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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

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89 answers

Hormones & Ovulation

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Hormones & Ovulation Nov 6, 2025

High testosterone during hormone suppression prior to fet

Hi I am currently doing suppression before embryo transfer. I am almost 2 month into suppression with lupron depot, letrozole, and norethindrone. I had done 2 months of suppression with just lupron about 6 months ago before a transfer that… — Holly F.

Dr. Geoffrey Sher answered

A high testosterone has an adverse effect on egg/embryo quality and endometriosis can adversely affect embryo attachment (implantation) through an immune mechanism. Feel free to email my assistant, Patti (concierge@sherivf.com if you wish to discuss your case with me online. Geoff Sher
Hormones & Ovulation Oct 14, 2025

estradiol

Can you kindly tell me what is the appropriate level of estradiol in a modified natural cycle? I am in the middle of a MN cycle. They had me take letrozole for 5 days and roughly 10 days later I… — Carmela R.

Dr. Geoffrey Sher answered

Each follicle should contribute 150-200pg/ml to the E2 level. Your dropping E2 is concerning and suggests premature luteinization. I think when this cycle is over we should talk. The protocol used for ovarian stimulation and its implementation are both pivotal. Call my assistant, Patti at 702-533-2691 and set…
Hormones & Ovulation Jul 12, 2025

FET

Hello! I had a recent FET just a few days ago. On the day oftransfer, my progesterone was 37 and estradiol was 1700. This estradiol level is considerably higher than it was for my last successful FET. So I am… — Eugenia T.

Dr. Geoffrey Sher answered

The E2 level, ideally, should be 500-100pg/ml on the day progesterone treatment starts. Endometrial thickness is measured also on the day progesterone starts. It needs to be >8mm with a trilaminar ultrsound appearance, The thickness on the day of transfer is not significant. See the article below, on…
Hormones & Ovulation Apr 27, 2025

TSH

Hello, I was wondering what the recommended parameters are for TSH level prior to FET. My most recent TSH level was 4.01, just wondering if these are good numbers for going into transfer. I’m 35 and low AMH(0.98). Just want… — Maria S.

Dr. Geoffrey Sher answered

Your elevated TSH could indicate an underlying hypothyyroid state which could be due to an autoimmune condition andf your low AMH points towards iminished ovarian reserve (DOR: 1. Thyroid Autoimmunity (TAI) & Immunologic Implantation Dysfunction (IID) Between 2% and 5% of women of the childbearing age have reduced…
Early Pregnancy & hCG Apr 27, 2025

To know much about my IVF journey

Thank you for receive me, what if my LH level is higher (15,45 mIU/ml on Day 3 of menstrual cycle — Paola U.

Dr. Geoffrey Sher answered

I would need much more information. If you would like to discuss your case with me , email my assistant (702-533-2691 and set up an online consultation with me,
Hormones & Ovulation Mar 13, 2025

Hypothalamic amenorrhea

31 F/ G2 T0 P1 A1 L1/5’2.5 103lbs. Diagnosis: functional hypothalamic amenorrhea. DOR/PCOS/Lactational/thyroid all ruled out. Background: Past successful pregnancy with letrozol at 114lbs. Have been struggling with HA since then for 12 months. Past OBGYN wanted weight closer to… — Sarah O.

Dr. Geoffrey Sher answered

Women with HA can experience poorer egg quality. In addition, the low ovarian estrogen output can blunt endometrial response to estrogen. I advise you to have your doctor monitor endometrial thickness at the time of the hCG "trigger". It should measure at least 8mm. If less, this could…
Hormones & Ovulation Feb 28, 2025

suppressedLH

To start the IVF cycle,myclinic putme birth control.lowered LH almost undetectable. is this oversuppression?do you expect LH go up with start of menopur? we are doing a5 day washout period after stopping the birth control. — Carmela R.

Dr. Geoffrey Sher answered

When I prescribe the BCP it is for at least 10 days. Thereupon I overlap with Lupron to promote antral follicle growth through exposure to early Lupron-induced FSH. If you do not overlap with such a GnRH-agonist, the woman's ovaries will often be suppressed. Feel free to reach…
Egg Health & Ovarian Reserve Jan 29, 2025

Cyst at baseline for FET

Hi Dr. Sher, a resolving functional hemorrhagic cyst was found during ultrasound for my modified natural (Letrazole assisted) FET. I had delayed ovulation and they performed an ultrasound and found the cyst. On Friday, ultrasound showed cyst was 36 mm,… — Peg T.

