Is there a bmi limit for IVF treatment?
Ask Our Doctors
Supporting Your Journey
Our Medical Directors are outstanding physicians that you will find to be very personable and compassionate, who take care to ensure that you have the most cutting-edge fertility treatments at your disposal. This is your outlet to ask your questions to the doctors.
-
Dear Patients,
I created this forum to welcome any questions you have on the topic of infertility, IVF, conception, testing, evaluation, or any related topics. I do my best to answer all questions in less than 24 hours. I know your question is important and, in many cases, I will answer within just a few hours. Thank you for taking the time to trust me with your concern.– Geoffrey Sher, MD
Fill in the following information and we’ll get back to you.
BMI limit
Name: Christie C
Is there a bmi limit for IVF treatment?
Answer:
Not really!
ADDITIONAL INFORMATION:
I am attaching online links to two E-books which I recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)……. for your reading pleasure:
1.From In Vitro Fertilization to Family: A Journey with Sher Fertility Solutions (SFS) “
http://sherfertilitysolutions.com/sher-fertility-solutions-ebook.pdf
- “Recurrent Pregnancy Loss and Unexplained IVF Failure: The Immunologic Link
https://drive.google.com/file/d/1iYKz-EkAjMqwMa1ZcufIloRdxnAfDH8L/view
………………………………………………………………..
Fertility Inducing Medications
Name: Audrey V
Hello! Do you use BMI as a metric for prescribing fertility inducing medication (Clomid/letrozole)? If so, what is the maximum BMI allowed? Thank you!
Answer:
No! By and large, I do not!
Geoff Sher
___________________________________________________________
ADDITIONAL INFORMATION:
I am attaching online links to two E-books which I recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)……. for your reading pleasure:
1.From In Vitro Fertilization to Family: A Journey with Sher Fertility Solutions (SFS) “
http://sherfertilitysolutions.com/sher-fertility-solutions-ebook.pdf
- “Recurrent Pregnancy Loss and Unexplained IVF Failure: The Immunologic Link
https://drive.google.com/file/d/1iYKz-EkAjMqwMa1ZcufIloRdxnAfDH8L/view
………………………………………………………………..
BCP Timing before IVF
Name: Liza A
I have short (25 day) cycles with early recruitment of follicles, and a history of lead follicles and asynchronous growth during previous IVF.
My dr instructed me to take 21 days BC before beginning my IVF cycle with 3 days Decapeptyl, followed by Gonal F from 3rd day onwards. Due to a miscommunication, I only started BC on day 6 of my cycle, instead of day 1. I was told this was ok, but I am concerned I have messed up my cycle.
Could you please advise if I am more at risk of developing dominant follicles due to starting the BC late?
Thank you for your insight.
Answer:
I do not think that starting the BCP on Day-6will have any adverse effects on your treatment.
One often hears the expressed opinion that the BCP suppresses response to ovarian stimulation. This is not the case, provided that the BCP is overlapped with administration of an agonist (e.g. Lupron, Buserelin, Superfact) for several days leading up to the start of menstruation and the initiation of ovarian stimulation cycle with gonadotropin drugs. If the latter precaution is not taken, and the cycle of stimulation is initiated coming directly off the BCP the response will often be blunted and subsequent egg quality could be adversely affected. The explanation for this is that in natural (unstimulated) as well as in cycles stimulated with fertility drugs, the ability of follicles to properly respond to FSH stimulation is dependent on their having developed FSH-responsive receptors . Pre-antral follicles (PAF) do not have such primed FSH receptors and thus cannot respond properly to FSH stimulation with gonadotropins. The acquisition of FSH receptor responsivity requires that the pre-antral follicles be exposed to FSH, for a number of days (5-7) during which time they attain “FSH-responsivity” and are now known as antral follicles (AF). These AF’s are now able to respond properly to stimulation with administered FSH-gonadotropins. In regular menstrual cycles, the rising FSH output from the pituitary gland insures that PAFs convert tor AF’s. The BCP (as well as prolonged administration of estrogen/progesterone) suppresses FSH. This suppression needs to be countered by artificially causing blood FSH levels to rise in order to cause PAF to AF conversion prior to COS commencing, otherwise pre-antral-to –antral follicle conversion will not take place in an orderly fashion, the duration of ovarian stimulation will be prolonged and both follicle and egg development may be compromised. GnRH agonists (e.g. Lupron, Buserelin, Superfact) , cause an immediate surge in release of FSH by the pituitary gland thus causing conversion from PAF to SAF. This is why, women who take a BCP to launch a cycle of COS need to have an overlap of the BCP with an agonist. By overlapping the BCP with an agonist for a few days prior to menstruation the early recruited follicles are able to complete their developmental drive to the AF stage and as such, be ready to respond appropriately to optimal ovarian stimulation. Using this approach, the timing of the initiation of the IVF treatment cycle can readily and safely be regulated and controlled by varying the length of time that the woman is on the BCP.
