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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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Egg Health & Ovarian Reserve Nov 21, 2022

IVF advice for optimal cycles

Hi Dr. Sher, I’m 34 with history of 2 early losses last year and DOR (last AMH 1.49). I have around 16 antral follicles based on ultrasound. Just finished my first round of stims and only yielded 6 eggs. Only… — Lauren M.

Dr. Geoffrey Sher answered

You are only 34y of age and with your high AFC, I expect that you ave ample ovarian reserve. My hunch is that you poor response could have to do with the protocol used for ovarian stimulation and its implementation.I really think we should talk!!. The importance of…
Ovarian Stimulation & OHSS Nov 20, 2022

IVF protocol meds

Hi, I have already had three cycles of IVF with my last one being the most successful. My protocol was 7 units omnitrope and testosterone gel with norethindrone for a few weeks before stopping norethindrone to start my cycle. I… — Vivian K.

Dr. Geoffrey Sher answered

I just don't know how the replacement of Menopur with low-dosage hCG would stack up as I personally have never used hCG in this way during stimulation. On the face of it it probably would work OK but it would be preferable if you could access other HMG…
Egg Health & Ovarian Reserve Nov 19, 2022

Infertility

I am 32, have PCO. I have experienced EFS in all egg collections, medicated and unmedicated. Recently, I found out I have ZP1 homozygous mutation (autosomal recessive) which means maturation oocyte defect. Is there a way to find eggs or… — Andria E.

Dr. Geoffrey Sher answered

There is certainly room for differing opinions her, But I would not go straight to egg donation. There are so many factors that impact egg quality in women with PCOS, but most of them are amenable to treatment using an individualized protocol for ovarian stimulation. Polycystic ovary syndrome…
Hormones & Ovulation Nov 19, 2022

IVF

Dr. Sher, My husband and I are 25 years old and have been trying for 2 years to conceive. I have stage 4 endometriosis, and had our first transfer 10/10 which failed. The protocol I was placed on was just… — Ashleigh G.

Dr. Geoffrey Sher answered

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 (IUI) ………as if to say that this would be just as likely to result in a baby as would in vitro fertilization (IVF).…
Ovarian Stimulation & OHSS Nov 15, 2022

Stim Protocol

Dear Dr. Sher, My spouse and I are both 36 years old with unexplained infertility. We've had 6 failed IUIs (4 with letrozole, 1 with letrozole and Menopur, and 1 with Gonal-F). My spouse's AMH is 1.27 ng/mL and AFC… — Gautam J.

Dr. Geoffrey Sher answered

. Obviously there are differences of opinion. What I have espoused is based upon 38Y in the field and >17000babies. The importance of the IVF stimulation protocol on egg/embryo quality cannot be overstated. This factor seems often to be overlooked or discounted by t IVF practitioners who use…
Age & Fertility Nov 14, 2022

Stimulation with LH in older women

Dear Dr. Sher, thank you very much for all the things you do for our community of fertility warriors. I have heard that gonadotrophins stimulation in older women with low ovarian reserve should only be done with FSH and no… — Shira M.

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,…
Embryos & Genetic Testing Nov 7, 2022

Thin Endometrium

Hello Dr., I am currently 36 with unexplained infertility. We sought help in 2019 and ended up with a successful IVF cycle, 7 PGS -tested normal embryos (1 day 5 and 6 day 6). We transferred our day 5 embryo… — Natasha B.

Dr. Geoffrey Sher answered

Obviously I cannot with certainty define the cause of your thin lining. I can tell you 2 things: 1. A lining of
Ovarian Stimulation & OHSS Oct 19, 2022

Back to back FETs

Hi Dr Sher, I've just had a failed medicated FET. I have now stopped all medication and am waiting for my period to start. I want to do my next transfer as quickly as possible and I'm keen to try… — Anne-Marie D.

Dr. Geoffrey Sher answered

The answer to both questions is yes! However, I am not a proponent of natural cycle FET. See below: 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…
Egg Health & Ovarian Reserve Oct 17, 2022

DOR Protocol Suggestions

I am 41.5 with DOR. I'm desperately looking for advice on what would be the right protocol. I don't believe BC helps me. I had 2 months cancelled when on it for cysts. 1 estrogen producing and the other was… — Kodi F.

Dr. Geoffrey Sher answered

I cannot provide you with a specific protocol via this venue. I can only do so for an active patient of mine. You would need to contact my assistant, Patti Converse at 702-533-26912 and set up an online consultation with me for this. However, below please find the…
Immunology & Implantation Oct 11, 2022

Recurrent miscarriage

Hi Dr Sher, I wish you had never left South Africa, as that is where I am from. I am 33 years old, we went to do ivf as my fiance is paralysed. He was placed on meds to improve… — Yvonne W.

Dr. Geoffrey Sher answered

I really sympathize with your predicament but there is no substitute for an appropriate and comprehensive medical evaluation of your problem....especially when it comes to an evaluation of immunologic implantation dysfunction. I urge you to download a free copy of my E-book , “Recurrent Pregnancy Loss and Unexplained…
Ovarian Stimulation & OHSS Sep 26, 2022

Review my protocol

I was wondering if you had online consults to review my records and previous protocol? I just finished my first egg retrieval with 7 eggs.. 3 immature 3 overmature and 1 fertilized but didn't make it past 2 cell. My… — Erin R.

Dr. Geoffrey Sher answered

I would be honored to do so! Please call my assistant, Patti Converse at 702-533-2691 and set up a consultation with me. The importance of the IVF stimulation protocol on egg/embryo quality cannot be overstated. This factor seems often to be overlooked or discounted by t IVF practitioners…
Embryos & Genetic Testing Sep 12, 2022

Where to go after 3 rounds of egg retrieval

Hello Dr. I have had 3 MCs ( chromosome issues) 3 rounds of er, in total 34 eggs, 23 fertilized, 5 blasts no euploid, 1 failed fresh 3-day transfer. I am 40 started all this when I was 38. My… — Desiree B.

Dr. Geoffrey Sher answered

There is really a great deal to talk about here. I strongly urge you to call my assistant Patti at 702-533-2691 and set up an online consultation with me. Given your history of 3 losses I think that aside from an egg/embryo quality issue you could, in addition,…
Male Infertility Sep 6, 2022

Sperm retrieval

Hi, My partner and I have had a friend that was successful at your clinic (Michelle and Steve Christie) and we are exploring a child together but do not have the funds to have it not be successful going back… — Kristen S.

Dr. Geoffrey Sher answered

Here is some information on : Previous vasectomy and IVF; Gender selection and Endometriosis and infertility. We should talk,. call Patti Converse (702-533-2691) and set up an online consultation with me. 1. GENDER SELECTION Couples have for centuries sought to influence the gender of their offspring. More than…
Embryos & Genetic Testing Aug 19, 2022

FET protocol

Just wondering if you see any pitfalls in doing a simple oestrogen/progesterone protocol. I asked about adding in prednisolone, as a precaution. But the clinic is not keen using steroid medications- such as prednisolone, in patients who do not necessarily… — Cassidy C.

Dr. Geoffrey Sher answered

Perhaps we should talk! 702-533-2691
Infertility Basics Aug 15, 2022

fluconazole safety

Hello Dr Sher! I've taken this drug to treat thrush, 150mg. I'm getting my period is 8 days and am planning to start FET protocol - but I've since read that it's not a safe drug to take when trying… — Cassidy C.

Dr. Geoffrey Sher answered

THERE WOULD IN MY OPINION BE NO PROBLEM!

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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