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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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165 answers

Egg Health & Ovarian Reserve

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Egg Health & Ovarian Reserve Mar 25, 2023

Am I a lost cause?

Dear doctor Sher, I am 33 years old and my husband is 36. After 5 months of trying to conceive (that was back in November 2022), we decided to visit a fertility specialist in Switzerland where we are currently located.… — Alexandra C.

Dr. Geoffrey Sher answered

Hi Alexandra, Yes indeed, based on your AMH blood level, you have prematurely developed diminished ovarian reserve (DOR) and this means you have very much reduced egg population (which cannot be replenished) and accordingly will propagate very few follicles. In addition, women with DOR often have an adverse…
Age & Fertility Mar 24, 2023

Adenomyosis, AMH and advanced maternal age

Hello Dr, Sher, from one South African to another :) I am living in Portugal now, and am trying to fall pregnant. I have been diagnosed with diffuse adenomyosis (mild) which is at the top of my uterus. Mainly on… — Lisa-Marie E.

Dr. Geoffrey Sher answered

Respectfully, I do not agree. Both age and diminishing ovarian reserve, make this a poor choice. I would move to IVF ASAP . Frankly , unless your adenomyosis is associated with a "thin uterine lining at mid-cycle, I would not be over concerned about this aspect.I am including…
Egg Health & Ovarian Reserve Mar 24, 2023

Egg Immaturity

Hello - I’ve just finished my second egg retrieval, both of which had disappointing results. I am 36 years old with a low AMH (0.69 as checked in November of 2022). Last FSH was 7.7. First egg retrieval was in… — Natalie M.

Dr. Geoffrey Sher answered

WE need to talk! Might I suggest that you contact my assistant, Patti Converse (702-533-2691) and set up an online3 consultation with me. In the meanwhile, please read below. The importance of the IVF stimulation protocol on egg/embryo quality cannot be overstated. This factor seems often to be…
Egg Health & Ovarian Reserve Mar 23, 2023

IVF – Friend of Ivan Sher

Hello, I am 41 years old. I am a friend of Ivan Sher's for many years and he mentioned I could get some help from Dr. Sher on here. My AMH levels are 2.87. We started IVF when I was… — Mash P.

Dr. Geoffrey Sher answered

I am flattered that Ivan referred you to me and will do my best to advise. The response will be lengthy but please read it carefully: There are several issues that apply here 1, AGE: It is primarily the egg (rather than the sperm) that determines the chromosomal…
Egg Health & Ovarian Reserve Mar 21, 2023

IVF

Hello, Im 41 . I had to have a myomectomy in 2021 which made me wait 6 months from consult to surgery then 7 months recovery. Long story short Dr did not tell me I had low ovarian reserve till… — Iris G.

Dr. Geoffrey Sher answered

Perhaps we should talk. I suggest you contact my assistant, Patti at 702-533-2691 and set up an online consultation with me to discuss. Geoff Sher 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…
Egg Health & Ovarian Reserve Mar 19, 2023

Hormone levels during IVF

I am 36 years old and only freezing eggs. My AMH was just over 1 ng about a year ago, AFC usually 6-8. I have a long history of stage 4 endometriosis. 1. Could a disproportionately high estrogen to follicle… — Lilly G.

Dr. Geoffrey Sher answered

I do not believe tyhat an E2 of 3000pg/ml at peak, is potentially harmful. This having been said, the protocol used for ovarian stimulation is important, but without much more information in this regard, I cannot comment authoritatively. Av separate issue is the effect of endometriosis on IVF…
Egg Health & Ovarian Reserve Mar 17, 2023

GV immature eggs

HI I am 41 y/o who recently went through IVF. When I began my menstrual cycle, I did a baseline US which showed 13 follicle in my left and 8 follicles in my right. I started my IVF cycle and… — Lisa L.

Dr. Geoffrey Sher answered

Very respectfully, in my opinion, the protocol used for ovarian stimulation might not have been optimal. Your low E2 level with so many follicles, suggests possible3 "premature luteinization. (see below). Geoff Sher 1. IMPORTANCE OF INDIVIDUALIZING THE PROTOCOL FOR OVARIAN STIMULATION. The importance of the IVF stimulation protocol…
Age & Fertility Mar 16, 2023

Pcos, AMH and menopause?

Hello Dr. I am turning 40 this year and have pcos. Can you explain why my AMH is still very high? 12 years ago it was 10 ng/ml, now it’s 6.85. I also used to have 15 follicles on each… — Amanda B.

