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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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230 answers

Ovarian Stimulation & OHSS

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Egg Health & Ovarian Reserve Nov 3, 2026

What protocol is best for me? 42, amh 4.34, afc 17-25,

Hi Dr Sher, please guide me urgently. Im currently in a cycle im thinking of cancelling. Started a Synarel (lupron) prime three weeks then stopped and started stims next day 150 menopur, 75 gonalf and hgh. My follicles were 17… — Kylie M.

Dr. Geoffrey Sher answered

WE should talk! I suggest that you email my assistant, Patti converse (concierge@sherivf.com) and she will set you up with on online consultation so we can interact one-on-one. In the interim...see below! Geoff Sher The Most Important Decision in IVF: Choosing the Right Ovarian Stimulation Protocol: Why Individualized…
Egg Health & Ovarian Reserve Nov 2, 2026

35F with DOR post ovarian fibroma surgery

I am 35 years old and underwent laparoscopic removal of a benign ovarian fibroma. I have DOR with last AMH < 3 pmol/L. My cycles have gradually shortened from 28–30 to 23–27 days, although I appear to ovulate regularly. We… — A. S.

Dr. Geoffrey Sher answered

I would personally NOT recommend either a natural cycle or a mini-stim cycle. You have very severely diminished ovarian reserve and it might not be possible to elicit an adequate response. We need to talk! I suggest that you email my assistant, Patti converse (concierge@sherivf.com) and she will…
Egg Health & Ovarian Reserve Nov 2, 2026

Age 40, 0 euploid of 3 on first retrieval. What would you change for cycle 2?

I'm 40 (born June 1986) and just finished my first IVF retrieval at a Boston clinic. Goal is two children, so I'm banking embryos. What would you change to improve egg quality and euploid yield before cycle 2? Reserve and… — Annmarie E.

Dr. Geoffrey Sher answered

We would need to talk! However, I would probably use an agonist/Antagonist conversion protocol . I suggest you set up an online cosultation with me to discuss! Email Patti at concierge@sherivf.com and she will set this up. GS The Most Important Decision in IVF: Choosing the Right Ovarian…
Embryos & Genetic Testing Sep 30, 2026

FET with Viagra help

Dr. Sher, I have been following you for quite some time and have found your research with IVF extremely helpful. I have completed 2 IVF cycles which have resulted in two precious embryos. I have attempted two FET attempts but… — Amanda K.

Dr. Geoffrey Sher answered

It would be my pleasure to interact with you. However, you should please contact my office Manager, Patti Converse and have her send you a brief questionnaire to complete, upon which she will set you up with an online consultation and we can discuss your issues in detail..…
Clinic & Practice Sep 28, 2026

Consultation Request – DOR and Difficult Response to IVF Stimulation

Dear Dr. Sher, I would like to arrange a consultation regarding my IVF history and response to stimulation. I have diminished ovarian reserve (DOR) with a very low AFC and have had several disappointing cycles with inconsistent responses. My current… — Daniela K.

Dr. Geoffrey Sher answered

It would be my pleasure to interact with you. However, you should please contact my office Manager, Patti Converse and have her send you a brief questionnaire to complete, upon which she will set you up with an online consultation and we can discuss your issues in detail..…
Ovarian Stimulation & OHSS Jul 21, 2026

BCP

Dear Dr. On day 24 of cycle, ultrasound before starting IVF was found a 22 mm ovarian cyst and decided to postpone stimulation. The plan is to take one bcp daily for 21 days, followed by a 7-day break, then… — Ola C.

Dr. Geoffrey Sher answered

No! If used correctly, the BCP should not suppress your response. Good luck! Geoff Sher
Egg Health & Ovarian Reserve Jul 6, 2026

Hashimotos DOR- Protocol

Hello Dr, I’m 37 years old and have Hashimotos and Diminished ovarian reserve what t protocol would you recommend for me — Emoata O.

Dr. Geoffrey Sher answered

Here is some informaion on the effect of Hashimoto's on embryo implantation. Unfortunately I would need a lot more information to recommend a protocol for you. I suggest you contact Patti at concierge@sherIVF.com and set up an online consultation to talk it through with me. Geoff Sher Thyroid…
Ovarian Stimulation & OHSS Apr 20, 2026

AACEP protocol-consultant recomendation in London

Dear Dr Sher, I have read your paper on the AACEP protocol and as a 42 year old poor responder about to start my 10th IVF cycle (3 of which being dual stimulation cycles) I was very interested in trying… — Beatriz J.

