Advanced Reproductive Specialists

09/21/2025

Cancer, the biggest fear for all People:

Metformin Use Tied To Improved Survival In Women With Type 2 Diabetes Mellitus, Hormone-Related Cancers, Research Suggests

From a theoretic standpoint only, this study suggests and supports the overall idea that higher insulin levels result in higher cancer survival rates and the though that insulin and the metabolic derangements associated with insulin resistance are the underlying cause of cancer to begin with. In this basic study Metformin use (a drug that lowers insulin levels somewhat) was shown to help survival in patients with hormonally sensitive cancers. I'm not so sure the hormone sensitive part is that important but this study was performed by gynecologic oncologists, so they will naturally look at "their" cancers.

It has been shown in other studies that a ketogenic nutritional approach, that by definition lowers insulin levels to their lowest baseline levels, can improve breast cancer survival by 50% which is a huge number! The benefit In this study is much less than 50% which is consistent with our clinical findings of metformin helping a little bit with insulin resistance and the resulting abnormal parameters in metabolic dysfunction and PCOS. The nutritional change (ketogenic approach) on the other hand seems to be 80-90% of the effect in re-establishing health in these patients. It would then make sense then that ketogenic nutrition and metformin would be the best strategy to first, prevent cancer and then to decrease the progression or increase the cure rates once the cancer is established. This is our current first line therapy for Insulin resistant patients.

The other important piece of information this study gives us was related to worsening outcome based on "severity" of metabolic dysfunction as demonstrated by severity of Diabetes type II shown in this study by required medication for treatment of their disease. Severity of metabolic dysfunction also correlates with higher BMI, or worsening metabolic syndrome with other diseases such as heart dz and cholesterol abnormalities. Here the crude death rates were highest in women treated with tier 3 medications {Insulin} (37%), followed by tier 2 users {true insulin raising drugs} (33%), patients on no medication (23%), and metformin users {no other Diabetes medications} (18%). Therefore, people with less advanced metabolic syndrome fared better and those with the least severe disease on metformin survived the best likely due to exposure to lower lifetime insulin levels.

Again, the overall implication here from a broad perspective is that higher insulin levels and longer lifetime exposure brings higher death rates from a hormonally sensitive cancer. If we extrapolate on a theoretic basis (with support from other sources and observational reports), Insulin causes cancer and less insulin is better for survival once cancer is diagnosed.

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

https://www.cancertherapyadvisor.com/home/cancer-topics/gynecologic-cancer/metformin-diabetes-hormone-related-cancer-improve-survival/

Researchers evaluated the association between metformin and survival in women with type 2 diabetes and 3 hormone-related cancers — breast, ovarian, and endometrial cancer.

09/21/2025

Approximately 85% of couples achieve a pregnancy within one year of regular unprotected in*******se. This means about 12-15% of couples seek some form of fertility treatment at some point during their lifetime.

If you fall into any of these categories, call for an evaluation:

Women
• Age 35 and under who have been trying to conceive for 1 year without success
• Over the age of 35 who have been trying to conceive for 6 months without success
• Who have irregular periods or an absence of periods
• Who have other known problems that may affect fertility; ovulation problems, fibroids, endometriosis, blocked fallopian tubes, history of pelvic or abdominal surgeries or sexually transmitted infections

• Who have successfully become pregnant in the past, but are now unable to achieve a pregnancy

• Who have had multiple miscarriages

• Who desire to electively preserve their fertility

• Who know they will be having chemotherapy, radiation, an/or pelvic surgery due to a cancer diagnosis and want to preserve their fertility for the future

Men
• With an abnormal semen analysis

• With hormonal abnormalities; varicocele, a blockage, or absence of the duct that transports s***m from the duct, and/or difficulty with ej*******on

• Who have undergone a vasectomy

• Who know they will be having chemotherapy, radiation, and/or pelvic surgery due to a cancer diagnosis and want to preserve their fertility for the future

We understand how a diagnosis of subfertility is extremely anxiety provoking and stressful.
At ARS/JCRM, we have extensive experience, not only with diagnosing and the surgical/medical management of subfertility, but also in managing the stress that this diagnosis may bring. We take a comprehensive approach that provides a couple with all possible treatment options. You have a choice and it should be a well-informed and knowledgeable one, made only after understanding the underlying diagnosis and individualized fertility paths that are available to you.

Please call our office to schedule an appointment.

Should I See a Fertility Specialist? Approximately 85% of couples achieve a pregnancy within one year of regular unprotected in*******se. This means about 12-15% of couples seek some form of fertility treatment at some point during their lifetime. If you fall into any of these categories, call JCRM....

09/19/2025

Meet our nurse practitioner at our Macon, Georgia office, Alex!

