Portrait of Bala Bhagavath
Bala Bhagavath, MD
Professor (CHS), Director, Division of Reproductive Endocrinology and Infertility, Wellness Chair
Reproductive Endcrinology and Infertility

Clinic Address

2365 Deming Way
Middleton, WI, 53562
Phone: 608-824-6160

Administrative Assistant

Fellowship University of Texas Southwestern Medical Center, Dallas, TX
Residency Medical College of Georgia, Augusta, Georgia
Advanced Training National University Hospital, Singapore
Internship Lemuel Shattuck Hospital, Jamaica Plain, MA
Residency Southmead Hospital, Birmingham Maternity Hospital, Glasgow Royal Infirmary, Falkirk Royal Infirmary, United Kingdom
Internship George Eliot Hospital, Nuneaton, United Kingdom
M.D. University of Madras, Chennai, India

American Board of Obstetrics and Gynecology 

Reproductive Endocrinology and Infertility

Director, Division of Reproductive Endocrinology and Infertility 

Wellness Chair

Medical School – Gold Medal for excellence in OBGYN 

Residency – Best teaching resident award, Junior resident of the year award, CREOG award for excellence in exams, Excellent Chief Resident performance award 

Faculty – CREOG excellence in teaching award and other multiple teaching awards, APGO educational scholar, APGO surgical scholar

American Society for Reproductive Medicine 

Association of Professors of Gynecology and Obstetrics 

American Association of Gynecologic Laparoscopists 

Society for Reproductive Surgeons

The era of surgical enlightenment begins now: appreciating the role different gynecologic subspecialties bring to the infertile patient

Victoria W Fitz, Bala Bhagavath, Steven R Lindheim, John C Petrozza

No abstract

Published: 08/27/2023

Fertility and sterility pmid:37634563

Nontubal ectopic pregnancies: overview of diagnosis and treatment

Anna Sokalska, Anupama Rambhatla, Christina Dudley, Bala Bhagavath

Nontubal ectopic pregnancies occur as a result of embryo implantation outside the uterine cavity and fallopian tubes. Sites include ovary, cervix, abdominal cavity, interstitial portion of fallopian tube, and cesarean scar. Nontubal pregnancies are uncommon. Nonspecific signs and symptoms of nontubal ectopic pregnancies make diagnosis challenging and, in many cases, significantly delayed, resulting in a high rate of morbidity. Although surgical management remains the mainstay of treatment, there...

Published: 07/26/2023

Fertility and sterility pmid:37495011

Surgical approach to 4 different reproductive pathologies by 3 different gynecologic subspecialties: more similarities or differences?

John C Petrozza, Victoria Fitz, Bala Bhagavath, Jose Carugno, Jaclyn Kwal, Emad Mikhail, Moawad Nash, Syem K Barakzai, Dario R Roque, Amy J Bregar, Joseph Findley, Michael Neblett, Rebecca Flyckt, Zaraq Khan, Steven R Lindheim

No abstract

Published: 12/27/2022

Fertility and sterility pmid:36574916

Blind physicians and the elephant: "Reality is one, although wise physicians speak of it variously"

Victoria Fitz, Bala Bhagavath, Steven R Lindheim, John Petrozza

No abstract

Published: 12/24/2022

Fertility and sterility pmid:36565978

The current and future state of surgery in reproductive endocrinology

Bala Bhagavath

PURPOSE OF REVIEW: The last decade has witnessed a radical change in the field of reproductive surgery. The increasing success of in-vitro fertilization (IVF) has caused a huge shift in emphasis with many downstream consequences. This review outlines the changes and provides insight into the future of reproductive surgery.

Published: 07/27/2022

Current opinion in obstetrics & gynecology pmid:35895956

Clinical and Patient Reported Outcomes of Pre- and Postsurgical Treatment of Symptomatic Uterine Leiomyomas: A 12-Month Follow-up Review of TRUST, a Surgical Randomized Clinical Trial Comparing Laparoscopic Radiofrequency Ablation and Myomectomy

Steve Yu, Bala Bhagavath, S Abbas Shobeiri, David Eisenstein, Barbara Levy

CONCLUSION: The results from this 12-month follow-up study suggest that LAP-RFA is a safe, effective, uterine-sparing alternative to laparoscopic myomectomy in the treatment of ULs. These data points build on previously published studies showing that LAP-RFA has lower healthcare resource use overall, including lower postprocedure hospitalization rate and shorter length of stay. In clinical practice, LAP-RFA is a promising treatment approach to ULs for women.

Published: 01/27/2022

Journal of minimally invasive gynecology pmid:35085837

Plan, plan, plan for a successful surgery!

