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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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Hormones & Ovulation Jun 28, 2023

Estrogen Priming in IVF

Hi Dr. I'm 39 with amh of 0.3 and going through my 3rd ivf cycle. Because of lab availability for PGS they are looking at delaying my priming and injections, starting my priming on CD19 (my cycle is 24 days)… — Yasmin G.

Dr. Geoffrey Sher answered

There are different philosophies regarding ovarian stimulation protocols. Of one thing I personally have no doubt about and that is that the protocol used needs to be tailored to the individual. I wish I could advise you directly but to do so I would need much more information.…
Egg Health & Ovarian Reserve Jun 27, 2023

Improving Maturity Rates and Blastocyst Development Rate

Hi Dr. Sher, I've been through 8 IVF cycles with two separate clinics. Overall, despite changes to protocols, I've encountered the same issues. The first issue is that, though my ovaries produce a good number of oocytes, not enough of… — J C.

Dr. Geoffrey Sher answered

I think we should talk. Please call my assistant, Patti Converse at 702-533-2691 and set up an online consultation with me. In the interim, please read the articles that I have written...below. A: EGG/ EMBRYO QUALITY IN IVF & HOW SELECTION OF THE IDEAL PROTOCOL FOR OVARIAN STIMULATION…
Ovarian Stimulation & OHSS Jun 26, 2023

IVF Antihistamine Protocol – FET for Endo

Hi Dr. Sher, I am a 34F, underwent IVF for UI/suspected endo (I have painful periods and hyperechoic cysts, which are 1-2 occasionally, that come and go on my ovaries). I did a Gonal F protocol with Luveris, Ovidril Trigger,… — Crystal B.

Dr. Geoffrey Sher answered

I am not in favor of natural cycle FET's. In my opinion, it is better to pinpoint the ideal window for implantation with hormonal preparation. Here is the protocol I use: IVF FET Protocol Until less than a decade ago, most women undergoing IVF would have embryos transferred…
Egg Health & Ovarian Reserve Jun 22, 2023

GV eggs

Hello I’m Asala from Saudi Arabia I’m 28 years old with stage 3 endometriosis my husband has normal semen analysis My fsh 9.9 amh 1.3ng/ml I have done 5 eggs retrievals with no success My first cycle one year ago… — Asala S.

Dr. Geoffrey Sher answered

The journey of in vitro fertilization can be a rollercoaster of emotions for many patients. Often times they have to face the harsh reality that the number and quality of eggs retrieved has fallen short of their expectations. Then, should fertilization of these eggs not propagate chromosomally normal…
Egg Health & Ovarian Reserve Jun 17, 2023

Differences between medication

I had many ivf cycles most of them failed due to empty follicles, I got 0 eggs after collection. I used gonal it shows goid response but no eggs collected. MENUPOR the ovaries didnt response at all. PUREGONI got 6… — Talia D.

Dr. Geoffrey Sher answered

The journey of in vitro fertilization can be a rollercoaster of emotions for many patients. Often times they have to face the harsh reality that the number and quality of eggs retrieved has fallen short of their expectations. Then, should fertilization of these eggs not propagate chromosomally normal…
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…

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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