Your family begins here
Southeastern Center for Fertility & Reproductive Surgery
865.777.0088     Jeffrey A. Keenan, MD, HCLD, Director

Dear Dr. Keenan - ...You have patiently worked with us, helped educate us, and you have persevered with us in the midst of great frustration and pain... As a pastor, I have had hundreds of indirect and a few direct encounters with physicians, and I have met no one who equals your compassion and concern for the patient...

M.C., Cookeville, Tennessee

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

The Southeastern Center for Fertility and Reproductive Surgery offers this site as an information resource for couples coping with the difficulties of infertility. Just as our center provides the most advanced treatment for our patients, this site provides the most recent and accurate medical information concerning infertility and reproductive surgery.

Located in Knoxville, Tennessee, the center specializes in the diagnosis and treatment of male and female infertility problems. Under the direction of Jeffrey A. Keenan MD, HCLD, our patients receive the highest quality medical care available in the region. Dr. Keenan is one of the most experienced and respected specialists in infertility and reproductive medicine and surgery.

We provide updates on this site to ensure you are receiving the latest information. If you wish to schedule an appointment with us or have questions, please call us at (865) 777-0088 or click here to use our appointment request form.

Dr. Jeffrey A. Keenan



Spring Update 2014

Spring may be here by the calendar, but there's still a little chill in the air. Hopefully, we'll be experiencing warmer temperatures soon! The blooming vegetation reminds us that Spring is generally considered a fertile period. Have you been struggling with infertility or thinking about expanding your family? Then, call today for an appointment and allow us to assist you in your efforts! (865) 777-0088

Goodbye Katie

Our IVF nurse, Katie, will soon be leaving us to rejoin the world of labor and delivery nursing as she has accepted a position at Physician's Regional Medical Center. We wish her all the best in her future endeavors. We anticipate a smooth transition in this process, but if any questions arise, please do not hesitate to ask.

New Providers?

You may have noticed some new providers in the office on occasion. As a professor of obstetrics and gynecology at the University of Tennessee, Dr. Keenan trains medical residents in his specialty, reproductive endocrinology. We appreciate your willingness to provide these new physicians with learning opportunities. If you ever feel uncomfortable about having a medical resident assist in your care, please do not hesitate to make us aware of this concern. We can simply ask that the resident does not assist.

Literature Review

How Will the Affordable Care Act Impact Your Fertility Care?

The Affordable Care Act (ACA) was passed into law on March 23, 2010. After examination of the legislation, there have been areas identified that might affect those individuals struggling with infertility who seek treatment. Under current IRS tax code, "fertility enhancements," including IVF, temporary egg and sperm storage, repair of blocked fallopian tubes, and vasectomy reversal are considered non-reimbursable medical expenses. Patients who utilize those services are allowed by the tax code to deduct only those expenses that are more than 7.5% of their adjusted gross income. Beginning in 2013, under the ACA, the threshold increased to 10%. This means that the deduction that a couple can claim on their taxes for infertility treatments such as IVF will be reduced. Equally important, many patients use flexible spending accounts (FSA) as another tax-advantaged method of paying for infertility treatments; however, the ACA will place a formal cap of $2,500 on the amount that a patient can contribute to their FSA, thus reducing the amount that one can save pretax toward infertility treatments. Overall, the goal of the ACA is to expand coverage to the uninsured by improving affordability, so any services that undermine that mission, i.e., infertility, will be met with resistance.

Uterus Transplantation?!!?

A recent article in Fertility and Sterility discusses a clinical pregnancy after uterine transplantation. Until now, women without a working uterus were forced to use a gestational surrogate in order to achieve genetic offspring. In this study, the uterus of a 22-year-old deceased donor was transplanted into a 23-year-old who was born without a uterus. The patient underwent ovarian stimulation and egg retrieval followed by the creation of embryos in the lab. In addition, the patient underwent immunosupression and infection prophylaxis in preparation for the transplantation. Eighteen months later, the endometrium was prepared for the embryo transfer (ET). The first ET resulted in a biochemical pregnancy, and the second ET resulted in a clinical pregnancy. Unfortunately, this pregnancy did not result in a life birth; however, this achievement represents a great step forward and proves that the implantation phase was successful. It will be interesting to see what additional advances will occur in the near future.

Suppression of Endometriosis

Following surgical treatment of endometriosis, it is common to place patients on oral contraceptives pills (OCPs) for suppression of the condition. A recent study published in Fertility and Sterility compared the usual cyclic fashion of OCPs, where the patient has a 7-day placebo or pill-free interval, to the use of continuous OCPs. The study group consisted of 356 patients out of which 167 were placed on the usual cyclic OCP course and 85 on continuous OCPs for a minimum of 6 months. They found that the continuous OCP group experienced a statistically significant reduction in recurrence rates for endometriomas (ovarian cysts caused by endometriosis), painful periods, and nonmenstrual pelvic pain as compared with the cyclic OCP group. There was no reduction in pain with intercourse between the two groups. Here at the Southeastern Center for Fertility and Reproductive Surgery, we have been using continuous OCPs for over 2 decades for suppression of endometriosis. If you are struggling with pelvic pain related to endometriosis, call today for an appointment (865) 777-0088, and allow us to help you begin the journey to being pain-free.