Bala Bhagavath

No abstract

Published: 12/06/2021

Fertility and sterility pmid:34865848

Prolactin is Expressed in Uterine Leiomyomas and Promotes Signaling and Fibrosis in Myometrial Cells

Alessandra DiMauro, Christina Seger, Briaunna Minor, Andrea M Amitrano, Ifunanya Okeke, Manisha Taya, Ashley R Rackow, Divya Kumar, R Matthew Kottman, Bala Bhagavath, Stephen R Hammes

Uterine leiomyomas are benign, estrogen-sensitive, fibrotic smooth muscle cell tumors occurring in the uterine myometrium. Leiomyomas are a considerable health burden, with a lifetime prevalence of 80% and limited treatment options. Estrogen and progesterone have positive effects on leiomyoma growth, but little is known about the roles of other hormones. One hormone of interest is prolactin, as it has been described to be present and functional in leiomyomas. The current study investigates...

Published: 11/01/2021

Reproductive sciences (Thousand Oaks, Calif.) pmid:34724171

Surgical simulation supplements reproductive endocrinology and infertility fellowship training

Tess Chase, Divya K Shah, J Preston Parry, Bala Bhagavath, Steven R Lindheim, John C Petrozza, Samantha Pfeifer, Christina Stetter, Allen Kunselman, Stephanie J Estes

CONCLUSIONS: An intensive surgical boot camp enhances surgical skill among REI fellows.

Published: 07/05/2021

F&S reports pmid:34223232

Crisis Management of Hysteroscopic Surgical Complications in the Office Setting

Robert A Roman, Carey C Roberts, Rachel Booth, Camran Nezhat, Bala Bhagavath, Steven R Lindheim

CONCLUSIONS: Health care providers need to be cognizant of the importance of CM for optimizing patient safety and quality improvement and consider its application on office-based procedures.

Published: 06/30/2021

Obstetrical & gynecological survey pmid:34192339

Resection of a uterine septum in a normal uterus: Whoa Nellie

Artur Ludwin, Mark P Trolice, Bala Bhagavath, Steven R Lindheim

No abstract

Published: 04/07/2021

Fertility and sterility pmid:33823997

Surgical management of interstitial (cornual) ectopic pregnancy: many ways to peel an orange!

Bala Bhagavath, Steven R Lindheim

No abstract

Published: 04/03/2021

Fertility and sterility pmid:33810847

Post-Market Safety of Laparoscopic Ultrasound-Guided Radiofrequency Ablation

Steve Yu, Kaylen Silverberg, Bala Bhagavath, S Abbas Shobeiri, Anthony Propst, David Eisenstein

CONCLUSION: Minimally invasive gynecologic surgeons can learn laparoscopic intraabdominal ultrasound-guided radiofrequency ablation and perform it safely (in terms of acute and near-term serious adverse events) after ≥ 2 proctored cases. There were no significant differences in safety outcomes compared to the premarket, pivotal study.

Published: 01/29/2021

JSLS : Journal of the Society of Laparoendoscopic Surgeons pmid:33510567

Billing, coding, and practice management: a primer for today's reproductive medicine professional

Bala Bhagavath, Linnea Goodman, John Petrozza

Despite years of recognition that many physicians are woefully unprepared to face challenges regarding the business of medicine, marginal progress has been made. In this piece, we aim to provide the contemporary reproductive medicine physician with an understanding of billing, coding, and, most importantly, cost containment for a typical fertility practice. It is critical for modern practices to not forego hard-earned revenue to insurance companies or not be aware of critical rules and...

Published: 01/08/2021

Fertility and sterility pmid:33413957

Specificity of the lactate dehydrogenase isoenzyme index as a preoperative screen for uterine sarcoma before myomectomy

Lauren E Spivack, J Christopher Glantz, Clare Lennon, Bala Bhagavath

CONCLUSION: A previously reported UMG index cutoff of 29 had a specificity of 91.1% (higher with normal BMI and lower when obese) in our patient population. Although lower than previously reported, the index could be a useful initial method of preoperative screening of women with symptomatic fibroids. Higher BMI appears to be associated with elevated UMG indices, increasing the false-positive rate in obese women.

Published: 10/19/2020

Fertility and sterility pmid:33070962

Reunification of the unicornuate uterus and the remnant horn- proceed with caution!

Bala Bhagavath, Artur Ludwin, Steven R Lindheim

No abstract

Published: 10/16/2020

Fertility and sterility pmid:33059888

Adolescent Endometriosis

Ashley Gubbels, Lauren Spivack, Steven R Lindheim, Bala Bhagavath

CONCLUSIONS AND RELEVANCE: Adolescent endometriosis is likely a more prevalent cause of dysmenorrhea than currently appreciated. A high index of suspicion combined with recognition of risk factors and history-based markers of endometriosis may help identify adolescent endometriosis earlier and avoid delays in diagnosis. Expert opinion supports earlier laparoscopic evaluation in patients with symptoms unresponsive to oral medications, those who have failed initial medical therapy, or those who...

