Your Trusted Fertility Clinic In New York, NY

Your Journey. Your Family.

At Sher Fertility Solutions, we understand that each patient is unique. Everything we do is customized to you and your specific needs.

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Your Trusted Fertility Clinic In New York, NY

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Your Trusted Fertility Clinic in New York, NY

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The Best of Dr. Sher on The Egg Whisperer Show

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Our Services

Infertility diagnosis/treatment

The causes of infertility are multiple and are often difficult to define but may include anatomical conditions involving tubal patency and/or function as well as diseases of the testicles and/or or sperm ducts, dysfunctional levels of certain hormones in both men and women, and ovulation difficulties in women.

Recurrent miscarriage diagnosis/treatment

The time has come to embrace the reality that the term “unexplained” is rarely applicable to 1) infertility of unknown cause, 2) repeated IVF failure, and 3) recurrent pregnancy loss (RPL). More often than not, rather than being “unexplained,” the condition is simply ignored and as such remains “undiagnosed.” All that is needed is to investigate and treat the issue appropriately in order to solve the problem.

Egg freezing for future fertility

There are many reasons why patients may need to preserve their fertility. For some, it may be a focus on education and career delays and for others it may be due to an illness. Although the decline in reproductive potential that occurs with age cannot be reversed, freezing your eggs at a younger age may allow the eggs to be preserved until you are ready to conceive. While there are no guarantees, using cryopreserved eggs may improve your chances for pregnancy in the future.

Testimonials

Ask Our 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

Name: Denisa K

Dear sir! My name is Denisa, I am 32. In my 29 I gave a birth to a beautiful boy. Got pregnant for the first month trying, verything went well. After labour, there was a very small piece of placenta left in my uterus. I had inflamatory and month after labour there was heavy bleeding and courretage had to be done. My menstruation since that is very poor and my lining grows up to 6,5mm. We have been trying for the second baby for more than 2 years. I had two hysteroscopies done, first to clean the adhesions (mild Asherman) second look to control my uterus. Everything seems nice and cavity is clear. But simply does not grow. I took oestrogen, for the first months it helped endometrium grow up to 8mm, but blocked my ovulation. After months we tried ivf, there were two transfers, but unsuccesful, I reached only 7mm after 10mg oestrogens orally+vaginally. I am very affraid I am the “Marissa example”. Now I would like to ask you abou Tadalafil Mylan. Do you think I can try this? Is it so helpful as Sildenafil? Maybe this treatment could help me a little. Or you see no chance in case like mine? Thank you for your answer! Denisa

Answer:

This is likely due to  post-partum endometritis following retained products of conception. WE should talk. Might I suggest that you call my assistant, Patti Converse (702-533-2691 and set up an online consultation with me to discuss options:

 

It was as far back as 1989, when I first published a study that examined the correlation between the thickness of a woman’s uterine lining (the endometrium), and the subsequent successful implantation of embryos in IVF patients. This study revealed that when the uterine lining measured <8mm in thickness by the day of the “hCG trigger” (in fresh IVF cycles), or at the time of initiating progesterone therapy (in embryo recipient cycles, e.g. frozen embryo transfers-FET, egg donation-IVF etc.) , pregnancy and birth rates were substantially improved. Currently, it is my opinion, that an ideal estrogen-promoted endometrial lining should ideally measure at least 9mm in thickness and that an endometrial lining measuring 8-9mm is “intermediate”. An estrogenic lining of <8mm is in most cases unlikely to yield a viable pregnancy.

 

A “poor” uterine lining is usually the result of the innermost layer of endometrium (the basal or germinal endometrium from which endometrium grows) ) not being able to respond to estrogen by propagating an outer, “functional” layer thick enough  to support optimal embryo implantation and development of a healthy placenta (placentation). The “functional” layer ultimately comprises 2/3 of the full endometrial thickness and is the layer that sheds with menstruation in the event that no pregnancy occurs.

