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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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Ovarian Stimulation & OHSS Apr 3, 2023

Ivf medicine

I just began estrogen priming I took my estrogen patch I mistakenly took the leuproliide instead of the fyramodel when I realized it was the wrong injection I took the fyramadel will this effect the process — Tamamiea J.

Dr. Geoffrey Sher answered

I do not believe that one transgression will impact your cycle. 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 pleasure: 1.From In Vitro Fertilization to Family: A…
Egg Health & Ovarian Reserve Mar 31, 2023

Success at 43

Hello! I have recently turned 43 and wondering whether to keep trying IVF. Have done 5 cycles in the past 12 months. AMH is 30 and AFC ~35. But, only get around 7-12 eggs at a time and poor fertilisation… — Kristy D.

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 Mar 28, 2023

Genuine Empty Follicle Syndrome

Hello Dr Sher I have just completed my 2nd ivf which failed due to my 13 follicles in egg collection being empty. The consultant diagnosed me with genuine empty follicle syndrome. I am 36 years old with a AMH of… — Laura K.

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…
Egg Health & Ovarian Reserve Mar 25, 2023

Am I a lost cause?

Dear doctor Sher, I am 33 years old and my husband is 36. After 5 months of trying to conceive (that was back in November 2022), we decided to visit a fertility specialist in Switzerland where we are currently located.… — Alexandra C.

Dr. Geoffrey Sher answered

Hi Alexandra, Yes indeed, based on your AMH blood level, you have prematurely developed diminished ovarian reserve (DOR) and this means you have very much reduced egg population (which cannot be replenished) and accordingly will propagate very few follicles. In addition, women with DOR often have an adverse…
Hormones & Ovulation Mar 24, 2023

2 failed cycles, No transfer

Hi Dr Sher I’m a 30 year old living in London. I have had 2 IVF cycles, but after both, all embryos stopped growing after 2-3 days post egg retrieval. I was also told I have mild PCO in my… — Abi S.

Dr. Geoffrey Sher answered

Very respectfully, this is not likely to be a uniform genetic issue. More than likely ity has to do with the protocol used for ovarian stimulation (see below). The importance of the IVF stimulation protocol on egg/embryo quality cannot be overstated. This factor seems often to be overlooked…
Egg Health & Ovarian Reserve Mar 24, 2023

Egg Immaturity

Hello - I’ve just finished my second egg retrieval, both of which had disappointing results. I am 36 years old with a low AMH (0.69 as checked in November of 2022). Last FSH was 7.7. First egg retrieval was in… — Natalie M.

Dr. Geoffrey Sher answered

WE need to talk! Might I suggest that you contact my assistant, Patti Converse (702-533-2691) and set up an online3 consultation with me. In the meanwhile, please read below. The importance of the IVF stimulation protocol on egg/embryo quality cannot be overstated. This factor seems often to be…
Egg Health & Ovarian Reserve Mar 23, 2023

IVF – Friend of Ivan Sher

Hello, I am 41 years old. I am a friend of Ivan Sher's for many years and he mentioned I could get some help from Dr. Sher on here. My AMH levels are 2.87. We started IVF when I was… — Mash P.

Dr. Geoffrey Sher answered

I am flattered that Ivan referred you to me and will do my best to advise. The response will be lengthy but please read it carefully: There are several issues that apply here 1, AGE: It is primarily the egg (rather than the sperm) that determines the chromosomal…
Embryos & Genetic Testing Mar 21, 2023

Should I continue to do egg retrievals or transfer?

Hi Dr Sher, I listened to you on The Egg Whisperer podcast. I found your way of explaining and just the overall wealth of knowledge you proved in just a couple of podcasts so incredibly helpful. Thank you for everting… — Danielle B.

Dr. Geoffrey Sher answered

Thank you for your communication. First , let me say that IUI in a woman over 40Y bis usually not a good idea. The baby rate is about 2-3% per cycle . And with diminished ovarian reserve (DOR), you do not have the time to waste on an…
Egg Health & Ovarian Reserve Mar 19, 2023

Hormone levels during IVF

I am 36 years old and only freezing eggs. My AMH was just over 1 ng about a year ago, AFC usually 6-8. I have a long history of stage 4 endometriosis. 1. Could a disproportionately high estrogen to follicle… — Lilly G.

Dr. Geoffrey Sher answered

I do not believe tyhat an E2 of 3000pg/ml at peak, is potentially harmful. This having been said, the protocol used for ovarian stimulation is important, but without much more information in this regard, I cannot comment authoritatively. Av separate issue is the effect of endometriosis on IVF…
Embryos & Genetic Testing Mar 17, 2023

Do I Need Another Retrieval?

Dr. Sher, We got the following PGT tested embryos from our first round of IVF at 33: two 4aa, one 3aa, one 3ab, two 5bb (six total genetic normals out of 10 that made it to blast). One of the… — Mary P.

Dr. Geoffrey Sher answered

I would not test the "inconclusive" blastocyst. In my opinion, 2ndary testing is too traumatic on trhe embryo. I would also not do another ER. You had a good result and all things being equal (e.g., the absence of an implantation dysfunction) you should be able to ave…
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…
Ovarian Stimulation & OHSS Mar 16, 2023

Missed dose of Buserilin

Hi I was taking Buserilin daily for two weeks as a down regulation, prior to beginning stimulation for a frozen embryo transfer. One evening, I took my injection 2.5/3 hours late and the next day my cycle had to be… — Ashleigh S.

Dr. Geoffrey Sher answered

In all like3lihood, the late dosage of Buserelin had nothing to do with this. 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 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…
IVF Failure & Pregnancy Loss Mar 14, 2023

Failed ivf

I just failed my first round of IVF. I am 33. I have a 3 year old (spontaneous pregnancy). History of ulcerative colitis and j pouch with revision in 2018. My HSG was normal however given my previous gut history.… — Lindsey M.

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?.…
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…

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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