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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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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…
Egg Health & Ovarian Reserve Nov 29, 2022

Getting FSH to rise following BCP

Hi Dr Sher, You've written that for women launching COS coming off a BCP something needs to be done to cause a rise in FSH for 5-7 days to facilitate PAF to AF conversion. You suggest that this be done… — Gautam J.

Dr. Geoffrey Sher answered

Theoretically this might be achievable through administration of gonadotropins for several days longer while still on BCP but in my pinion would hold no advantage.
Egg Health & Ovarian Reserve Nov 21, 2022

IVF advice for optimal cycles

Hi Dr. Sher, I’m 34 with history of 2 early losses last year and DOR (last AMH 1.49). I have around 16 antral follicles based on ultrasound. Just finished my first round of stims and only yielded 6 eggs. Only… — Lauren M.

Dr. Geoffrey Sher answered

You are only 34y of age and with your high AFC, I expect that you ave ample ovarian reserve. My hunch is that you poor response could have to do with the protocol used for ovarian stimulation and its implementation.I really think we should talk!!. The importance of…
Egg Health & Ovarian Reserve Nov 19, 2022

Infertility

I am 32, have PCO. I have experienced EFS in all egg collections, medicated and unmedicated. Recently, I found out I have ZP1 homozygous mutation (autosomal recessive) which means maturation oocyte defect. Is there a way to find eggs or… — Andria E.

Dr. Geoffrey Sher answered

There is certainly room for differing opinions her, But I would not go straight to egg donation. There are so many factors that impact egg quality in women with PCOS, but most of them are amenable to treatment using an individualized protocol for ovarian stimulation. Polycystic ovary syndrome…
Egg Health & Ovarian Reserve Nov 7, 2022

Primary Ovarian Insufficiency

Hi Doctor, I am a 30 year old woman with a recent POI diagnosis. I no longer have a natural cycle and at diagnosis in January my FSH was as high as 105. Currently I have been on HRT for… — Brittany F.

Dr. Geoffrey Sher answered

Yes! I do offer the opportunity to try and ovulate on ovarian stimulation. However, you need to be realistic about the fact that in the final analysis, egg donor-IVF might ultimately be your only option. Feel free to call my assistant, Patti at 702-533-2691 and set up an…
Egg Health & Ovarian Reserve Oct 17, 2022

DOR Protocol Suggestions

I am 41.5 with DOR. I'm desperately looking for advice on what would be the right protocol. I don't believe BC helps me. I had 2 months cancelled when on it for cysts. 1 estrogen producing and the other was… — Kodi F.

Dr. Geoffrey Sher answered

I cannot provide you with a specific protocol via this venue. I can only do so for an active patient of mine. You would need to contact my assistant, Patti Converse at 702-533-26912 and set up an online consultation with me for this. However, below please find the…
Egg Health & Ovarian Reserve Oct 15, 2022

High AFC with PCOS and pregnancy

Hi Dr. I am 39 and have PCOS. I went for my day 3 AFC and I was informed by the nurse that I have 20 follicles on my left ovary and another 20 on my right. The strange thing… — Kristin C.

Dr. Geoffrey Sher answered

Quite frankly, at 39y ,with PCOS, I would favor IVF over ovarian stimulation with or without IUI. 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…
Egg Health & Ovarian Reserve Aug 8, 2022

No normal embroys

Hi Dr. Sher, I am asking this question after first egg retrieval. I am 40 years old, first time doing this IVF. I saw about 23 follicles during ultrasound and was on 21 days lupron protocol ended with 20 eggs,… — Esther L.

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 Jul 26, 2022

I would like to ask you about DUO stim protocol for women with DOR

Dear Dr. Sher, I would like to ask you about DUO stim protocol for women with DOR. Is it OK to have double stim within the same menstruation cycle? I have DOR, endometriosis stage 1, MTHFR, 35 yrs old and… — Ola

Dr. Geoffrey Sher answered

Respectfully, I am not a protagonist of Duo-stimulations. In my opinion it can compromise follicle development as well a jeopardize egg/embryo “competency”. Geoff Sher
Egg Health & Ovarian Reserve Jul 25, 2022

I have very low ovarian reserve Amh=0.4

Dear Doctor, I saw your video on internet and I noticed that you master very well my case. I have very low ovarian reserve Amh=0.4 So I live in France and I want to came and have an ivf protocol… — Elies E.

Dr. Geoffrey Sher answered

Thank you! If you wish to consult with me online, please contact my assistant, Patti Converse at 702-533-2691. When it comes to reproductive performance, humans are the least efficient of all mammals. Even in young women under 35y, at best only 1 out of 2 eggs are chromosomally…

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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