 

The main causes of a “poor” uterine lining are:

 

  1. Damage to the basal endometrium as a result of:
    1. Inflammation of the endometrium (endometritis) most commonly resulting from infected products left over following abortion, miscarriage or birth
    2. Surgical trauma due to traumatic uterine scraping, (i.e. due to an over-aggressive D & C)
  2. Insensitivity of the basal endometrium to estrogen due to:
    1. Prolonged , over-use/misuse of clomiphene citrate
    2. Prenatal exposure to diethylstilbestrol (DES).  This is a drug that was given to pregnant women in the 1960’s to help prevent miscarriage
  3. Over-exposure of the uterine lining to ovarian male hormones (mainly testosterone): Older women, women with diminished ovarian reserve (poor responders) and women with polycystic ovarian syndrome -PCOS tend to have raised LH biological activity.. This causes the connective tissue in the ovary (stroma/theca) to overproduce testosterone. The effect can be further exaggerated when certain methods for ovarian stimulation such as agonist (Lupron/Buserelin) “flare” protocols and high dosages of menotropins such as Menopur are used in such cases.
  4. Reduced blood flow to the basal endometrium:

Examples include;

    1. Multiple uterine fibroids – especially when these are present under the endometrium (submucosal)
  1. Uterine adenomyosis (excessive, abnormal invasion of the uterine muscle by endometrial glands).

 

 

“The Viagra Connection”

 

Eighteen years ago years ago, after reporting on the benefit of vaginal Sildenafil (Viagra) for to women who had implantation dysfunction due to thin endometrial linings I was proud to announce the birth of the world’s first “Viagra baby.” Since the introduction of this form of treatment, thousands of women with thin uterine linings have been reported treated and many have gone on to have babies after repeated prior IVF failure.

 

For those of you who aren’t familiar with the use of Viagra in IVF, allow me to provide some context. It was in the 90’s that Sildenafil (brand named Viagra) started gaining popularity as a treatment for erectile dysfunction.  The mechanism by which it acted was through increasing penile blood flow through increasing nitric oxide activity. This prompted me to investigate whether Viagra administered vaginally, might similarly improve uterine blood flow and in the process cause more estrogen to be delivered to the basal endometrium and thereby increase endometrial thickening. We found that when Viagra was administered vaginally it did just that! However oral administration was without any significant benefit in this regard.  We enlisted the services of a compound pharmacy to produce vaginal Viagra suppositories. Initially, four (4) women with chronic histories of poor endometrial development and failure to conceive following several advanced fertility treatments were evaluated for a period of 4-6 weeks and then underwent IVF with concomitant Viagra therapy. Viagra suppositories were administered four times daily for 8-11 days and were discontinued 5-7 days prior to embryo transfer in all cases.

 

Our findings clearly demonstrated that vaginal Viagra produced a rapid and profound improvement in uterine blood flow and that was followed by enhanced endometrial development in all four cases. Three (3) of the four women subsequently conceived. I expanded the trial in 2002 and became the first to report on the administration of vaginal Viagra to 105 women with repeated IVF failure due to persistently thin endometrial linings. All of the women had experienced at least two (2) prior IVF failures attributed to intractably thin uterine linings. About 70% of these women responded to treatment with Viagra suppositories with a marked improvement in endometrial thickness. Forty five percent (45%) achieved live births following a single cycle of IVF treatment with Viagra The miscarriage rate was 9%. None of the women who had failed to show an improvement in endometrial thickness following Viagra treatment achieved viable pregnancies.

 

Following vaginal administration, Viagra is rapidly absorbed and quickly reaches the uterine blood system in high concentrations. Thereupon it dilutes out as it is absorbed into the systemic circulation. This probably explains why treatment is virtually devoid of systemic side effects

 

It is important to recognize that Viagra will NOT be effective in improving endometrial thickness in all cases. In fact, about 30%-40% of women treated fail to show any improvement. This is because in certain cases of thin uterine linings, the basal endometrium will have been permanently damaged and left unresponsive to estrogen. This happens in cases of severe endometrial damage due mainly to post-pregnancy endometritis (inflammation), chronic granulomatous inflammation due to uterine tuberculosis (hardly ever seen in the United States) and following extensive surgical injury to the basal endometrium (as sometimes occurs following over-zealous D&C’s).

