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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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230 answers

Ovarian Stimulation & OHSS

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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…
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…

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.

230 answers

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