Published: 08/29/2020

Obstetrical & gynecological survey pmid:32856715

Longitudinal vaginal septum: a proposed classification and surgical management

Artur Ludwin, Steven R Lindheim, Bala Bhagavath, Wellington P Martins, Inga Ludwin

CONCLUSION(S): A new classification of longitudinal vaginal septum allows better characterization compared with the currently available classification systems. Different surgical modalities are discussed with their respective advantages and disadvantages. Vaginoscopic incision using resectoscope is a reasonable alternative for women with an intact hymen and vaginal stenosis. The impact of vaginal septum resection on obstetric, reproductive, and sexual outcomes should be assessed in randomized...

Published: 08/23/2020

Fertility and sterility pmid:32826051

Removal of Essure: TMTOWTDI

Bala Bhagavath, Steven Lindheim

No abstract

Published: 07/06/2020

Fertility and sterility pmid:32622416

Saline-Air Hysterosalpingo-Contrast Sonography Is Equivalent to the Modified Hysterosalpingogram Following Hysteroscopic Sterilization

Emerly Luong, Artur Ludwin, Thomas Winter, Jerome Yaklic, Rose A Maxwell, Bala Bhagavath, Steven R Lindheim

CONCLUSIONS: Our findings revealed a high degree of diagnostic accuracy with SA-HyCoSy for tubal occlusion, although coil location changed in nearly half of cases. Avoidance of radiation and patient convenience/compliance with SA-HyCoSy may outweigh the drawbacks.

Published: 06/09/2020

Ultrasound quarterly pmid:32511207

Overdiagnosis, overdetection, and overdefinition of the septate uterus: reexamination of the ASRM and ESHRE-ESGE criteria is urgently needed

Artur Ludwin, Wellington P Martins, Bala Bhagavath, Steven R Lindheim

No abstract

Published: 08/03/2019

Fertility and sterility pmid:31371057

Reproductive surgery: decreasing skills and advancing technology-an existential conundrum

Antonio R Gargiulo, Bala Bhagavath

Our article endeavors to be both a review of the recent past and a preview of the future of reproductive surgery. By reflecting on the rate of technological advancement over the past decade, we attempt to predict the trajectory of the next. We also delve into the changing nature and practical challenges of the practice of gynecologic surgery for the reproductive endocrinology and infertility subspecialist. We will explain how technological advances may alter our perception and expectations...

Published: 07/30/2019

Fertility and sterility pmid:31352960

Case Series of Reproductive Outcomes after Laparoscopic Radiofrequency Ablation of Symptomatic Myomas

Jay M Berman, Abraham Shashoua, Christopher Olson, Sara Brucker, John A Thiel, Bala Bhagavath

CONCLUSION: Conception and safe, full-term pregnancy are achievable after Lap-RFA of symptomatic myomas. Additional large, rigorous, multivariate prospective studies that adjust for confounders and report pregnancy outcomes after symptomatic myoma treatment are needed.

Published: 06/26/2019

Journal of minimally invasive gynecology pmid:31238151

Creation and Piloting of a Model for Simulating a Minimally Invasive Myomectomy

Mary N Towner, Yolianne Lozada-Capriles, Amy LaLonde, Ashkan Ertefaie, Jonathan Stone, Bala Bhagavath, Ahmed Ghazi

CONCLUSION: We were able to successfully create a model for simulating a minimally invasive myomectomy. Initial simulations using the model were well received by participants. Further development and investigation of the model will be pursued to determine if this is a valid and useful tool for teaching and practicing a minimally invasive myomectomy.

Published: 05/25/2019

Cureus pmid:31123645

Options for controlling blood loss during myomectomy

Bala Bhagavath, Steven R Lindheim

No abstract

Published: 04/29/2019

Fertility and sterility pmid:31029243

Overcoming the Challenging Cervix: Identification and Techniques to Access the Uterine Cavity

Michelle A Wood, Katherine L Kerrigan, Megan K Burns, Tanya L Glenn, Artur Ludwin, Mindy S Christianson, Bala Bhagavath, Steven R Lindheim

CONCLUSIONS AND RELEVANCE: Cervical stenosis is associated with iatrogenic complications that can result in significant patient morbidity. In patients undergoing in vitro fertilization, difficult embryo transfer is associated with lower pregnancy rates. The clinician should carefully consider the patient's menopausal status, risk factors, and symptoms in order to anticipate difficult navigation of the endocervical canal. Various medical and surgical management strategies, including hysteroscopic...

Published: 11/24/2018

Obstetrical & gynecological survey pmid:30468239

Virginity-sparing management of blind hemivagina in obstructed hemivagina and ipsilateral renal anomaly syndrome

Artur Ludwin, Inga Ludwin, Bala Bhagavath, Wellington P Martins, Steven R Lindheim

CONCLUSION(S): 3D-SVC is a useful and accurate technique in diagnosis, surgery planning, and postoperative assessment in women with blind hemivagina and intact hymen. TRUS-guided vaginoscopic septoplasty is a reasonable alternative to traditional vaginal surgery and allows hymen preservation.