 

Combining vaginal Viagra Therapy with oral Terbutaline;

In my practice I sometimes recommend combining Viagra administration with 5mg of oral terbutaline. The Viagra relaxes the muscle walls of uterine spiral arteries that feed the basal (germinal) layer of the endometrium while Terbutaline, relaxes the uterine muscle through which these spiral arteries pass. The combination of these two medications interacts synergistically to maximally enhance blood flow through the uterus, thereby improving estrogen delivery to the endometrial lining. The only drawback in using Terbutaline is that some women experience agitation, tremors and palpitations. In such cases the terbutaline should be discontinued. Terbutaline should also not be used women who have cardiac disease or in those who have an irregular heartbeat.

 

About 75% of women with thin uterine linings see a positive response to treatment within 2-3 days. The ones that do not respond well to this treatment are those who have severely damaged inner (basal/germinal) endometrial linings, such that no improvement in uterine blood flow can coax an improved response. Such cases are most commonly the result of prior pregnancy-related endometrial inflammation (endometritis) that sometimes occurs post abortally or following infected vaginal and/or cesarean delivery.

 

Viagra therapy has proven to be a god send to thousands of woman who because of a thin uterine lining would otherwise never have been able to successfully complete the journey “from infertility to family”.

 

 

___________________________________________________

ADDENDUM: PLEASE READ!!

INTRODUCING SHER FERTILITY SOLUTIONS (SFS)

Founded in April 2019, Sher Fertility Solutions (SFS) offers online (Skype/FaceTime) consultations to patients from > 40 different countries. All consultations are followed by a detailed written report presenting my personal recommendations for treatment of what often constitute complex Reproductive Issues.

 

Patients are encouraged to share the information I provide, with their treating Physicians and/or to avail themselves of my personal hands-on services, provided through batched IVF cycles that I conduct every 3 months at Los Angeles IVF (LAIVF) Clinic, Century City, Los Angeles, CA.

 

If you wish to schedule an online consultation with me, please contact my assistant (Patti Converse) by phone (800-780-7437/702-533-2691), email (concierge@SherIVF.com) or,  enroll online on then home-page of my website (www.SherIVF.com). 

 

PLEASE SPREAD THE WORD ABOUT SFS!

 

Geoff Sher

 

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Our Team

The emphasis we put on innovative, state-of-the-art technology began with our founder, Dr. Geoffrey Sher, one of the pioneers in the field of IVF, who has been influential in the births of more than 17,000 IVF babies. Dr. Sher plays an active role alongside our medical director, Dr. Drew Tortoriello. Together they have over 55 years of clinical and academic experience in the field of Reproductive Medicine.

Together, they were the first to introduce Preimplantation Genetic Testing which vastly increases the chances of IVF success and is now performed worldwide. They also pioneered the testing and treatment of Immunologic Implantation Dysfunction (IID) that frequently leads to “unexplained” infertility, repeated IVF failure, and recurrent miscarriage. We’re able to conduct a variety of other treatments and tests right on site. For example, we offer on-site sperm testing to ensure proper sperm selection techniques are used to create the healthiest possible embryos.

For those women seeking to preserve their fertility, we offer vitrification, a state-of-the-art technology that ensures their eggs will ultimately be thawed successfully.

From the moment you walk into our state-of-the-art New York fertility clinic, you’ll feel the warmth and compassion that will define your experience with us. Drew Tortoriello, MD serves as our Medical Director. He’s an outstanding fertility specialist that you’ll find to be caring, compassionate and personable.

When you receive fertility treatment with us, your doctor will participate with hands-on management of your case throughout your treatment. We’ve gained a reputation of being the place to turn to when all other treatment options have failed, and patients are searching for hope and fresh alternatives.

TL;DR:

  • Our doctors are among the best in the world, with over 55 years of combined experience
  • Together, they pioneered several tests and treatments that can help where other treatments have failed
  • We do many tests right here at the clinic, which means faster results and ensures proper techniques are used
  • Your doctor will be with you at every step of your treatment
  • Everyone here will get to know you during your treatment so you won’t just feel like a number
  • We’re known for being the clinic to go to when all other treatments have failed