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and Procedures

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Information Center

Review documents about Tubal Reversal, HSG's, semen analysis, postcoital tests, and more. Click here!

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and Learn More

Learn more about the causes of and treatment for infertility as well as many related issues. Click here!

Dr. Keenan and staff, Scott and I wanted to thank you and your staff again for helping us bring our baby into the world. We really appreciate your aggressiveness and your willingness to answer all of our questions - goodness knows we had plenty. Thank you once more. K.H., Knoxville, Tennessee
~ K.H., Knoxville, Tennessee
Dr. Jeffrey KeenanDr. Jeffrey Keenan

Dr. Keenan and Ciera Roberts, Board Certified Women's Health Nurse Practitioner, work collaboratively to provide you with holistic care and multidisciplinary treatment. You will receive compassionate care and the most up to date treatments available. Click here or call today to schedule an appointment.

Frozen More Than 24 Years, Born Perfectly Healthy!

What once sounded like science fiction became reality when a 26-year-old gave birth to an embryo frozen for more than 24 years, and it happened right here in East Tennessee! In fact, she was our patient! In late 2017, Tina Gibson gave birth to baby Emma Wren, delivering the world's longest-frozen embryo to successfully come to birth. Tina and her husband Benjamin were embryo-receiving parents through the National Embryo Donation Center and had their frozen embryo transfer (FET) performed through us. This story made global headlines! Click here to view the coverage on Good Morning America. We're so happy for the entire Gibson family!

Spring Update 2019

Welcome spring! The wet winter has made us grateful for the prettier days of spring. Is this season of renewal urging you to follow your unfulfilled hopes of having or growing your family? Remember, spring is generally considered a fertile period, so call today to schedule an appointment. We can help to get you on track towards the family you've always dreamed of. We also offer general GYN services, so if you need to do a little "spring cleaning" of your healthcare, call today to schedule an appointment.

Well Wishes to Autumn!

Please send well wishes to our nurse practitioner of 8 years, Autumn Galbraith, as she is no longer with us. Autumn accepted another position that will afford her more time with her growing family. We are thankful to Autumn for the many years of service she has provided to our patients, and we wish her the best of luck in her future endeavors.

Welcome Ciera!

Please join us in welcoming our new nurse practitioner, Ciera Roberts. Ciera is Board Certified in Women's Health and has 11 years of experience in Women's Healthcare. She will be joining Dr. Keenan in seeing patients Monday-Friday and will begin offering some days of extended evening hours, to be announced. You will love working with Ciera and be impressed by her thoroughness and knowledge.

New neighbor!

Quest Diagnostics, our new next-door tenet, has completed construction of their new space. The good news for our patients is you will be able to have all of your weekend labs done right there, instead of our current arrangements with different partner labs.

Spring/Summer Observances

Literature Review

Malnourishment in Utero Can Affect Egg Supply

A study of a large sample of Chinese women who lived through the Great Famine (1956-1964) found that being malnourished in utero can increase the risk of early menopause and premature ovarian failure (POF). They looked at 3 groups: a childhood-exposed group, a fetal-exposed group, and a non-exposed group. Compared with women with non-exposure to famine, those who had fetal-exposure were more likely to experience menopause before age 45. Being exposed to famine in childhood was not statistically associated with early menopause or POF. Women who had been malnourished in utero were over twice as likely to experience POF, compared with women not malnourished in utero. The risk of early menopause in the fetal-exposed group was 37% higher than non-exposed women.

The thinking behind this theory is that being exposed to malnutrition during fetal development might affect the development of the reproductive organs, which in turn could affect menstruation and fertility in later years. Early life malnutrition may reduce the number of a woman's eggs, which are formed in utero, and therefore results in a higher risk of an early decreased egg supply. This study reaffirms the importance of adequate nutrition during early life stages to avoid adverse effects on adult reproductive health.

Endometrial Scratching and Live Birth Rate

Endometrial scratching is essentially an endometrial biopsy performed to "scuff" up the endometrium prior to IVF in an effort to promote embryo implantation and increase the probability of pregnancy. This practice has become very popular due to a number of studies, which found favorable pregnancy results after this intervention. The most recent study looked at a total of 1,364 women who underwent endometrial scratching between day 3 of the cycle preceding the embryo-transfer cycle and day 3 of the embryo-transfer cycle. The frequency of live birth was 180 of 690 women (26.1%) in the endometrial-scratch group and 176 of 674 women (26.1%) in the control group. There were no significant between-group differences in the rates of ongoing pregnancy, clinical pregnancy, multiple pregnancy, ectopic pregnancy, or miscarriage. In conclusion, endometrial scratching DID NOT result in a higher rate of live birth than no intervention among women undergoing IVF. SO, the jury is still out, but I believe this will result in a loss of enthusiasm for this intervention.

Embryo Freezing... BRRR!

A recent study featured in Fertility and Sterility, assessed IVF and pregnancy outcomes in patients having their first frozen embryo transfer (FET) after a freeze-all cycle versus similar patients having their first fresh embryo transfer (ET). Of the 82,935 cycles analyzed, 69,102 patients had their first fresh transfer, and13,833 had a first FET. High responders (15+ eggs retrieved) were found to have a higher clinical pregnancy rate (CPR) and live-birth rate (LBR) in the FET cycles compared with the fresh ET cycles. In intermediate responders (6-14 eggs), both CPR and LBR were higher after fresh ET compared with FET. Similarly, in low responders (1-5 eggs), CPR and LBR were higher after fresh compare with FET.

In conclusion, a freeze-all strategy is beneficial in high responders, but not in intermediate or low responders, thus refuting the idea that freeze-all cycles are preferable for all patients.

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