Published: 10/15/2018

Fertility and sterility pmid:30316446

Pre-, intra-, and postoperative management of Robert's uterus

Artur Ludwin, Inga Ludwin, Bala Bhagavath, Steven R Lindheim

CONCLUSIONS: Three-dimensional ultrasound techniques seem to be the best tool for complex pre- and postoperative management of Robert's uterus. Minimally invasive ultrasound-guided hysteroscopic metroplasty should be considered as the first choice of treatment because of the potential for normalization of uterine morphology and function.

Published: 09/11/2018

Fertility and sterility pmid:30196976

Optimal management of symptomatic cesarean scar defects

Bala Bhagavath, Steven R Lindheim

No abstract

Published: 08/13/2018

Fertility and sterility pmid:30098693

Cesarean Scar Ectopic Pregnancy: Current Management Strategies

Tanya L Glenn, James Bembry, Austin D Findley, Jerome L Yaklic, Bala Bhagavath, Pascal Gagneux, Steven R Lindheim

CONCLUSIONS: Recent research supports any method that removes the pregnancy and scar to reduce morbidity and promote future fertility. Laparoscopic and transvaginal approaches are options for CSEP treatment, although continued research is required to identify the optimal approach.

Published: 06/01/2018

Obstetrical & gynecological survey pmid:29850919


Ceana H Nezhat, Samantha Pfeifer, Bala Bhagavath, Steven R Lindheim, John C Petrozza, Peter T K Chan, Steven F Palter

No abstract

Published: 03/17/2018

American journal of epidemiology pmid:29547879

Uterine Malformations: An Update of Diagnosis, Management, and Outcomes

Bala Bhagavath, Greiner Ellie, Kara M Griffiths, Tom Winter, Snigdha Alur-Gupta, Carter Richardson, Steven R Lindheim

CONCLUSIONS: Current evidence favors continued use of the American Society of Reproductive Medicine classification. Three-dimensional sonography, especially when combined with saline infusion, can be very helpful in accurately classifying müllerian anomalies.

Published: 06/30/2017

Obstetrical & gynecological survey pmid:28661551

A Review of Laparoscopic Salpingo-Oophorectomy: Technique and Perioperative Considerations

Yolianne Lozada, Bala Bhagavath

Hysterectomy is the most frequently performed major gynecologic surgery in women in the United States. This procedure is often accompanied by unilateral or bilateral removal of the fallopian tubes and ovaries. Although the overall incidence of bilateral salpingo-oophorectomy has been shown to be in a decreasing trend in recent years, it is possibly 1 of the most common scenarios that the gynecologic surgeon will encounter. As the field of minimally invasive surgery continues to expand, it is...

Published: 12/29/2016

Journal of minimally invasive gynecology pmid:28027976

Hysteroscopic morcellator to overcome cervical stenosis

Bijan W Salari, Bala Bhagavath, Michael L Galloway, Austin D Findley, Jerome L Yaklic, Steven R Lindheim

CONCLUSION(S): Our technique is an alternative method for overcoming severe cervical stenosis and minimizing potential intraoperative complications.

Published: 08/21/2016

Fertility and sterility pmid:27542706

Minimally Invasive Gynecologic Surgery for Benign Conditions: Progress and Challenges

Bala Bhagavath, Amy Benjamin

CONCLUSIONS: Although huge advances have been made in minimally invasive gynecologic surgery, high-quality evidence from well-designed clinical trials is lacking for many of the new technologies. Accurate estimates regarding the risk of occult leiomyosarcoma are also lacking. Additional research is urgently needed to address these deficiencies.

Published: 10/23/2015

Obstetrical & gynecological survey pmid:26490165

Metroplasty to treat chronic pelvic pain resulting from outflow tract müllerian anomalies

Bala Bhagavath, Eric Behrman, Bijan W Salari, Wendy Vitek, Sheela Barhan, Jerome L Yaklic, Steven R Lindheim

Chronic pelvic pain can result from noncommunicating uterine cavities in patients with müllerian anomalies. Traditional management has been to resect the noncommunicating uterine horn. Two cases are described. One had a unicornuate uterus with noncommunicating left uterine horn (American Fertility Society [AFS] classification IIb) and the other had a normal external uterine contour with noncommunicating left uterine cavity that did not fit any category of the AFS classification of müllerian...

Published: 09/13/2015

American journal of obstetrics and gynecology pmid:26363477

Longitudinal vaginal septa with associated uterine anomalies: a case series

Snigdha Alur, Katrina Nicandri, Bala Bhagavath

CONCLUSIONS: The correct diagnosis of associated uterine anomalies in patients presenting with vaginal septa can be challenging. Diagnosis solely based on imaging should be cautioned because of its limitations. Use of ultrasound in the operating room can be a valuable tool.

Published: 10/29/2014

Female pelvic medicine & reconstructive surgery pmid:25349941

Metformin and other insulin sensitizers in polycystic ovary syndrome

Bala Bhagavath, Wendy Vitek, John Queenan, Kathleen Hoeger

Polycystic ovary syndrome (PCOS) is a complex disorder affecting a substantial group of women from adolescent to menopausal age groups. A substantial subgroup of these women exhibits increased insulin resistance. Insulin resistance is difficult to establish in clinical practice and many surrogate tests are available, although their value in the clinical setting is uncertain. The QUICKI method is an inexpensive and easy test to administer and is probably the best test to be used in PCOS patients,...