Dr. Geoffrey Sher answered

USorry! I do not have anyone I could refer you to. Geoff Sher 702-533-2691
Embryos & Genetic Testing Mar 9, 2026

Recurrent Natural Pregnancy Loss followed by Recurrent Implantation Failure

I (33 years old) have a small piece of "benign" genetic material (#15) mosaically which may be contributing to recurrent natural pregnancy loss (4 losses, 2 were between 10-16 weeks with confirmed T18 and T21). Genetic Counselors could not confirm… — Sam L.

Dr. Geoffrey Sher answered

WE really need to talk. I invite you to contact my Office Manager, Patti Converse (702-533-2691 and set up an online consultation with me. UNDERSTANDING RECURRENT PREGNANCY LOSS ( RPL): CAUSES AND SOLUTIONS. When it comes to reproduction, humans face challenges compared to other mammals. A significant number…
Ovarian Stimulation & OHSS Jan 21, 2026

Protocols

Wanted to chate about my protocols.. — Sabrina K.

Dr. Geoffrey Sher answered

I suggest you email Patti at concierge@sherivf.com and set up an online consultation with me. Geoff Sher
Egg Health & Ovarian Reserve Jan 21, 2026

Research papers on trigger dosage for POI/DOR patients

Dear Dr. Sher, with great interest have I read your articles on the "empty" follicle syndrome: I was diagnosed with premature ovarian insufficiency incl. elevated LH levels. In my two egg retrieval attempts only 1 egg could be retrieved out… — Lena T.

Dr. Geoffrey Sher answered

I suggest you email Patti Converse (concierge@sherivf.com and set up an online consultation with me. Geoff Sher
Ovarian Stimulation & OHSS Jan 21, 2026

Fresh or frozen transfer

I’m currently on a short antagonist with a fresh cycle, following my egg retrieval the doctor noted she could see triple layer endometrium but there was no triple layer detected in the most recent scan so mentioned as she didn’t… — Louise S.

Dr. Geoffrey Sher answered

Yes you can go ahead. However, please be aware that 30% of women with endometriosis (regardless of severity, havd an immunologic implantation dysfunction (see below) which needs treatment. Geoff Sher Contact my Office manager..for appointment: Concierge@sherivf.com ENDOMETRIOSIS AND IMMUNOLOGIC IMPLANTATION FAILURE. Patients with endometriosis have immunologic abnormalities. The…
Ovarian Stimulation & OHSS Nov 14, 2025

Agonist/Antagonist Conversion protocol-meds

Hello Dr. Sher. I have a question about the Agonist/Antagonist Conversion protocol I am to start this protocol, and I wonder if it matters if I use Menopur or Gonal-F/Follistim during the stimulation? The reason for this question is that… — Liz S.

Dr. Geoffrey Sher answered

Embarking on the journey of in vitro fertilization (IVF) can be a daunting experience especially for women with sub-normal AMH levels (diminished ovarian reserve -DOR). Here is a novel and highly effective protocol known as the Agonist/Antagonist Conversion Protocol (A/ACP), designed to optimize the chances of success for…
Ovarian Stimulation & OHSS Nov 6, 2025

DOR,age,IVF

Hello, dear doctor. Listened to you podcast and been blown away by your expertise! I am a youthful 45 year old trying to get pregnant. Gotten pregnant 2 years ago naturally, but miscarried in week 9. Had done 3 IVF… — Maja S.

Dr. Geoffrey Sher answered

Understanding the impact of age and ovarian reserve on the success of in vitro fertilization (IVF) is crucial when it comes to reproductive health. This article aims to simplify and clarify these concepts, emphasizing their significance in the selection of ovarian stimulation protocols for IVF. By providing you…
Ovarian Stimulation & OHSS Oct 14, 2025

4th IVF cycle questions on microdose flare protocol

Hello Dr. Sher, I am 42 yrs old with a low AMH (less than 1) trying to get pregnant for the 2nd time. My first pregnancy was natural when I was 38. I started my 2nd fertility journey with IUI… — Terri M.

Dr. Geoffrey Sher answered

At 42 years of age and especially if you are experiencing diminishing ovarian reserve, a flare protocol (in my opinion) is less than ideal. I suggest you call my assistant, Patti at 702-533-2691 and set up an online consultation with me. Geoff Sher EGG/ EMBRYO QUALITY IN IVF…

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.

230 answers

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