At JCRM, Our Goal is to Excel in the Following Areas:

• Traditional conservative stepwise approach to fertility treatment
• Warm and caring treatment environment
• Offering lower cost and creative IVF alternatives
• State of the Art technology
• Commitment to ethical treatment approaches
• Providing an environment for patient education and informed treatment decisions
• Offering the most skilled surgical approach to infertility, endometriosis and fibroids available in the Southeast
• Providing the most comprehensive metabolic approach to PCOS and ovulation disorders available, which has more than doubled our pregnancy rates without requiring IVF 
• Highly specialized and skilled staff of Nurses and Female Nurse Practitioners
• Incorporating Mind / Body and Nutrition aspects into fertility care
• An excellent track record in helping our patients achieve pregnancy
• In short, we consider it a privilege to serve you as a patient, we care about you,  and we are focused and committed to your goal of attaining pregnancy

Choosing a Reproductive Medicine Practice is a very important and often confusing task.  As the fertility consumer, there are some impediments to this choice.  Reproductive medicine practices differ in their approach to diagnosis, treatment and the patient relationship.  During the evolution of our specialty, the emphasis has become a more treatment focused approach.  Fewer diagnostic studies and a more rapid move toward treatment which focuses financial resources on the endpoint, which is pregnancy. 

Our goal at JCRM is to utilize the above philosophy to help us separate couples based on diagnosis and approach problems with targeted treatment.  Although we utilize IVF as an important treatment modality for many couples, it is certainly not the first line of treatment offered to most patients.  Our hope is to help couples become comfortable with their need for assistance with pregnancy and striving to meet our goals as close to the "old fashioned" way as possible.  If you are a patient that requires IVF, we hope to help you come to this decision with comfort and the peace of mind that our stepwise approach to treatment helps achieve.  We always want patients to feel like they have choices, and we strive to never push patients towards a treatment option they may not be ready for. 

At JCRM, we have made great efforts to find ways of improving conservative therapies which are less expensive and less time intensive for our patients, while increasing our pregnancy rates.  Our goal is to reduce the need for IVF for patients that may respond to less aggressive treatments.  Examples include a major focus on the metabolic aspects of PCOS and mind body / focus that helps with other subtle disorders of ovulation.  This treatment approach has significantly reduced the need for IVF in our patients.  In many cases, we see patients where a short trial of Clomid was used and if unsuccessful, recommendations were made for IVF.  It has been our experience that this group of patients can achieve pregnancy with simple alterations to their treatment plans.  IVF for patients with ovulatory disorders has a high risk of multiple pregnancy which can result in complications for both mother and baby.

There have been some controversial areas within our specialty and often access to only certain information on the internet has left patients with inappropriate and misinformation.  ICSI, or intracytoplasmic sperm injection, has fallen into this category.  ICSI has been revolutionary for couples with truly severe male factor subfertility and can be the only successful treatment.  It does however, have some theoretic concerns regarding sperm choice and egg damage during the procedure.  Additionally, it adds significantly to the cost of IVF.  ICSI is used by some programs in all or the large majority of patients.  In our practice, we utilize ICSI in cases where it is necessary (20-30%), but have not applied this expensive therapy to all comers.  Often offered as a rationale for this excessive use is the "fear" of fertilization failure.  The concern amongst patients becomes revealed particularly when a semen analysis is abnormal.  At JCRM, we find that in many of these instances, fertilization occurs normally and ICSI is not required. 

As this is written, we are now approaching our first year anniversary in our new Southpoint office location.   The design of the office is unique in that it blends the function of our medical practice with a warm and soothing home like atmosphere.  We have had many compliments on our new space and even ourselves find it a much more pleasant place to work.  We have taken the time to introduce ourselves through our office.  Each of our rooms is named after places we have been and love.  There is a certain sense of peace and comfort to us in the memories we find here and hope to share that sense with you. 

We have developed several different approaches to aid couples who struggle to afford IVF and other fertility treatments.  Our novel oral and injectable cycles provide a blend of high pregnancy rates with relatively low cost compared to conventional injectable drug therapy. 

For IVF cost reduction, we have designed a minimal stimulation protocol that reduces cycle cost and dramatically reduces drug cost.  While this may have a lower pregnancy rate than traditional IVF we believe that the results are very comparable.  We are proud to offer an IVF refund program now available.  Shared egg donation where the patient shares a portion of her eggs in exchange for financial help in the cycle is an option for some younger patients (age <32).  Additionally, if couples require multiple cycles of IVF, we discount subsequent treatment cycles.  If IVF is needed, the maximal cumulative benefit to the therapy is achieved at the 3rd to 4th cycle so our ability to make this therapy affordable allows you to maximize your successful outcome.  To this end, we are committed to helping in any way possible.

