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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.

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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225 answers

Ovarian Stimulation & OHSS

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Ovarian Stimulation & OHSS Feb 21, 2023

Safety of Letrozole – Limit?

Hi Dr.Sher, Is there a limit to the number of letrozole cycles that one can do due to safety. I have done 12 cycles of letrozole. 8 of these have included using a trigger shot, Ovidrel. I know there are… — Kristin C.

Dr. Geoffrey Sher answered

In my opinion it is safe! However, that does not mean it is a judicious approach. Perhaps we should talk. I invite you to call my assistant Patti Converse at 702-533-2691 and set up an online consultation with me. Geoff Sher ADDITIONAL INFORMATION: I am attaching online links…
IVF Failure & Pregnancy Loss Feb 13, 2023

Failed IVF Cycles

Hi Dr. Sher - I recently learned about you and your practice after listening to the Egg Whisperer Podcast. I've had two IVF cycles at two separate clinics in the Orlando, FL area. My first cycle resulted in 5 embryos,… — Ashley G.

Dr. Geoffrey Sher answered

Respectfully, This is likely NOT a lab issue but rather due to a combination of diminished ovarian reserve and the protocol used for ovarian stimulation. We should talk before you go any further. It is primarily the egg (rather than the sperm) that determines the chromosomal integrity (karyotype)…
Ovarian Stimulation & OHSS Feb 13, 2023

Clomiphene

Hi Dr. Sher, I am 42, trying for our 2nd baby. I had regular periods and ovulated well till October 2022 when My OB doctor prescribed Clomiphene x5 days. My cycles became mess after that. Periods last for 16-17 days,… — Iryna S.

Dr. Geoffrey Sher answered

Clomiphene (syn; Clomid , Serophene) is by far the most widely prescribed agent for the induction of human ovulation for women who do not ovulate, those with dysfunctional ovulation and women with ”unexplained” infertility. When used in young women (who have adequate ovarian reserve) with these problems the…
Age & Fertility Feb 5, 2023

Risk of fertility meds

Hello Dr, I have pcos and I am 40 years old. I have an 8 year old and over the years, I’ve been through 7 rounds of timed intercourse with ovidrel with no success. My doctor is recommending a round… — Marcella J.

Dr. Geoffrey Sher answered

Ever since January 1993 when a study was reported by researchers at Stanford University suggesting that the use of fertility agents increased the risk of ovarian cancer, there has been tremendous concern and anxiety among women who use fertility drugs. At first the findings seemed well founded because…
Hormones & Ovulation Feb 2, 2023

Fertility Inducing Medications

Hello! Do you use BMI as a metric for prescribing fertility inducing medication (Clomid/letrozole)? If so, what is the maximum BMI allowed? Thank you! — Audrey V.

Dr. Geoffrey Sher answered

No! By and large, I do not! 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 Journey with Sher Fertility Solutions (SFS)…
Ovarian Stimulation & OHSS Feb 1, 2023

BCP Timing before IVF

I have short (25 day) cycles with early recruitment of follicles, and a history of lead follicles and asynchronous growth during previous IVF. My dr instructed me to take 21 days BC before beginning my IVF cycle with 3 days… — Liza A.

Dr. Geoffrey Sher answered

I do not think that starting the BCP on Day-6will have any adverse effects on your treatment. One often hears the expressed opinion that the BCP suppresses response to ovarian stimulation. This is not the case, provided that the BCP is overlapped with administration of an agonist (e.g.…
Ovarian Stimulation & OHSS Jan 28, 2023

Thin uterine lining after egg retrieval

Is it possible to have damaged the lining of my uterus during egg retrieval? My uterine lining went from 9.9mm 2 days before egg retrieval to 5mm after. Please advise. — Shernelle T.