Published: 06/12/2014

Seminars in reproductive medicine pmid:24919033

Familial 46,XY sex reversal without campomelic dysplasia caused by a deletion upstream of the SOX9 gene

Bala Bhagavath, Lawrence C Layman, Reinhard Ullmann, Yiping Shen, Kyungsoo Ha, Khurram Rehman, Stephen Looney, Paul G McDonough, Hyung-Goo Kim, Bruce R Carr

CONCLUSION: This is the first report of 46,XY sex reversal in three siblings who have a paternally inherited deletion upstream of SOX9 associated with reduced SOX9 mRNA expression.

Published: 06/08/2014

Molecular and cellular endocrinology pmid:24907458

Surgical aspects of removal of Essure microinsert

Catherine M Albright, Gary N Frishman, Bala Bhagavath

Essure is designed as a hysteroscopically placed permanent birth control. Removal of the Essure microinsert can be a technically challenging procedure. Requests for removal are uncommon but do occur. Although hysteroscopic and laparoscopic removal has been reported, there is limited information available describing appropriate surgical technique. There have been six patients requesting Essure removal at our institution (one approximately 2 years after placement). Based on this experience, we...

Published: 01/08/2013

Contraception pmid:23290426

Role of routine monitoring of liver and renal function during treatment of ectopic pregnancies with single-dose methotrexate protocol

Lindsay E Clark, Bala Bhagavath, Carol A Wheeler, Gary N Frishman, Sandra A Carson

CONCLUSION(S): Routine measurement of serum aspartate aminotransferase and creatinine levels may not be necessary before instituting a single-dose methotrexate treatment regimen for the management of ectopic pregnancy.

Published: 04/24/2012

Fertility and sterility pmid:22521698

Ectopic pregnancy in a cesarean-section scar: the patient >6 weeks into an ectopic pregnancy, underwent local treatment

Gary N Frishman, Katherine E Melzer, Bala Bhagavath

Cesarean scar ectopic pregnancies may be difficult to diagnose and may result in uterine rupture or hysterectomy. Based on location and vascularity, especially in the presence of fetal cardiac activity, local treatment with transvaginal ultrasound-guided injection of methotrexate is an excellent option which also optimizes the chance for fertility preservation.

Published: 04/03/2012

American journal of obstetrics and gynecology pmid:22464290

Testosterone and progesterone rapidly attenuate plasma membrane Gbetagamma-mediated signaling in Xenopus laevis oocytes by signaling through classical steroid receptors

Kristen Evaul, Michelle Jamnongjit, Bala Bhagavath, Stephen R Hammes

Many transcription-independent (nongenomic) steroid effects are regulated by G proteins. A well-established, biologically relevant example of steroid/G protein interplay is steroid-triggered oocyte maturation, or meiotic resumption, in Xenopus laevis. Oocyte maturation is proposed to occur through a release of inhibition mechanism whereby constitutive signaling by Gbetagamma and other G proteins maintains oocytes in meiotic arrest. Steroids (androgens in vivo, and androgens and progesterone in...

Published: 10/06/2006

Molecular endocrinology (Baltimore, Md.) pmid:17021048

Bhagavath joins ASRM in nation’s capital to support IVF legislation

Bala Bhagavath, MD, director of the Division of Reproductive Endocrinology and Infertility, joined American Society for Reproductive Medicine (ASRM) leadership in Washington, D.C. on June 12 in support of the Right to IVF Act.

Members of the organization, as well as families affected by IVF legislation, were at the Capitol on June 12 to share stories with legislators in advance of a scheduled vote on the act. You can read the ASRM’s statement on the outcome of the vote here.

Thank you for joining the advocacy efforts, Dr. Bhagavath!

Bhagavath discusses infertility and pregnancy conditions with WMTV-15

Bala Bhagavath, MD, director of the Division of Reproductive Endocrinology and Infertility, spoke with WMTV-15 in a recent story about a local woman, Abby Wiley, and her battle with infertility. The interview took place during National Infertility Awareness Week in late April. 

In “Wisconsin mom of three shares unique battle overcoming infertility,” Bhagavath explained what happens to a patient like Wiley, who had placenta accreta and how this leads to infertility.

Placenta accreta means the placenta has grown too deeply into the uterine wall and, “as a result, the placenta cannot separate and come off. It is stuck there. Of course, the uterus needs to expel that and contract to stop all the bleeding and if women cannot expel the placenta, they will continue to bleed, which is not healthy.”

Read the whole article here.

**by Ob-Gyn Communications Intern Paige Stevenson

Healthy Women Community Talk: Navigating Your Fertility Journey – April 10, 2023

Starting or growing a family is a deep desire for many people, but the path to parenthood is not always straightforward.