Dr. Geoffrey Sher answered

It ism true thatvwo9men with PCOS have an increased risk of developing breast and ovarian cancer. However, this is by no means a great risk. You need to have regular check-up evaluations at least yearly, but I would not become paranoid about this. In the vast majority of…
Egg Health & Ovarian Reserve Mar 15, 2023

3rd failed IVF and problem with egg maturity

Hello Dr Sher, First of all I would like to thank you in advance for giving me a chance to ask you a question and for answering if. I really appreciate it. I am 33 years old, have a good… — Stephanie K.

Dr. Geoffrey Sher answered

One of the commonest questions asked by patients undergoing IVF relates to the likelihood of their eggs fertilizing and the likely “quality of their embryos. This is also one of the most difficult questions to answer. On the one hand many factors that profoundly influence egg quality; such…
Age & Fertility Mar 13, 2023

46 year old with multiple canceled IVF cycles because of dominant ovarian follicle

What is in your opinion the best IVF protocol for a 46 year old with FSH 19 and AMH 0.51, poor responder, 4 canceled IVF cycles turned into IUI because of dominant ovarian follicle and only 1 egg retrieval of… — Nari J.

Dr. Geoffrey Sher answered

Very respectfully, the chance of IVF success at 46y with these parameters is negligible. Of course it would be your right to try, but in my opinion, only IVF with egg donation would offer success! Geoffrey Sher The importance of the IVF stimulation protocol on egg/embryo quality cannot…
Egg Health & Ovarian Reserve Mar 9, 2023

IVF & Endometriosis

37 yrs old, 1.6 amh. 7 years of infertility, 4 failed IUI's before surgery, 2 surgeries to remove endometriosis and endometriomas on both ovaries, 1 IVF completed and obtained one normal 5BB embreyo. What protocol is best for 2nd IVF… — Jule A.

Dr. Geoffrey Sher answered

ENDOMETRIOSIS AND IVF When women with infertility due to endometriosis seek treatment, they are all too often advised to first try ovarian stimulation (ovulation Induction) with intrauterine insemination (IUI) ………as if to say that this would be just as likely to result in a baby as would in…
Age & Fertility Mar 4, 2023

Low ovarian reserve

Hi, for women age 41+ with low ovarian reserve what are options to conceive successfully using own eggs? I've been discouraged with clinic's pushing donor eggs and I am looking for a specialist that can help someone like me. Any… — Newbie F.

Dr. Geoffrey Sher answered

It is primarily the egg (rather than the sperm) that determines the chromosomal integrity (karyotype) of the embryo, the most important determinant of egg/embryo competency”. A “competent” egg is therefore one that has a normal karyotype and has the best potential to propagate a “competent” embryo. In turn,…
Egg Health & Ovarian Reserve Feb 7, 2023

Empty follicle sybdrome

Hello, I have had 3 rounds of ivf and twice had 6/7 follicles and only 3 eggs. Now I had 9 follicles and 1 egg. I am 37 and AMH around 7 pmol. I have been having several false peaks… — Angharad B.

Dr. Geoffrey Sher answered

Frequently, when following vigorous and often repeated flushing of follicles at egg retrieval they fail to yield eggs, it is ascribed to “Empty Follicle Syndrome.” This is a gross misnomer, because all follicles contain eggs. So why were no eggs retrieved from the follicles? Most likely it was…
Egg Health & Ovarian Reserve Jan 12, 2023

Low AFC in IVF cycle after BCP vs IUI

Hi Dr Sher, I’ve done 5 IUIs before and my AFC has varied between 13 and 18. I’m now doing IVF. After 13 days of taking BCP, my ultrasound only showed 9 follicles and I was asked to start stims.… — Sophie J.

Dr. Geoffrey Sher answered

I would not take this AFC count as an accurate indication of how many follicles you might end up with. I suspect that with stimulation there will likely be more. Good luck! Geoff Sher ADDITIONAL INFORMATION: I am attaching online links to two E-books which I recently co-authored…
Egg Health & Ovarian Reserve Jan 10, 2023

Unexpected IVF Results

Hi Dr. Sher- I just completed my first failed IVF cycle and I'm left shocked and confused by the results, for both egg retrieval and transfer. I am 38 years old, AMH is 5.12, FSH 6.3, follicle count around 40-… — Jennifer M.

Dr. Geoffrey Sher answered

One of the commonest questions asked by patients undergoing IVF relates to the likelihood of their eggs fertilizing and the likely “quality of their eggs and embryos. This is also one of the most difficult questions to answer. On the one hand many factors that profoundly influence egg…

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.

165 answers

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