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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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Embryos & Genetic Testing Jun 13, 2023

effect trigger on euploidy rate?

Dear dr Sher, I have a question about the IVF trigger and aneuploidy/euploidy. I'm asking you because I found a lot of profound information about different triggers on your website, thanks for that!! I'm a woman of 34 years old.… — Eline L.

Dr. Geoffrey Sher answered

Understanding the article below which I recently wrote will answer all your questions. It emphasizes that the choice of ovarian stimulation protocol As well as the type, timing and dosage of the “trigger” can greatly impact egg development and thereby embryo “competency”. The trigger's purpose is to initiate…
Egg Health & Ovarian Reserve May 31, 2023

Diminished ovarian reserve

I have been diagnosed with diminished ovarian reserve and my husband has some morphology issues on semen analysis. We have completed 6 egg retrievals, 1 fresh transfer of 2 day 3 embryos, 1 FET of 2 day 3 embryos, 1… — Sahar T.

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…
Hormones & Ovulation May 31, 2023

IVF fertility freezing egg

My daughter did IVF treatments and froze her eggs one month ago. She was very hormonal during treatments, moody and yelling and screaming at every one. She does not act that way normally. Her behavior has not changed back, she… — Deborah L.

Dr. Geoffrey Sher answered

I doubt it, but the stress of going through this might be playing a role. GS
Ovarian Stimulation & OHSS May 30, 2023

Fertility

I've done fertility treatment before. Two rounds of letrozole. Wanted to try another round of letrozole — Takida H.

Dr. Geoffrey Sher answered

Perhaps we should talk first. 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…
Hormones & Ovulation May 30, 2023

Clomid

Hello, I was treated with Clomid day 5-9 and I am 36 years old. I failed to get pregnant 5 months and was prescribed this because of pcos. At the ultrasound at 12 days I had 4 mm endometrium and… — Erin K.

Dr. Geoffrey Sher answered

Clomiphene citrate (Clomid, Serophene) is the most popular agent used for inducing ovulation and in the 1980’s was also the most widely used method for COH in preparation for In Vitro Fertilization (IVF). Clomiphene citrate is a synthetic hormone that deceives the hypothalamus into thinking that the body's…
Egg Health & Ovarian Reserve May 30, 2023

IVF with low ovarian reserve

Hello, I am 40 yr old female with low ovarian reserve. I responded poorly to my first protocol OCP/antagonist. That cycle was cancelled and I was restarted on estrogen priming antagonist protocol with clomid and omnitrope adjuncts. I cleared my… — Amanda M.

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…
Embryos & Genetic Testing May 30, 2023

ZP1 mutation

Dr Sher My doctor says I have to undergo genetic testing to confirm if I have ZP1 mutation. My blood works and hormone level are within normal range. She says the eggs are killed before retrieval as there is abnormal/no… — Rana A.

Dr. Geoffrey Sher answered

Perhaps we should talk before you proceed along those lines . 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…
Egg Health & Ovarian Reserve May 30, 2023

To IVF again or not…

Aloha Dr. Sher! I just finished a second IVF cycle that was a total failure. I just turned 41, AMH .6, FSH 15, AFC 5. I had three follicles that were 17-20 at trigger but only retrieved one egg that… — Katie W.

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…
Egg Health & Ovarian Reserve May 30, 2023

Infertility

I had stimulation done and during it it had antral follicles growing and got to 21,19 15,13 on day 11 ,with a high dose of 4501u ,on day 11 it was stepped down to 225iu as I complained of feeling… — Abigail R.

Dr. Geoffrey Sher answered

__ The importance of the IVF stimulation protocol on egg/embryo quality cannot be overstated. This factor seems often to be overlooked or discounted by t IVF practitioners who use a “one-size-fits-all” approach to ovarian stimulation. My experience is that the use of individualized/customized COS protocols can greatly improve…
Egg Health & Ovarian Reserve May 30, 2023

Low maturity rate related to retrieval timing?

Hello - I have gone through 5 rounds of freezing embryos with limited success, primarily due to very low maturity rates of my eggs (~25%). For example, I recently retrieved 27 eggs, similar in size, dr. pushed the size greater… — Rebecca P.

Dr. Geoffrey Sher answered

The problem is far more likely to be related to the protocol used for ovarian stimulation. The importance of the IVF stimulation protocol on egg/embryo quality cannot be overstated. This factor seems often to be overlooked or discounted by t IVF practitioners who use a “one-size-fits-all” approach to…
Hormones & Ovulation May 24, 2023

Letrozole + HRT for ovulation induction

I am 40-year-old female trying to get pregnant. My estrogen levels and my AMH are rather low and my follicular phase very long of 27 days. Before going for IVF I am trying to improve my ovulation. My gynecologist gave… — Lucie M.

Dr. Geoffrey Sher answered

This is a very unconventional approach that I both do not advocate nor use. The protocol used for ovarian stimulation in women with DOR is very important. Consider the following: It is primarily the egg (rather than the sperm) that determines the chromosomal integrity (karyotype) of the embryo,…
Ovarian Stimulation & OHSS May 24, 2023

IVF protocol

Hello there! I’m currently on my first cycle of IVF after 4 failed attempts of IUI. I have been prescribed 150 units of gonal f, and 75 units of menopur. At my first scan on day 6 of being on… — Steevie D.

Dr. Geoffrey Sher answered

The rate of follicle growth to reach full development is not important here. Rather, it is that they develop fully and that the timing of an adequate hCG trigger is well decided. I cannot respond as to whether or to what extent the dosages should be altered. For…
Ovarian Stimulation & OHSS May 22, 2023

Egg Retrieval

Hi doctor Sher During my egg retrieval yesterday they only found some cumulus cells no oocytes. What does this mean? Can there be cumulus cells without eggs? — Gauri P.

Dr. Geoffrey Sher answered

There is in my opinion no such entity as “Empty Follicle Syndrome”. All follicles contain eggs. Failure to access those eggs at ER can often be a result of the protocol used for controlled ovarian stimulation (COS. Not infrequently, when following vigorous and often repeated flushing of follicles…
Hormones & Ovulation May 22, 2023

PCOS But regular period

Hi Dr Sher I am diagnosed with pcos but my cycles are regular but I was not able to conceive despite trying for 2 years. After every ovulation my basal body temperature increased and progesterone also increased ( my gynecologist… — Teresa M.

Dr. Geoffrey Sher answered

I need much more information to provide an authoritative response . Please call my assistant, Patti at 702-533-2691 and set op an online consultation with me to discuss. ADDITIONAL INFORMATION: I am attaching online links to two E-books which I recently co-authored with my partner at SFS-NY (Drew…
Ovarian Stimulation & OHSS May 18, 2023

Overmature Follicles?

Hi Dr. Sher, I am writing to you because I am extremely upset at the negligence of my clinic and am looking for some insight. The clinic upped my meds of rekovelle and menopur and decided to wait 3 days… — Kristin C.

Dr. Geoffrey Sher answered

Of course I cannot say with certainty, but in my experience follicles >22mm will commonly produce poor quality eggs. I believe in triggering when several follicles reach 20-22mm. After this cycle is over, I suggest we talk. If interested, please contact my assistant Patti Converse at 702-533-2691 and…

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.

225 answers

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