09/19/2025

So what is it about women that gives them a longer lifespan than men? A single word: Estrogen. Estrogen is cardio protective, despite the government and the WHI's attempt to discredit this idea. there is also very suggestive evidence that it reduces the incidence of Alzheimer’s disease. In our practice of reproductive medicine, we recognize that fertility problems also carry with them chronic health consequences. PCOS and insulin resistance cause a host of metabolic diseases including diabetes and heart disease. The newer soon to be more common, hypothalamic dysfunction or stress induced ovulation dysfunction also will be shown to result later in stress induced diseases that mimic those of PCOS but also will result in significant osteoporosis, bone and joint problems later in life. At ARS/JCRM, we are committed to educating women on these risks and offering changes and strategies that will improve long term outcomes. This study:
Women With Irregular Periods May Be More Likely To Die Before 70, Researchers Say highlights this problem.

https://www.hsph.harvard.edu/news/hsph-in-the-news/irregular-periods-premature-mortality/

In this study it was determined that if women had cycles that were long (our definition >30days) that their lifespan was significantly compromised. All of reproductive medicine should take a much more active role in helping women see these issues and provide valid strategies to avoid these negative outcomes.

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

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09/18/2025

Please help us welcome Kimberly Gallo APRN to the ARS Gainesville location.

Kimberly was born and raised in West Palm Beach, Florida.

She began her nursing career in 2019 after graduating from the University of Florida with her Bachelor of Science in Nursing. She has worked in both inpatient and community health settings as a nurse. Since nursing school, she has always had an interest in Women’s Health.

In May 2023, she graduated from the University of Florida with her Doctorate of Nursing Practice and is Board Certified through American Nurses Credentialing Center as a Family Nurse Practitioner. She began her Nurse Practitioner career working in Otolaryngology. She is so excited to have this opportunity to pursue her interest in Fertility and Women’s Health.

In her free time, she enjoys spending time with her family and 2 dogs. She also enjoys going on the boat and Gator football!

09/14/2025

We recognize that PCOS continues to be very poorly understood by the medical community. Unfortunately, birth control pills continues to be the primary treatment method supplemented in some cases by Metformin. Those with PCOS know all too well this approach has a very small effect on the overall process. Without a distinct focus on the treatment of insulin resistance (insulin elevation), patients will continue to worsen over time and ultimately most will suffer many of the listed complications of PCOS. A simple change in nutrition to dramatically reduce the insulin levels will make a dramatic difference to patients with this syndrome. This approach is the only way to truly treat PCOS and the associated problems that arise from elevated insulin. In addition to our aggressive treatment of PCOS, we do handle patients with type II diabetes and metabolic syndrome. There exists a large number of women who may not meet the strict criteria for PCOS but still have the same insulin resistance physiology and need similar treatment. Remember, PCOS is one of numerous major health concerns that result from Insulin Resistance. After being in practice for over 20 years, it is clear that patients don't "read the textbook," meaning that they don't always have the classic symptom pattern for particular diseases. Instead, we see a variety of presentations for a particular disease process such as PCOS.

We treat PCOS. Call today to schedule a consultation.

https://jcrm.org/treatment-options-for-pcos/


Michael D. Fox, MD
Advanced Reproductive Specialists
Jacksonville Center
Reproductive Medicine

09/12/2025

More praise for lowering carbs and eating higher fat!

Researchers report that the ketogenic diet decreased depression symptoms more effectively than traditional medications and counseling in a pilot study by Ohio State University.

09/11/2025

Happy Birthday to an incredible doctor!
Dr. Lipari, your dedication, expertise, and compassion have brought joy to countless families. You've changed lives in ways that go beyond words. We wish you another year filled with miracles! Wishing you a day filled with love, celebration, and all your favorite things! 🌟🥳🎉

09/09/2025

09/08/2025

From our Jacksonville Center for Reproductive Medicine office!

09/07/2025

September is Ovarian Cancer Awareness
And PCOS Awareness month

Ovarian cancer is a serious gynecological cancer that affects the ovaries. It is important to be aware of the signs and symptoms of ovarian cancer so that it can be detected and treated early.
Symptoms:
Persistent bloating
Pelvic pain or pressure
Changes in bowel habits (e.g., constipation, diarrhea)
Feeling full quickly after eating
Unexplained weight loss
Fatigue
Risk Factors:
Age (most cases occur in women over 50)
Family history of ovarian or breast cancer
Early menstruation
Late menopause
Infertility
Use of hormone replacement therapy
Diagnosis:
Pelvic exam
Blood tests
Imaging tests (e.g., ultrasound, CT scan, MRI)
Treatment:
Surgery (removal of the ovaries and uterus), Chemotherapy, and Targeted therapy.
Prevention:
Regular pelvic exams
Genetic testing (if family history is present)
Healthy lifestyle (diet, exercise, weight management)
Awareness Efforts:
September is Ovarian Cancer Awareness Month:
During this month, organizations raise awareness about ovarian cancer, promote early detection, and support research.
Wear Teal Day:
On the second Friday of September, people wear teal ribbons or clothing to show their support for ovarian cancer awareness