Dr. Geoffrey Sher

Many infertile patients, are erroneously advised by their physicians
to first try IUI
[/blog/reflecting-upon-use-misuse-intrauterine-insemination-iui-time-serious-reality-check/]
several times before resorting to IVF. Additionally many misguided
insurance providers often, purely for economic
[/blog/ivf-the-economic-realities/] reasons, req…

It is primarily the egg (rather than the sperm) that determines the
chromosomal integrity (karyotype) of the embryo, the most important
determinant of egg/embryo competency
[/blog/ivf-factors-affecting-egg-embryo-competency-during-controlled-ovarian-stimulation-cos/].
A “competent” egg is therefore one that has a normal karyotype and
has the best potential to pro…

Polycystic ovary syndrome (PCOS)
[/blog/understanding-polycystic-ovarian-syndrome-pcos-and-the-need-to-customize-ovarian-stimulation-protocols-sfs/]
is a common hormonal system disorder among women affecting between 5%
and 10% of women of reproductive age worldwide. Women with PCOS may
have enlarged ovaries that contain multiple small collections of fluid
(subc…

Mini-IVF is a procedure that involves ovarian stimulation using low
dosage medications (often oral drugs like clomiphene
[/blog/clomiphene-induction-ovulation-use-misuse/] and letrozole)
under the premise that it is a “safer” and less expensive than
conventional gonadotropin stimulation regimes while yielding
comparable success. Nothing could be further from the truth. The fact
is that success rates per fresh mini-IVF cycl…

Advanced endometriosis is often associated with ovarian endometriotic
cysts, known as endometriomas. The cysts contain decomposed menstrual
blood that looks like melted chocolate – hence the name
“chocolate cysts.” They are space occupying cystic lesions within
the ovarian connective tissue (stroma/theca) and if sizable (>1cm)
often will activate the surrounding tissue to produce excessive
amounts of male hormones (androgens) such as testosterone and
androstenedione that can compr…

Staggered-IVF involves the use of Preimplantation Genetic Testing
[/blog/preimplantation-genetic-sampling-pgs-using-next-generation-gene-sequencing-ngs-method-of-choice/]
of advanced embryos (blastocysts) to identify those that are euploid
(“c…

Endometriosis [/blog/endometriosis-and-infertility-sfs/] is a complex
condition where, the lack or relative absence of an overt anatomical
barrier to fertility often belies the true extent of reproductive
problem(s). All too often the view is expounded that the severity of
endometriosis-related infertility is inevitably directly proportionate
to the anatomical severity of the disease itself, thereby implying
that endometriosis causes …

All multiple pregnancies pose a risk to both mother and offspring.
Pregnancy induced maternal complications such as miscarriage
[/blog/recurrent-pregnancy-loss-rpl/], pre-eclampsia, antepartum and
post-partum hemorrhage become progressively more prevalent the higher
the

Most pregnancy induced placental complications that compromise
placentation and intrauterine development have their origin in
conditions that present prior to conception. As such, a patient
requiring IVF presents her RE with a golden opportunity to
preemptively identify and address such factors in order to optimize
the quality of life after birth. IVF conducted with the sole objective
of pregnancy as the end-point ignores the opportunity to set one’s
sights higher….and take aim at ac…