Our new facility and recent move has allowed us to develop a brand new state of the art IVF laboratory.  We offer all IVF services including ICSI, Micromanipulation, and laser hatching.  Laser hatching offers the safest most accurate hatching procedure available.  PGD is also available for genetic issues.  At transfer, you will be shown pictures of your embryos as we discuss the transfer number.  Our medical and embryology team has well over 30 years of combined experience in IVF treatment to serve you.  JCRM was the first program in the late 1990's to offer blastocyst culture, which now is used selectively to help reduce multiple pregnancy.

Education is key to informed decision making.  In contrast to the medical directive approach, we aim to give you all the facts and educate you on your diagnosis(es) and the possible success of various treatment methods.  We look to you for the therapeutic direction after being thoroughly convinced that you understand all the issues.  There are times where options are very limited, but in most cases of subfertility, there are several treatment options available.  Our staff is available to answer questions.

Other areas of our website describe our surgical expertise in more detail.  Serving as a regional southeastern US referral center for Endometriosis surgery has allowed us to bring our surgical expertise to the highest level.  We routinely perform laparoscopic complete excisional treatment of Stage IV endometriosis, tackling bowel, bladder, ovarian, uterine, and appendiceal endometriosis.  We now perform roughly 75% of our myomectomies laparoscopically and have been doing so for 10 years.  This, even without the robot which adds at least 45 minutes to the surgery.  Innovative use of local anesthesia and perioperative protocol allows nearly all our open surgeries to go home the same day and return to work much sooner than the traditional 6 weeks.   Tubal surgery for blockage has nearly been abandoned by most IVF practices.  Our success rates are excellent for tubal repair and we strongly favor this especially in younger patients.  We have a superb success rate for our tubal reversals and recently have started offering these laparoscopically.  Again, this is without the robot which is merely a costly addition to the procedure. 

In late 2004, our practice made the decision to add a strong emphasis on the metabolic and nutritional aspects of PCOD and Insulin resistance as it applied to ovulation and fertility.  Since that time we have refined our approach to cover all potential treatment options for this most misunderstood disease.  Our pregnancy rates have more than doubled with this approach and patients overall have a much better quality of life.  In the very near future we will have a full time nutritionist to work with our patients in this area in a more structured way.

In addition, for ovulation induction, we adopted the use of Letrozole early on in 2004.  This drug, as opposed to clomid, has no negative or anti-pregnancy effects and has been much more successful.  Experience with Letrozole has demonstrated to us that it is very different from a monitoring and timing standpoint than clomid.  Due to our experience, we have developed very effective protocols using Letrozole.  This too has boosted our overall non-IVF pregnancy rates.   

JCRM has made a significant investment in highly skilled nurses and nurse practitioners to deliver the highest quality care to you as a couple.  We send our team to national / international educational conferences each year and hold in house training sessions on a regular basis.  We seek in our employees the same qualities that we hold vitally important in our own medical practice as physicians, those of  professionalism, the highest ethical standards, and an inherent drive to be the best most knowledgeable providers we can be.  You won't find a better group of nurses and nurse practitioners anywhere in the country.  We are proud of who we work with day in and day out. 

It has long been observed in fertility practice that pregnancies can occur for couples "on vacation" or soon after the decision for adoption is made.  These examples would be a time of low stress for couples.  While studies have never "proven" this association, it is an observation that all of us have made who practice reproductive medicine.  Our world today gets more and more stressful as time goes on.  Traditionally, we have worked closely with psychologists and other medical associated disciplines when needed or by patient choice.  It has become apparent through experience and patient inquiry that most of our patients could benefit from a mind / body approach to fertility care.  The emotional aspects of this process have always been a priority to us at JCRM.  We are adding on-site stress reduction classes, group support sessions and individual/couple sessions to aid in rounding out the care for our patients.   

 In summary, we are committed to the highest ethical and moral standards in medicine and to the highest quality patient care.  Our team will work very hard for you to achieve your goal.  If you don't feel that you understand your diagnosis or treatment fully, we encourage you to contact us for further clarification.  If you choose another practice we wish you the best of success and know that we are always available should the need arise. 

Thank you for visiting our website,

 Dr.'s Michael Fox, Christopher Lipari, and the entire JCRM Staff