 All are invited to a free, virtual community talk about navigating your fertility journey, presented by the UW Department of Ob-Gyn! Bring your questions about all aspects of fertility to a panel of experts at 6:30pm on April 10, 2023:

  • Generations Fertility Care Director Dr. Bala Bhagavath will discuss physical and medical aspects of fertility care
  • Clinical Psychologist Dr. Julianne Zweifel will talk about common mental and emotional concerns during fertility treatment
  • Panelists at different points of their own fertility journeys will talk about their experiences with expanding their families

Register today for this free event and invite your friends!

Healthy Women Community Talk: Navigating Your Fertility Journey

Starting or growing a family is a deep desire for many people, but the path to parenthood is not always straightforward. 

A panel of experts answered fertility questions during the well-attended virtual community talk "Navigating Your Fertility Journey" on April 10, 2023:  

  • Generations Fertility Care Director Dr. Bala Bhagavath discussed physical and medical aspects of fertility care 
  • Clinical Psychologist Dr. Julianne Zweifel talked about common mental and emotional concerns during fertility treatment 
  • Panelists at different points of their own fertility journeys shared their experiences with expanding their families 

Watch the whole Community Talk now! 

Reproductive Endocrinology and Infertility Fellowship earns ACGME accreditation

The Department of Obstetrics and Gynecology’s Reproductive Endocrinology and Infertility (REI) Fellowship received initial accreditation from the Accreditation Council for Graduate Medical Education (ACGME) on February 7, 2024! Bala Bhagavath, MD, professor and director of the Division of REI, will serve as the fellowship program director. This will be the first REI fellowship program in the state of Wisconsin and one of only about 40 in the country.

Preparing and applying for this fellowship took a tremendous effort from Bhagavath, Division of REI faculty, and the department’s education program, including Fellowship Program Manager Dylan Kittell. The Department of Ob-Gyn would not have been able to meet this crucial goal of expanding training opportunities and improving access to fertility care services without their tireless work over the last two years.

With this accreditation, the REI Fellowship is on track to welcome the first fellow: Jayapriya Jayakumaran, MD, will join us in August 2024. Jayakumaran earned her medical degree from Madras Medical College, followed by obstetrics and gynecology residency at Jawaharlal Nehru Medical College Hospital and University of Central Florida-Orlando. The REI fellowship will recruit their second fellow in the summer of 2024.

Research and leadership at 2023 AAGL Global Congress on MIGS

The AAGL held the annual Global Congress on MIGS November 5-8, 2023, in Nashville. Members of the Department of Obstetrics and Gynecology brought research and contributed to the success of the event! 

Olga Fajardo, MD, assistant professor in the Division of Academic Specialists in Ob-Gyn, co-authored two abstracts presented during oral sessions. Other authors on the abstracts are from Vanderbilt University Medical Center, where Fajardo recently completed her Minimally Invasive Gynecologic Surgery (MIGS) fellowship: 

New instrumentation/Research Oral Session: Language-Based Disparities in Surgical Route of Hysterectomy for Benign DiseaseT.I. González Peña, N.J. Jesse, Z. Zhao, L.F. Harvey, O. Fajardo  

Hysteroscopy Oral Session: Surgical Treatment for Uterine Isthmoceles - V. Fox, O. Fajardo, E. Cook, T.L. Anderson, H. Curlin  

Bala Bhagavath, MD, professor and director of the Division of Reproductive Endocrinology and Infertility, served on the conference’s Abstract and Video Review Committee. 

Incredible work, all! 

Grand Rounds: Bhagavath presents “Reproductive Surgery: Past, Present, Future”

On November 9, 2023, Bala Bhagavath, MD, professor and director of the Division of Reproductive Endocrinology and Infertility, presented the Grand Round lecture “Reproductive Surgery: Past, Present, Future”.

In this lecture, Bhagavath described the history of reproductive surgeries and the various things they help fix. Advancements in reproductive surgeries was also discussed, with Bhagavath focusing on developments in tubal, uterine, cervical, and vaginal surgeries throughout time.

You can watch the whole lecture here.

**by Ob-Gyn Communications Intern Paige Stevenson

REI Division members lead sessions at 2023 ASRM Congress

Division of Reproductive Endocrinology and Infertility Director Bala Bhagavath, MD, and Associate Professor Aleks Stanic-Kostic, MD, PhD, led sessions at this year’s American Society for Reproductive Medicine Scientific Congress on October 14-18 in New Orleans, Louisiana. 

Bhagavath presented Cesarean Scar Isthmoceles: When and How to Diagnose and Treat Surgically.

Stanic-Kostic led a full day course focussed on Translating Bench Research to the Clinical Management of Recurrent Pregnancy Loss as well as a clinical session No Good Deed Goes Unpunished, or Why We Should Stick with Professional Guidelines. 

The ASRM Congress in general aims to give top experts in the reproductive medicine field a chance to share their research and discover new information. Congratulations to both speakers and all of ASRM Congress’s presenters!