Dr. Geoffrey Sher answered

Very respectfully, I would not enter an FET until the cyst is gone and you have had at least one interim natural cycle. I would also strongly recommend a medicated FET. FROZEN EMBRYO TRANSFER : ONE PREFERRED APPROACH AT SFS. Two decades ago, when women went through IVF…
Hormones & Ovulation Jan 11, 2025

possible pcos

Hi I am a 20 years old female. 5'7 roughly 150-160 pounds A year ago i was experiencing a bunch of symptoms that led me to get a check up. My symptoms were - excessive hair growth especially on my… — Zipporah T.

Dr. Geoffrey Sher answered

This indeed sounds like PCOS. I suggest that you contact my assistant, Patti at concierge@sherivf.com to set up an online consultation with me. Navigating Polycystic Ovary Syndrome: Understanding, Hope, and Treatment Understanding the intricate interplay of hormones and the impact on egg development empowers us to create personalized…
Embryos & Genetic Testing Sep 4, 2024

Treatment for immune issues and euploid RPL

Hello, I am a 32 y/o in Canada with history of 3 euploid miscarriages. First pregnancy embryo stopped growing 6.5 weeks, second pregnancy was a MMC of a blighted ovum, third pregnancy mono/mono twins resulted from a single embryo, both… — Anastasia S.

Dr. Geoffrey Sher answered

Respectfully, your immunologic implantation dysfunction is likely due to an alloimmune cause and if so would require different treatment (see below and read the E-books presented below ). I suggest you call my assistant, Patti Converse and set up an online consultation with me to discuss your case…
Early Pregnancy & hCG Aug 26, 2024

Fertility

I had heavy bleeding during an abortion. Followed by a second pregnancy which was a blighted ovum. Ever since then I have had irregular periods and low libido. Is something wrong with me? — Mandy A.

Dr. Geoffrey Sher answered

WE really should talk. If you wish, you could call my assistant Patti Converse at 702-533-2691 and set up an online consultation with me to discuss Geoff Sher PLEASE SHARE THIS WITH OTHERS AND HELP SPREAD THE WORD!! Herewith are online links to 2 E-books recently co-authored with…
Egg Health & Ovarian Reserve Aug 12, 2024

Transfer at age 45

Hello, Im am 45 . We have male factor infertility and in 2012 we got pregnant on our first try with a non medicated IUI using donor sperm. I had a healthy baby boy via C section. He is 11.5… — Emily B.

Dr. Geoffrey Sher answered

You clearly have diminished ovarian reserve. This in conjunction with your age (45y) makes the chance of successful pregnancy using your own eggs, very improbable. You actually need IVF with egg donation. Also, IUI has less than a 1:80 chance of success for you. If in spite of…
Hormones & Ovulation Aug 5, 2024

Repeated Miscarriages

Hi, My husband and I have been trying to conceive for 2 years now and have had 6 miscarriages within that time, all being early miscarriages except for our little girl who stopped growing at 13 weeks due to triploidy.… — Breann W.

Dr. Geoffrey Sher answered

_ When it comes to reproduction, humans face challenges compared to other mammals. A significant number of fertilized eggs in humans do not result in live births, with up to 75% failing to develop, and around 30% of pregnancies ending within the first 10 weeks (first trimester). Recurrent…
Egg Health & Ovarian Reserve Aug 5, 2024

Trying to get pregnant

How can I get pregnant with 470 DHEA-S levels and irregular periods? I am 28 years old and we are trying to concieve since november 2023 — Rotila S.

Dr. Geoffrey Sher answered

An elevated DHEAS points to either over-ingestion of DHEA supplements or a possible adrenal factor. This needs to be looked into before proceeding any further. Might I suggest that you contact my assistant, Patti C9onverse at 702-281-7437 mand set up an online consultation with me. Geoff Sher,
Hormones & Ovulation Jun 19, 2024

infertility questions

Hi Dr. Sher, First off thank you for what you do & all of the valued information you provide people. Good information is hard to find on infertility. Here is my scenario: I am currently 39 y/o Female and my… — Holly B.

Dr. Geoffrey Sher answered

Hi Holy, Thank you for that detailed letter. I really would need to talk to you after receiving all relevant information. It does sound as if a male factor might be involved but I cannot vouch for this without more detail. It is possible (in spite of US…

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.

89 answers

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