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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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Embryos & Genetic Testing May 2, 2023

transfer

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 May 1, 2023

Implantation Failure

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 May 1, 2023

Lupron and retrieval

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 May 1, 2023

persistently thin utering lining

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 Apr 28, 2023

Rising progesterone before starting PIO in transfer cycle

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 Apr 25, 2023

Anemia and egg quality

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 Apr 20, 2023

Adenomyosis and egg freezing

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 Apr 16, 2023

How to improve next time

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 Apr 12, 2023

Thin endometrium 3 years after successful egg donor pregnancy

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 Apr 10, 2023

2 failures with Donor Eggs

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 Apr 4, 2023

Should I try again?

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 Mar 28, 2023

Lining Thickness for FET

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 Mar 27, 2023

Laparoscopy for endometriosis after failed ivf

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…
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…
Uterine & Endometrial Health Mar 23, 2023

Trilaminar Endometrium

Dear Dr. Sher, Thank you so much for your dedication to answering all our questions. I have a problem concerning the endometrium. Mine gets thick enough but never trilaminar anymore (it was like that for the last three attempts). I… — Shira M.

Dr. Geoffrey Sher answered

In my opinion, the trilaminar configuration is NOT important. It is endometrial thickness that matters. This needs to be >8mm on the day of "the trigge3r" or the start of progesterone. Geoffrey Sher It was as far back as 1989, when I first published a study that examined…

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.

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