**by Paige Stevenson, Ob-Gyn Communications Intern

Bhagavath accepted into 2024 UW Health Physician Leadership Development Program cohort

Congratulations to UW Ob-Gyn Professor and Division of Reproductive Endocrinology and Infertility Director Bala Bhagavath, MD! He was accepted into the UW Health Physician Leadership Development Program’s 2024 cohort.

As part of the program, Bhagavath will participate in 10 live courses on topics including leadership, strategy and human resources. The curriculum includes leadership development within a culture of trust, project management, strategic thinking, planning and decision making, emotional intelligence, managing physician performance, resolving conflict, leading and managing strategic change, authentic leadership development, and building and leading effective teams.  

Incredible work, Dr. Bhagavath!

Bhagavath discusses infertility coverage on Let’s Get Local podcast

During National Infertility Awareness Week in April, Bala Bhagavath, MD, professor and director of the Division of Reproductive Endocrinology and Infertility, joined the Let’s Get Local podcast to talk about efforts in Wisconsin to improve access to fertility care.

During the interview, Bhagavath contrasted his experience working in states with state-mandated infertility coverage compared to working in Wisconsin, average costs for fertility treatment without insurance coverage, and the work the Building Families Alliance is doing to make fertility care more manageable for people in Wisconsin.

Listen to the whole interview now – Dr. Bhagavath’s segment starts at 21:44.

Bhagavath discusses Dobbs’ implications on fertility care with Tone Madison

In a recent article on Tone MadisonBala Bhagavath, MD, professor and director of the Division of Reproductive Endocrinology and Infertility, weighted in about the impact of the Dobbs decision on infertility care.

In “Fertility care in Wisconsin faces worrisome unknowns in the wake of Dobbs, Bhagavath discussed common questions and concerns he has heard from patients, and what the current legal landscape means for fertility care in Wisconsin: 

““There were panicked calls from patients, regarding many things,” Bhagavath says. “‘My embryos are stored here in Wisconsin, so, what does it mean?’ ‘Am I allowed to transfer the embryos to a different state?’ There are patients calling who are concerned because their embryos were stored in a long-term storage facility. ‘When I want to transfer my embryos, would I still be able to do it? Or do I have to go to a different state to continue my management?’”

For now, Bhagavath says, “at least in Wisconsin, there is no immediate worry regarding infertility management and treatment of patients.” But that is not guaranteed going forward. A change in state law could throw the whole industry into flux.”

Read the whole article here!

Women’s Healthcast: Finding Out About Fibroids, featuring Bala Bhagavath, MD

Uterine fibroids are incredibly common – between 20 and 70 percent of people with uteruses will develop fibroids during their lifetimes. And while they’re often benign, they can still cause some troublesome symptoms.

Bala Bhagavath, MD joined the Women’s Healthcast to talk about common symptoms of uterine fibroids, the broad variety of treatment options, and whether all fibroids need to be treated. Bhagavath is the director of the UW Ob-Gyn Division of Reproductive Endocrinology and Infertility.h

Did you know the Women’s Healthcast is available on all your favorite podcast platforms? Whether you like to listen on Apple PodcastsSpotifyStitcherPodbean, or anywhere else, you can find us! (Just search Women’s Healthcast, and while you’re at it, may as well subscribe!)

Bhagavath co-authors publication in Journal of Minimally Invasive Gynecology

UW Ob-Gyn Division of Reproductive Endocrinology and Infertility Director Bala Bhagavath, MD, co-authored a study in the latest issue of the Journal of Minimally Invasive Gynecology!

Clinical and Patient Reported Outcomes of Pre- and Postsurgical Treatment of Symptomatic Uterine Leiomyomas: A 12-Month Follow-up Review of TRUST, a Surgical Randomized Clinical Trial Comparing Laparoscopic Radiofrequency Ablation and Myomectomy” uses outcome data from a multicenter trial conducted at academic and non-academic hospitals, surgery centers, and fertility centers around the country. In comparing outcomes between two methods of surgery, the study found:

“The results from this 12-month follow-up study suggest that LAP-RFA is a safe, effective, uterine-sparing alternative to laparoscopic myomectomy in the treatment of ULs. These data points build on previously published studies showing that LAP-RFA has lower healthcare resource use overall, including lower postprocedure hospitalization rate and shorter length of stay. In clinical practice, LAP-RFA is a promising treatment approach to ULs for women.”

Read the whole study here!

Bhagavath discusses endometriosis and infertility in Milwaukee Journal Sentinel

In a recent article in the Milwaukee Journal Sentinel, a Wisconsin woman shares her experience with endometriosis and infertility. UW Ob-Gyn Division of Reproductive Endocrinology and Infertility Director Bala Bhagavath, MD adds insight into the challenges of endometriosis and the importance of insurance coverage for fertility services in the article. 

