Jacksonville Center for Reproductive Medicine

11/23/2025

A heartfelt message from Dr. Fox.

11/20/2025

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. ❤️

11/19/2025

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.

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...

11/18/2025

Sustained Weight Loss Tied To Breast Cancer Risk Reduction, Research Suggests

Here is yet another study that ties insulin elevation (resistance) to cancer and in this case breast cancer. Physiologically we know that as fat increases, so does insulin resistance and with weight loss, insulin levels decrease. Even in starvation diets, insulin decreases due to decreased absolute carbohydrate intake. Remember in the early 1900's when "primitive stone age" societies were first encountered eating their stone age diet (ketogenic) the researchers encountered No Cancer in these populations. Women and doctors are fixated on estrogen as a cause of breast cancer but here further support by association for the idea that insulin is a significant cause of breast cancer. Estrogen + Progesterone reportedly increased breast cancer by "25%" and here just 4 lbs of weight loss dropped risk 18% while 20lbs reduced it by 32%. Wonder what the incidence would drop to on a ketogenic, maximally reduced insulin approach would do? Maybe a 90 - 100% reduction based on findings in the stone age populations referenced above. In those groups further studied as they were introduced to the western diet, cancers begin showing up 5-10 years later. A good read to understand this more is "Nutrition and Physical Degeneration" by Weston Price, one of those researchers in the early 1900's.

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

Even later in life

11/14/2025

We wre blessed to have Nicole as part of the ARS/JCRM team!

R. Nicole Bishop, RN: A Beacon of Compassionate Care in Reproductive Medicine

November 3, 2025 Karen Johnson
Dedicated Registered Nurse and Faithful Advocate for Patients’ Well-Being

Nicole Bishop, RN, is making a significant impact in the field of reproductive medicine through her compassionate care and unwavering commitment to her patients. A Registered Nurse based in Florida, Nicole embodies the essence of nursing by offering exceptional support and medical expertise to those navigating the complex and often emotional journey of fertility treatments.
Nicole’s nursing journey began at Southeast Bulloch High School/Vocational School in 1991, where she laid the groundwork for her future in healthcare. Valdosta Technical Institute in 1994, LPN program. LPN (1994 – 2017) Her passion for nursing led her to earn an Associate of Science Degree in Registered Nursing from Wallace Community College in 2017, officially marking her entry into the nursing profession.

Currently, Nicole specializes in fertility care at Advanced Reproductive Specialists / Jacksonville Center for Reproductive Medicine. In her role, she is recognized as a “jack of all trades,” providing vital support in various capacities. From assisting in-office procedures and delivering post-anesthesia care to performing lab draws, IVF coordinator, and ultrasounds for cycling patients, Nicole is committed to ensuring that each patient receives comprehensive and compassionate care. She also plays a pivotal role in the clinic’s egg donor program, directly contributing to the joy of helping families grow.

Nicole’s approach to nursing is deeply rooted in her faith. As a Christian, she strives to reflect God’s grace and glory in her daily work, continuously seeking to improve herself both personally and professionally. “My success is driven by a genuine passion for helping others,” Nicole shares—an outlook that inspires her dedication, perseverance, and compassion in every aspect of her nursing practice.

Outside of her professional commitments, Nicole finds joy in simple pleasures such as reading, coloring, and leisure walking. These activities provide her with the peace and balance necessary to maintain her dedication and enthusiasm for her work.

As R. Nicole Bishop continues her journey in healthcare, she remains a beacon of hope and support for her patients. Her story is a testament to the profound impact that committed healthcare professionals can have on individuals and families during some of their most challenging times.

Learn More about R. Nicole Bishop:
Through her online profile, https://todaysnurse.org/nurse/4152204

https://pressrelease.healthcare/r-nicole-bishop-rn-a-beacon-of-compassionate-care-in-reproductive-medicine.html?utm_medium=email&_hsmi=214570269&utm_content=214570269&utm_source=hs_automation

11/13/2025

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.
Wright Photos

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, 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!

11/08/2025

Meet Dr. Sarah Paschall. We are blessed to have her on the team.

11/06/2025

As a nurse, I've seen the beauty of life and the struggles of infertility. Holding that sweet baby in my arms... it's a reminder that miracles happen. Years of hope, prayers, and perseverance - it's all worth it for this precious moment. To all the families I've cared for, you're not alone. 💕

11/05/2025

Endometriosis is TREATABLE!

Endometriosis is one of the most misunderstood (and mistreated) diseases in Gynecology and maybe medicine in general. The following discussion aims to explain our professional experience with this disease over the last 20 years where we took a special interest in the disease and its management. Our perspective is very different than what is conventionally believed.

Our surgical treatment method is complete excision that still, even today, is very unusual. There are few gynecologists in the US that do extensive excision surgery for endometriosis. The reasons for this relates very much to history and the advent of laparoscopic technology. From 1900 – 1975, all surgery for endometriosis was through an open incision like that for a hysterectomy. The treatment technique, though, was excision. There are numerous studies during that time period that showed 80+ % long term success for pain relief. This is compared to many laparoscopic cautery studies where long term relief is much less than 50%. There were also many studies that demonstrated an increase in fertility after excision treatment.

Recurrence: In contrast to what patients read on the internet, or told by physicians, endometriosis is most likely NOT a recurrent disease. We have re-operated on many patients in 18 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 life-cycle 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.

Adenomyosis: Endometrial cells located in the muscle wall of the uterus. All patients with endometriosis probably have some degree of adenomyosis. The pain with endometriosis is probably most often characterized as pain with periods in the teen years. As the lesions begin to burn out in the 20’s, many patients report cycles becoming less painful. By the mid 30’s, many patients are again having increased pain with periods. This however, is most likely due to the slowly progressive problem of adenomyosis. Therefore, after excision of endometriosis, if pain with periods recurs it is likely adenomyosis. Adenomyosis is not visible at or treated by surgery except through hysterectomy. It is most commonly suspected when the uterus is enlarged on ultrasound. Continuous birth control suppression can slow the progression of this process.

Call our office to schedule a consultation.

Advanced Reproductive Specialists
Jacksonville Center for Reproductive Medicine
www.JCRM.org

11/03/2025

Holding this Miracle is what it is all about!
So many prayers answered right here!
We are incredibly thankful to be part of the process.