Dr. Geoffrey Sher answered

That is highly unusual. The ER would not have caused this. Perhaps one of these measurements was not accurate. 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…
Ovarian Stimulation & OHSS Jan 22, 2023

Stimulation protocol

Good morning Dr. Sher. Hope this message finds you well and that you can provide me with some insight. We have MFI with my husband’s sperm having 0% morphology, borderline low motility (0% fast A progressive swimmers and 26-28% slow… — Nakia O.

Dr. Geoffrey Sher answered

That sounds like a reasonable approach! I wish you well! 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 Journey with Sher…
Embryos & Genetic Testing Jan 22, 2023

Repeated Chemical Pregnancies

I have done 3 FETs with PGT-A tested euploid embryos. Results were 1 pregnancy that ended at 14.5 weeks due to genetic abnormalities, followed by 2 chemical pregnancies in the last 8 months. Since my 14.5 week loss, I have… — Alysa W.

Dr. Geoffrey Sher answered

RECURRENT PREGNANCY LOSS (RPL) Geoffrey Sher MD. When it comes to reproduction, humans are the poorest performers of all mammals. In fact we are so inefficient that up to 75% of fertilized eggs do not produce live births, and up to 30% of pregnancies end up being lost…
Hormones & Ovulation Jan 19, 2023

Trigger using HCG10,000 and Decapeptyl

Hi Dr Sher, my RE has asked me to trigger with both HCG 10,000 and Decapeptyl 1 ml. I find this strange. I understand that Dual Trigger is considered for cases where there might be risk of OHSS, but I… — Jenna H.

Dr. Geoffrey Sher answered

Respectfully, I do agree with you, but this is something you need to discuss with your treating RE “Triggering” Egg Maturation in IVF: Comparing urine-derived hCG, Recombinant DNA-hCG and GnRH-agonist: Geoffrey Sher MD Ideal egg development sets the scene for optimal egg maturation that occurs 36-42h prior to…
Egg Health & Ovarian Reserve Jan 12, 2023

Low AFC in IVF cycle after BCP vs IUI

Hi Dr Sher, I’ve done 5 IUIs before and my AFC has varied between 13 and 18. I’m now doing IVF. After 13 days of taking BCP, my ultrasound only showed 9 follicles and I was asked to start stims.… — Sophie J.

Dr. Geoffrey Sher answered

I would not take this AFC count as an accurate indication of how many follicles you might end up with. I suspect that with stimulation there will likely be more. Good luck! Geoff Sher ADDITIONAL INFORMATION: I am attaching online links to two E-books which I recently co-authored…
Egg Health & Ovarian Reserve Jan 10, 2023

Unexpected IVF Results

Hi Dr. Sher- I just completed my first failed IVF cycle and I'm left shocked and confused by the results, for both egg retrieval and transfer. I am 38 years old, AMH is 5.12, FSH 6.3, follicle count around 40-… — Jennifer M.

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 eggs and embryos. This is also one of the most difficult questions to answer. On the one hand many factors that profoundly influence egg…
Hormones & Ovulation Jan 7, 2023

38 and ovulation infection meds

I’m 38 years old and having difficulty conceiving. I developed Ashermans (moderate) in 2020. I got lysis of adhesions and conceived my daughter shortly after at 36 years old. I ovulate and haven’t regular cycles. My doctor is giving me… — Sarah E.

Dr. Geoffrey Sher answered

Respectfully, . After Ashernan's, endometrial thickness poses a real problem in many cases. In my opinion, Tamoxifen will make matters worse as far as the uterine lining is concerned. Look this up in my book, From In Vitro Fertilization to Family: A Journey with Sher Fertility Solutions (SFS)…
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…
Ovarian Stimulation & OHSS Dec 27, 2022

FET Protocol

Hello I will be going for my next FET for baby #2, I have PCOS, any supplements advices , I will be taking aspirin for my pre eclampsia for sure, i just completed 5 days of Provera for period for… — Steph P.

Dr. Geoffrey Sher answered

There are many approaches to prepare for FET. Below is my preferred method! Geoff Sher 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…

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.

225 answers

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