In “Summit woman shares her story of endometriosis, infertility”, published online for subscribers, Bhagavath describes the difficulties many people experience when trying to find a solution to endometriosis-related pain:

““The sad truth of endometriosis is that very often young girls who complain of pain or painful periods are told that everyone’s periods are painful; just live with it,” said Bala Bhagavath, UW Health fertility clinic’s medical director of Generations Fertility Care.

On average, it takes about 12 years and four doctors to get a diagnosis for endometriosis, which affects one in six women, said Bhagavath.”

Read the whole article here!

Bhagavath discusses fibroids with HealthCentral

Uterine fibroids can have big effects on menstruation, fertility, pregnancy, even sleep and exercise. In a new article on HealthCentral, UW Ob-Gyn Division of Reproductive Endocrinology and Infertility Director Bala Bhagavath, MD discussed how to recognize and manage uterine fibroids:

“Uterine fibroids aren’t cancerous—but that doesn’t mean they can’t affect your life profoundly, Dr. Bhagavath says. This is a condition that can interfere with all areas of your life, increasing the risk of pregnancy complications, making it hard to go to work, and even interfering with your relationships. That’s why it’s important to have frank and open conversations with your doctor about how your fibroids are affecting you.”

Read the rest of “How Uterine Fibroids Affect Your Health”!

Advocacy Update: Bill for insurance coverage of infertility care introduced in Wisconsin legislature

Fertility treatments can be costly, and most states across the country do not require insurance plans to cover fertility care (take a look at this Kaiser Family Foundation issue brief on coverage and use of infertility services in the United States). A bill recently introduced in the Wisconsin State Legislature would require insurance companies to provide coverage for fertility services.

In “Infertile couples support Wisconsin bill to require fertility coverage”, recently published in the Wisconsin State Journal, UW Ob-Gyn Division of Reproductive Endocrinology and Infertility Director Bala Bhagavath, MD discussed the negative effects fertility challenges can have on individuals and families, and the inequities in current access to fertility care:

““The impact of the disease can be devastating; studies on the psychosocial impact of infertility have placed it on par with a diagnosis of cancer,” said the letter, by Dr. Bala Bhagavath, medical director of Generations Fertility Care in Middleton, UW Health’s fertility clinic; and Dr. Laurel Rice, UW’s chair of obstetrics and gynecology.

Society needs children to support an aging population, but typically only infertile people who have higher incomes can afford to pay for treatments, Bhagavath said in an interview. “The more middle-income and definitely lower-income you are, the greater impact on you,” he said.”

Bhagavath serves on the steering committee for the Building Families Alliance Wisconsin, which supports the Building Families Act. Learn more about the bill, and read the rest of the Wisconsin State Journal article here.

Bhagavath accepted as AGOS fellow

Congratulations to UW Ob-Gyn Division of Reproductive Endocrinology and Infertility Director Bala Bhagavath, MD, who was recently accepted as an active fellow of the American Gynecological and Obstetrical Society (AGOS)!

AGOS advances the health of women by providing dedicated leadership and promoting excellence in research, education and medical practice. In order to be considered as an AGOS fellow, candidates must be outstanding leaders in academic obstetrics and gynecology with good character, high ethical standing and recognized ability as a teacher, physician and scholar.

Amazing work, Dr. Bhagavath! 

Bhagavath presents at SREI fellows forum

UW Ob-Gyn Division of Reproductive Endocrinology and Infertility Director Bala Bhagavath, MD presented at the Society for Reproductive Endocrinology and Infertility fellows forum in Utah on November 19!

Bhagavath’s presentation on reproductive surgeries garnered a lot of excitement from the REI fellows and physicians in attendance, with more than half the fellows expressing an interest in developing their surgical skills.

Incredible work, Dr. Bhagavath!

Bhagavath discusses fibroid treatment with HealthCentral

UW Ob-Gyn Division of Reproductive Endocrinology and Infertility Director Bala Bhagavath, MD answered common fibroid questions in the HealthCentral article “10 Things to Know About Uterine Fibroid Treatment.

In the article, Bhagavath explains what fibroids are and what kinds of symptoms they can sometimes cause (including heavy bleeding and pelvic pressure) and how to bring fibroid-related issues up to your doctor. He also discusses several treatment paths, from low-intervention options like birth control and pain medication, to more intensive options like surgery.

Read the whole article here!

Bhagavath explains endometriosis with Spectrum News

UW Ob-Gyn Division of Reproductive and Population Health Director Bala Bhagavath, MD discussed endometriosis in an article with Spectrum News.

In “Founded in Milwaukee, Endometriosis Awareness Month Shines Light on Women’s Health”, Bhagavath explains what endometriosis is, common symptoms, options for treatment and management, and why it can take a long time to arrive at an endometriosis diagnosis:

“…because pain can be a hard thing to measure, and these symptoms can also be linked with other conditions, Bhagavath said endometriosis doesn’t always get diagnosed right away. Confirming a case requires a laparoscopy or “putting a camera down the belly button.””

Read the whole article here!

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