– Geoffrey Sher, MD
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Uterine & Endometrial Health
I understand you offer PRP therapy? I am 44 with DOR and several failed IVF cycles. Would you recommend? If so, what is involved? — Patty M.
Dr. Geoffrey Sher answered
WE do offer PRP for those who wish to indulge...,And, there are differences of opinion, but I am not a proponent of PRP. 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…
Uterine & Endometrial Health
I lost my Ivf twins at 19 weeks due to incompetent cervix. My OB refused to give me a d&c until 3 months postpartum because she didn’t believe I had retained products even though I told her my body was… — Michelle K.
Dr. Geoffrey Sher answered
Clearly the retained products of conception (for such a long time period), caused endometritis that compromised the basal endometrium, rendering it unable to respond optimally to estrogen. In my opinion, the D&C was probably delayed for too long. This may or may not be reversible (see below). It…
Embryos & Genetic Testing
Hi, I am preparing for a transfer next week. My doctor says lining is good. I am wondering what you think of bed rest after a transfer? Also, I am stressed about this working and have a busy work and… — Fay K.
Dr. Geoffrey Sher answered
Good luck! In my opinion there is no need for extended bed-rest post-transfer. Unquestionably, the IVF doctor’s expertise in performing embryo transfer ranks as one of the most important factors that will determine IVF outcome. It takes confidence, dexterity, skill, gentility and above all, experience to do a…
Embryos & Genetic Testing
Hi! I have had two FETs with embryos made with my wifes egg and sperm donor, PGT tested and good quality. Both times did not work. I am 28 years old, have had many tests, Hysteroscopy, Uterine Imaging, etc and… — Ann S.
Dr. Geoffrey Sher answered
Whenever a patient fails to achieve a viable pregnancy following embryo transfer (ET), the first question asked is why! Was it simply due to, bad luck?, How likely is the failure to recur in future attempts and what can be done differently, to avoid it happening next time?.…
Ovarian Stimulation & OHSS
Hi How are you? I'm currently going through my second round of IVF and had a chemical pregnancy with a pgt normal embryo. I had endometritis before and they cleared it with cipro. I changed my doc since and my… — Lynn C.
Dr. Geoffrey Sher answered
Respectfully, I would not recommend depot Lupron prior to FET. After a few months, it can interfere with endometrial receptivity by down-regulation estrogen receptors. AND yes! I would recommend another ER sooner rather than later to try and " make hay while the sun still shines". Endometriosis is…
Uterine & Endometrial Health
Hi Dr. Sher, I am hoping you could help me know what to do next. I just turned 37 and did my first IVF cycle. We retrieved 6 mature eggs. Prior to this I had been trying for about 6… — Mira S.
Dr. Geoffrey Sher answered
It was as far back as 1989, when I first published a study that examined the correlation between the thickness of a woman’s uterine lining (the endometrium), and the subsequent successful implantation of embryos in IVF patients. This study revealed that when the uterine lining measured
Hormones & Ovulation
Hi Dr Sher, I hope you're well. I'm so glad to see you are still doing this forum! Your advice helped me tremendously three years ago when I embarked on my first (successful) FET. I'm about to embark on my… — Rhian T.
Dr. Geoffrey Sher answered
Respectfully, I do all my FETs under hormonal control. That avoids such issues. Until less than a decade ago, most women undergoing IVF would have embryos transferred to the uterus in the same cycle that the egg retrieval was performed (“Fresh” Embryo Transfer). This was because embryo cryopreservation…
Egg Health & Ovarian Reserve
Hi Dr. She’s, Due to countless fibroids and endometriosis, I spent two and half years bleeding heavily with no respite. As a result I was severely anemic and had to undergo many iron and blood infusions/transfusions to stabilize my iron.… — Rebecca M.
Dr. Geoffrey Sher answered
As long as the anemia has been cured, there should not be any significant adverse effect on egg/embryo quality. Good luck! 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…
Fertility Preservation
Hello Dr. Tortoriello, I was diagnosed with diffuse adenomyosis a month ago and am two weeks post-op for an excisional surgery for endometriosis. I am 31 and not yet married/partnered, so my surgeon recommended I consider freezing my eggs. Since… — N K.
Dr. Geoffrey Sher answered
I think you need to freeze about 10 mature (MII eggs) or 4 euploid (PGT-A normal) blastocysts. However, please read below on adenomyosis and its effect on fertility. Adenomyosis is a condition where endometrial glands develop outside the uterine lining (endometrium), within the muscular wall of the uterus…
IVF Failure & Pregnancy Loss
Hi Dr Sher. I'm 33 yrs old, and my husband is 40. I developed uterine scarring in 2019 after a D&C from an incomplete miscarriage. I was cleared to try again after several hysteroscopies. After 2 failed IVFs, I finally… — Rashida J.
Dr. Geoffrey Sher answered
I agree with you! Clearly you had post=pregnancy endometritis that compromised the basal (germinal layer) of you endometrium. This could absolutely explain your implantation dysfunction.Unfortunate, this kind of injury is often refractory to treatment but it is worth a try with vaginal Viagra and Estradiol to see if…
Third-Party Reproduction
I had my first egg donor transfer at 43 years old and it was successful. Had a c-section with no complications. Now I am 47 years old and wanted to try once more. This time I have had 4 transfer… — Alicia C.
Dr. Geoffrey Sher answered
It is possible that with established menopause, the chronically low estradiol has suppressed endometrial estrogen receptors, rendering the lining refractory to short-term estrogen stimulation. In my opinion you s might try a few months of cyclical estrogen/progesterone therapy to try and prime the endometrium (reawaken estrogen receptor response).…
Immunology & Implantation
Hi Dr. Sher, I’m writing you at a complete loss and low point in my treatment. I am 34. My husband is 41. We started to try to conceive when I was age 31 and within 3 months, I became… — Alyssa J.
Dr. Geoffrey Sher answered
There is very likely to be an implantation dysfunction. We should talk. I suggest you call my assistant, Patti Converse (702-533-02691 and set up an online consultation with me. Implantation dysfunction is unfortunately often overlooked as an important cause of IVF failure. In the pursuit of optimizing outcome…
Uterine & Endometrial Health
Hi Dr. Sher - I'm 34 yrs old, and developed uterine scaring after an incomplete miscarriage 4 years ago. Scaring was cleared and I have done 1 IVF and 4 rounds of IUI, but they all ultimately failed due to… — Jennifer I.
Dr. Geoffrey Sher answered
It was as far back as 1989, when I first published a study that examined the correlation between the thickness of a woman’s uterine lining (the endometrium), and the subsequent successful implantation of embryos in IVF patients. This study revealed that when the uterine lining measured
Uterine & Endometrial Health
In 2020 (age 42), we had 2 natural pregnancies at 6-8 weeks and miscarried naturally. In 2021, we tried IVF, we had 2 cycles that gave us 11 embryos, only 1 grew and it was abnormal. In July of 2022,… — Tracy W.
Dr. Geoffrey Sher answered
It was as far back as 1989, when I first published a study that examined the correlation between the thickness of a woman’s uterine lining (the endometrium), and the subsequent successful implantation of embryos in IVF patients. This study revealed that when the uterine lining measured
IVF Failure & Pregnancy Loss
Hi Dr. Sher , I have scheduled a robotic assisted laparoscopy to remove the endometriomas off of my ovaries based on your advice last year . My procedure description is “robotic assisted laparoscopy , lysis of adhesions , resection /… — Mindy D.
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 to discuss! 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…
