Dr. Geoffrey Sher

IVF: FACTORS AFFECTING EGG/EMBRYO “COMPETENCY” DURING CONTROLLED OVARIAN STIMULATION (COS)

 
The potential for a woman’s eggs to undergo orderly development and
maturation, while in large part being genetically determined can be
profoundly influenced by the woman’s age, her “ovarian reserve”
and proximity to menopause. It is also influenced by the protocol used
for controlled ovarian stimulation (COH) which by fashioning the
intra-ovarian hormonal environment, profoundly impacts egg development
and maturation.

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Endometriosis and Infertility

 

Endometriosis is a condition that occurs when the uterine lining
(endometrium)  grows not only in the interior of the uterus but in
other areas, such as the Fallopian tubes, ovaries and the bowel.
Endometriosis 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 …

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Selective Banking of Genetically Tested Donor Eggs

 
As a woman ages beyond 30 years, the quality of her eggs starts to
decline progressively and with it also her fertility potential. By age
40 she is about half as likely to conceive and by her mid forties she
will be approximately, 10 times less fertile. This holds true for
natural conception as well as for conception following IVF. For more
than a quarter century scientists have attempted to defy the
biological clock by freeze-storing a woman’s eggs to preserve her
fertility.Â…

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Centers for disease control (CDC)IVF: The Economic Realities

 

Patrick Steptoe and Robert Edwards were responsible for the birth of
the world’s 1st IVF baby, Louise Brown, in 1978. Since then about
>5 million babies have been born worldwide, and the number is growing
fast. The introduction of  Assisted Reproductive technology (ART)
which comprises IVF and associated procedure has literally
revolutionized the treatment of infertility and Reproductive failure
but has also spawned religious and social controversy.
In 2011,…

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Egg Freezing and Banking: What are the Merits? (Case Report)

 

Hi Dr Sher,

I am considering pursuing egg freezing in a few months. I had an
initial consult with and RE in which my numbers were as follows:

Age: 34 years, 8 months
Day 3 FSH: 8.1MIU/ml
Day 3 AMH: 1.57ng/ml
Antral Follicle Count (AFC) = 13 (6 on one side, 7 on the other)
Cycle length: typically 28 to 34 days
Is such a variance in AFC typical? Are these numbers still indicative
of Diminished Ovarian Reserve? If I go through with egg freezing,
wi…

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Egg Donation-Fashioning Rational Expectations: Preparation; Donor Selection; Using Fresh versus Frozen (Banked) Eggs; Financial/Ethical Considerations; The Process; Outcome!…

For many women, disease, the physiological decline in ovarian reserve
(DOR) and spontaneous or pathologically induced menopause will
preclude pregnancy using own eggs. For such women, the performance of
IVF using the eggs of a chosen young third party (egg donor-ED) offers
an excellent opportunity to go from infertility to family. For such
women, ED offers several advantages:

* _M_ore eggs are retrieved from a young donor than would ordinarily
be needed to complete a sing…

Egg Donation-Fashioning Rational Expectations: Preparation; Donor Selection; Using Fresh versus Frozen (Banked) Eggs; Financial/Ethical Considerations; The Process; Outcome!… Read More »

Immunologic Implantation Dysfunction (IID) -Making the Diagnosis

Currently there are fewer than a dozen immunology reference
laboratories in the U.S that are capable of analyzing the required
elements with a sufficient degree of  sensitivity and specificity as
to be reliable in my opinion. These elements include measuring blood
levels of the eighteen to twenty IgA, IgG and IgM-related APA’s that
are directed against six or seven specific phospholipids, as well as
assessing Natural Killer (NK) cell activity (cytotoxicity) as measured
by their killi…

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Immunologic Implantation Dysfunction (IID): Treatment

In the United States, effective treatment of NK/CTL activation
associated with either alloimmune or autoimmune implantation
dysfunction requires the administration of primarily Intralipid (IL)or
Intravenous gamma globulin (IVIg) plus corticosteroid. Such treatment
is much more likely to be successful in the case of` autoimmune
implantation dysfunction where the NK/CTL activation is present in
advance of the uterus being exposed to the embryo. It is not nearly as
effective for the treatme…

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