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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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159 answers

Egg Health & Ovarian Reserve

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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…
Egg Health & Ovarian Reserve Jan 7, 2023

Chinese herbal medicine and acupuncture

Can Chinese herbal medicine help with egg quality? Is acupuncture effective for egg quality? — Sarah E.

Dr. Geoffrey Sher answered

I don't believe anyone can answer that question with confidence. But it wont hurt! 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 your reading pleasure: 1.From In Vitro Fertilization to Family:…
Egg Health & Ovarian Reserve Dec 27, 2022

Are my poor outcomes just related to age?

[et_pb_section admin_label="section"] [et_pb_row admin_label="row"] [et_pb_column type="4_4"][et_pb_text admin_label="Text"]Hello, I had my daughter via ivf aged 40 after 2 cycles (first and only FET). Have been trying for a second (aged 41-42 years) over 4 cycles. My AMH is 31 and I… — Kay L.

Dr. Geoffrey Sher answered

Age could well be a factor, however, the protocol used for ovarian stimulation should be reviewed and if need be, revised. Also, I do suggest doing PGT on all blastocyst sand selective transferring only "competent" ones. Geoff Sher The importance of the IVF stimulation protocol on egg/embryo quality…
Egg Health & Ovarian Reserve Dec 12, 2022

Egg Maturity

What approach is best for optimising egg maturity? Would HGH be useful for this? I already use a double ovidrel trigger, but only get 1-3 mature eggs, despite retrieving about 8 eggs. I also stimulate rather quickly, with my follicles… — Cristina Y.

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 IVF…
Egg Health & Ovarian Reserve Dec 12, 2022

DHEA & Testosterone Levels

Hello, I am wondering what you thoughts were on my situation. I just turned 39 and I have “lean” pcos. I have one living child conceived 6 years ago through medicated timed intercourse. Since then I have had a few… — Stephanie W.

Dr. Geoffrey Sher answered

Here is an article I wrote on PCOS an IVF: Polycystic ovary syndrome (PCOS) is a common hormonal system disorder among women affecting between 5% and 10% of women of reproductive age worldwide. Women with PCOS may have enlarged ovaries that contain small collections of fluid — called…
Egg Health & Ovarian Reserve Dec 5, 2022

Poor response to oestrogen

Hello, My first IVF cycle with embryo adoption has been cancelled due to a thin endometrium as I have not responded well to the oestrogen medication (it was increased to 8mg of Progynova a day in combination with an estraderm… — Alyson B.

Dr. Geoffrey Sher answered

It is possible that the treatment of your endometrial cancer might have negatively impacted endometrial thickening in response to estrogen. This having been said, I would need much more information in order to provide an authoritative response! ADDITIONAL INFORMATION: I am attaching online links to two E-books which…
Egg Health & Ovarian Reserve Nov 29, 2022

POI and egg quality

Hello, a few weeks ago I was diagnosed with POI by my OB - I had one blood test that showed my FSH at 100, AMH at .003, and Estriadol at 17. I do not know my AFC yet, I… — Caitlin D.

Dr. Geoffrey Sher answered

I doubt it has anything to do with your long term use of BCP. What I can say is that with your FSH of 100 and very low AMH, I am doubtful you will respond to stimulation for IVF. However, if you do, your age would be in…

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.

159 answers

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