Since optimizing follicular response to COS requires that prior to stimulation with gonadotropins, FSH-induced conversion from PAF to AF’s first be completed and the BCP suppresses FSH, it follows when it comes to women launching COS coming off a BCP something needs to be done to cause a rise in FSH for 5-7 days prior to menstruation heralding the cycle of CO S.This is where overlapping the BCP with an agonist (e.g. Lupron/Superfact/Buserelin) comes in. The agonist causes FSH to be released by the pituitary gland and if overlapped with the BCP for several days and this will (within 2-5 days) facilitate PAF to AF conversion…. in time to start COS with the onset of menstruation. Initiating ovarian stimulation in women taking a BCP, without doing this is suboptimal
I believe it to be essential regardless of the protocol of COS protocol being contemplated, for women who launching ovarian stimulation coming off a BCP to overlap with an agonist for several days in advance of initiating ovarian stimulation with the onset of menstruation,
Geoff Sher
____________________________________________________________
ADDITIONAL INFORMATION:
I am attaching online links to two E-books which I recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)……. for your reading pleasure:
1.From In Vitro Fertilization to Family: A Journey with Sher Fertility Solutions (SFS) “
http://sherfertilitysolutions.com/sher-fertility-solutions-ebook.pdf
- “Recurrent Pregnancy Loss and Unexplained IVF Failure: The Immunologic Link
https://drive.google.com/file/d/1iYKz-EkAjMqwMa1ZcufIloRdxnAfDH8L/view
Partial DQ Alpha & elevated NK cells
Name: Melissa K
Hello Dr Sher, thanks for your reply, I made an error in my last message to you. Please read amended below:
I have elevated NK cells and even after completing a full immune protocol (ivig, intrallipids, dex, nupogen) my NK cells only went from 15.6 down to 14.9.
My husband and I have a part DQ alpha match (01.01, 02.01) and no matter how many immune protocols we did, nothing worked, so we created embryos using donor eggs and used a surrogate which has worked for us.
My question is, If I transfer one of these new donor egg embryos into my body, will I face the exact same issues?
It’s been 3 years since last testing my NK cells, should I run new tests to see if they have reduced over the years?
Answer:
Unfortunately, this is not a sperm: egg matching issue. It has to do with genotypic matching between the fertilizing sperm and the host……. So using donor egg will likely not help matters.
Geoff Sher
Geoff Sher
Semen analysis
Name: Jorge S
Does this clinic do semen analysis for infertility? I’ve been trying to find somewhere that does semen analysis but all the places I’ve contacted only do it for post vasectomy patients.
Answer:
Absolutely we do.Simply call the clinic (contact info is on website).
Good luck!
Geoff Sher
Yudy
Name: Yudy D
Tengo ligadura de trompa y tengo 36 años podría reverser mis trompas ya que me gustaría tener otro bebe
Answer:
Please re-post in English!
Geoff Sher
__________________________________________________________________
ADDITIONAL INFORMATION:
I am attaching online links to two E-books which I recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)……. for your reading pleasure:
1.From In Vitro Fertilization to Family: A Journey with Sher Fertility Solutions (SFS) “
http://sherfertilitysolutions.com/sher-fertility-solutions-ebook.pdf
- “Recurrent Pregnancy Loss and Unexplained IVF Failure: The Immunologic Link
https://drive.google.com/file/d/1iYKz-EkAjMqwMa1ZcufIloRdxnAfDH8L/view
………………………………………………………………..