment.
Recurrence: Endometriosis is most likely NOT a recurrent disease. We have re-operated on many patients in the last 20 years for other reasons with rare findings of recurrent disease. Most, >99% of gynecologists in the US, use destructive methods at surgery (cautery and laser) in an attempt to “destroy” visible lesions. In most cases, there are numerous lesions present, making this spot treatment very difficult. Microscopic lesions can be missed, and the tissue changes color with cautery and it is impossible to know if the entire lesion has been destroyed, especially for deeper lesions. With excision, the entire area including all the lesions extending out to normal peritoneum is removed. If lesions are deep, we recognize it as we undermine the peritoneum and can completely remove it. We believe a person gets all the endometriosis they are going to have by the mid teens and from there lesions go through their lifecycle and if removed are gone forever. No new disease is forming. What has been observed though by other physicians over time is recurrent pain in patients with endometriosis and when re-operated after a prior cautery procedure, lesions are seen. We see this also in nearly all patients after cautery and laser procedures and there is disease present but it is obvious that some of the disease has been treated before, just not completely. The appropriate word therefore is persistence not recurrence. We therefore feel that excision is curative for endometriosis. Pain could recur but endometriosis would be an unlikely cause of the problem. Hence pain does not equal endometriosis.

Advanced Reproductive Specialists
Jacksonville Center for Reproductive Medicine

Endometriosis Endometriosis and Pelvic pain are some of the most confusing and poorly managed areas in medicine. Endometriosis is one of the most misunderstood (and mistreated) diseases in Gynecology and maybe medicine in general. Our surgical treatment method is complete excision that still, even t...

11/20/2025

We celebrate with them!

Yesterday we celebrated our son’s first birthday — a moment I once feared we’d never reach. After six years of infertility, navigating diminished ovarian reserve and endometriosis, there were days when the news felt like my whole world was crashing down.

But then we found Dr. Paschall. She was the kindest, most patient doctor, and she listened to every concern my husband and I had. She never dismissed our fears. When I went through my ectopic pregnancy, she was there for us with compassion and unwavering support.

I can’t thank her and the entire team at ARS/JCRM enough for helping us get to this beautiful day. I truly don’t believe we would be here, celebrating our sweet boy’s first birthday, without them. ❤️

11/18/2025

Even later in life

11/15/2025

After three long years of trying to start our family, my husband and I were referred to Dr. Fox for both male and female factor infertility. From the very first appointment, we felt seen, supported, and truly cared for. Dr. Fox performed both my retrieval and transfer with such compassion and expertise, and we’ll forever be grateful for his role in our journey.

A special thank you to Terri Bishop and staff in the Panama City office — her kindness, encouragement, and warmth made every step of monitoring so much easier.

At 35, we are now blessed with our beautiful, healthy 6-month-old daughter, Nora Reece, and we couldn’t be more thankful. 💕

Through this journey, we even met another amazing couple through your office who have become lifelong friends — proof that miracles come in more than one form.

11/14/2025

Common Gynecological Problems May Increase Risk Of Heart Disease, Stroke, Study Finds:

“These reproductive health problems might be increasing their risk of heart disease and stroke.” Researchers found that “women with one or more gynecological disorders had higher risk of heart disease and clogged arteries affecting either their heart or brain health,” with the risk “highest among women with endometriosis or polycystic o***y syndrome.”

There is more to endometriosis than simply pain and infertility. The underlying pathology is dramatic peritoneal inflammation. Inflammation has been closely linked to cardiovascular disease and stroke. The findings in this study from Heart, are completely expected given the underlying inflammatory nature of endometriosis. Excisional Surgery can cure Endometriosis and reverse the dramatic inflammatory state associated.

There has been great resistance to surgery in lieu of medical treatment for the disease which is neither reduces disease or disease progression with pain reduction being the only benefit. These expensive drugs have been pushed into the system by drug makers. The only CURE for this disease process is laparoscopic peritoneal excision - not ablation. Unfortunately due to many converging events early in laparoscopy, ablation was adopted and made the standard laparoscopic treatment for endometriosis. This happened without any studies comparing the efficacy of this new approach against the former gold standard of Excision with "open surgery" (large insicision), utilized for 75 years leading up to the advent of laparoscopy. Thus generations of gynecologists now believe that ablation is the appropriate technique and that endometriosis is not curable. This set back in treatment outcomes, came with the advent of a new technology, one that has offered immense benefits in other areas. This is one of the few examples where new technologies have not improved outcomes in medicine.

Michael D. Fox, MD
Advanced Reproductive Specialists�Jacksonville Center For�Reproductive Medicine�jcrm.org

https://www.healthday.com/health-news/women-health/gynecological-problems-risk-heart-brain-health

TUESDAY, Feb. 25, 2025 (HealthDay News) -- Women experience a great deal of pain or discomfort from common gynecological problems like endometriosis, heavy or i

11/13/2025

This is what it’s all about!
This is our passion!
Thank you for letting us be part of the process!
We are so grateful!

11/11/2025

On Veterans Day, we honor the brave men and women who served our country. Their strength and sacrifice inspire us. At ARS/JCRM, we're grateful for the veterans who have served, including those who've faced challenges on their journey to parenthood. We're honored to support the fertility journey of veterans and their families. Thank you to all veterans for your service.

11/09/2025

Happy Nurse Practitioner Week to all the amazing NPs out there, especially those who specialize in infertility care! Your compassion, expertise, and dedication make a world of difference in helping families achieve their dreams. Keep shining and know that your work is truly life-changing!

11/07/2025

Dr. Fox, Dr. Hearne, and Dr. Paschall discussing supplements during infertility journey.

11/05/2025

From our Jacksonville office.

We are thankful to be part of their journey.

11/03/2025

Pictured are my 5 and 3 year old pumpkins. 🎃 Dr. Fox completed total excision in 2012 for stage 4 endometriosis. It took 7 years before my first positive pregnancy test. My oldest was conceived after ovulation induction cycle. My youngest was spontaneous.