Ask Our Doctors
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
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Hi Dr Sher
I have been trying to conceive for 3 years now with no success. I’ve recently had 1 failed ivf cycle where I began bleeding 7 days post embryo transfer. Which I believe is implantation failure.
I have a history of heavy painful periods, stomach problems such as diarrhea and bloating, mid cycle bleeding (i spot randomly at any point during the cycle and it feels like having a mini period as i spot and have pain at the same time), painful ovulation. I suspect that I have endometriosis however my doctor refused to investigate further and said I only have hormonal imbalance. However, I have heard that endometriosis and estrogen dominance go hand in hand.
A year before pursuing ivf, I had a hysteroscopy which showed that I didn’t have any polyps and my uterus is normal. My question to you is that can you detect endometriosis with hysteroscopy and should I continue to push my doctor for endometriosis diagnosis.
I also want to ask you that I suffer from allergies such as hayfever, does this make my immune system overactive and creates more natural killer cells?
Dear Dr Sher,
I recently had a baseline scan and oestrogen and progesterone blood tests for an upcoming FET cycle. The scan and blood tests identified a 2.5cm hormone-producing simple cyst on my left ovary. I have been prescribed 21 days of Provera (2 x 10mg tablets daily), which I’m told usually resolves these cysts. How long does it normally take for simple cysts of this size to resolve? Is this course of Provera likely to resolve the cyst within 3 weeks?
Good day Dr. Geoffrey,
I salute you from Mexico City. I’m in the mieddle of the preparatios for the FET, and I want to know what should the maximium estradiol levels be at the day before my FET. Today I’m on day 13 of my cycle and my endometrium is meassuring 9 mm.
Thank you very much for your time. Best regards,
Hi Dr. Sher, I am asking this question after first egg retrieval. I am 40 years old, first time doing this IVF. I saw about 23 follicles during ultrasound and was on 21 days lupron protocol ended with 20 eggs, 13 matured, 10 fertilized and 6 became 6 days blastocysts. After pgta I got results as follows: one low level mosaic trisomy 22, 1 high level complex mosaic, three abnormal and one chaos. I currently have 7 years old daughter and trying for the 2nd baby. My first child was conceived naturally. My amh was 4.2. I am preparing for the 2nd egg retrieval. Can do anything differently. I eat healthy, taking all coq10, vit D, prenatal, calcim magnesium, dha, dhea(25mg only one pill) vit c and nac. I walk every other day. Do I have a hope to have good embryos next cycle. I am very healthy no disease illnesses in the past. Thank u.
Hi Dr. Sher,
Just following up from my last question regarding my 14mm follicle on day 15 when I had a LH surge… isn’t this too small of a follicle for a surge to happen meaning an immature/eggless follicle? I thought a mature follicle must reach a minimum of 17mm in order for a surge to occur. Mine was only 14mm. We did try but I want to be realistic with my expectations. Is there any way to treat this going forward if this continues to happen? Thanks!
I am doing an investigative cycle through my fertility clinic this month. Yesterday was my day 15 and on ultrasound I had a dominant follicle measuring 14mm. It was growing at a rate of 1mm per day since day 10. The nurse informed me that based on the size of the follicle that I should expect my lh to surge later this week. I got home a few hours after doing my ultrasound (and bloodwork) and the nurse called to say that my bloodwork results just came in and I was having a surge.
I am of course devastated as everything I have read states that the follicle must be at least 18 mm in order for a surge to happen. And as mine was only 14mm at the time of the surge, the follicle most likely did not contain an egg or if it did it was immature. My husband and I tried last night anyway. Any insight or advice would be greatly appreciated. I am 39, have PCOS and have had RPL (all very early before 6 weeks). Are there any drugs to help with this?
Hello Dr. Sher, I can only imagine how busy you are so I will try to make this question as brief and concise as possible. I just turned 39. Currently 5wks pregnant (naturally conceived–was told it was an impossibility by RE). I have Graves disease and Hashimotos. History of two miscarriages around 8wks (healthy heartbeats, good HCG, thyroid levels near optimal). I have two living children through fertility (2018 and 2020). My last loss was in May 2022; my first was in 2020 around the time I was diagnosed with Hashimotos. I strongly suspect my losses were due to my immune diseases. I also suspect I will need, at minimum, prednisone (potentially LDN?) to calm my immune response in order to prevent a subsequent loss. I realize I’m working against the clock as my pregnancy advances. I am learning that there are waiting lists everywhere (understandably) and lab results can take weeks. I’m looking for ANY advice here. I live in rural Johnson City TN where there are few specialists or drs who know much about immune diseases and particularly how they influence pregnancy. If you have any referral options, if you have an opening in your schedule, or know of any physicians who have a baseline knowledge of autoimmue responses I would LOVE any help I can get! THANK YOU for you time.
Dear Dr. Sher,
Do you recommend Sildenafil 4x 25mg/day during the follicular phase or only when the embryo transfer is scheduled?
Do you recommend Sildenafil although there are no previous evidences of lack of thickening of the endometrial walls?
I need your advice. I have had two failed embryo transfers. I had my embryos PGT tested and they were normal and very high-quality embryos. I am 37 years old with no underlining health conditions. But maternal history of endometriosis. I have not been diagnosed with this. The second transfer my doctor place me on Lupron for three months. It was ineffective. I have in asking for natural killer cells labs because I watch your videos. I am waiting for the results.
My question is, what if I have elevated NK cells?
My current doctor does not have any solution as to why my second transfer did not work and does not know what she should do for the next protocol.
Dr. Sher, from the research I have done on you, you have so much more knowledge on specialty fertility in cases where women cannot have a successful pregnancy. I would appreciate if you can give me some guidance and advice thank you for your time.
Dear Dr. Sher,
I would like to ask you about DUO stim protocol for women with DOR. Is it OK to have double stim within the same menstruation cycle?
I have DOR, endometriosis stage 1, MTHFR, 35 yrs old and 12 chemical pregnancies.
I want to continue with your protocol A/ACP with HGH but just came across this one DUO stim in the clinic where I am thinking of doing IVF NGS.
Thank you very much