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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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Hormones & Ovulation Oct 14, 2025

estradiol

Can you kindly tell me what is the appropriate level of estradiol in a modified natural cycle? I am in the middle of a MN cycle. They had me take letrozole for 5 days and roughly 10 days later I… — Carmela R.

Dr. Geoffrey Sher answered

Each follicle should contribute 150-200pg/ml to the E2 level. Your dropping E2 is concerning and suggests premature luteinization. I think when this cycle is over we should talk. The protocol used for ovarian stimulation and its implementation are both pivotal. Call my assistant, Patti at 702-533-2691 and set…
Ovarian Stimulation & OHSS Oct 14, 2025

IUD/Egg Retrieval

Hello! I’m interested in getting an IUD and freezing my eggs. I’d like to do the IUD insertion while under anesthetia for egg retrieval. Is that possible? Thanks! Isabella — Isabella G.

Dr. Geoffrey Sher answered

WE can help! Please call us and ask for Dr Ravikumar.
Immunology & Implantation Aug 15, 2025

implantation dysfunction

Listened to you on a podcast recently and appreciate you so much for sharing your knowledge on this topic. Wondering if you have any input for next steps after 2 implantation failures (of 5AA embryos without PGT-A testing, female age… — Ashley S.

Dr. Geoffrey Sher answered

Implantation dysfunction is often overlooked as a significant reason for IVF failure. This is especially true when IVF failure is unexplained, or when there are recurring pregnancy losses or underlying issues with the uterus, such as endo-uterine surface lesions, thin uterine lining (endometrium), or immunological factors. IVF success…
Clinic & Practice Jun 5, 2025

IVF second opinion

I need a second opinion. I am 35 years old on my first round of IVF after 2 failed IUIs. I have been trying for a year to get pregnant. I have AMH level of .112 and 7 follicles. This… — Gweneth V.

Dr. Geoffrey Sher answered

Thank you for reaching out. I will do my best to help: Given your diminished ovarian reserve; IUI is definitely not for you. The success rate is far too low and you do not have the time to spare. You do need IVF but unless an individualized protocol…
Egg Health & Ovarian Reserve May 29, 2025

Stimulation protocols for DOR in 45 yr old

I'm trying to write up the protocol outlined in one of your recent videos with the egg whisper to take to my Dr. whom is going to do my next cycle. We've started the HGH and we did the PRP… — Ariane B.

Dr. Geoffrey Sher answered

I would never presume tom tell your doctor what to do with regard to your stimulation. I can tell you that regardless of protocol, the chance of propagating euploid ("competent") eggs at 45y is very slim (!:2o eggs or so will end up being viable). Obviously if in…
Egg Health & Ovarian Reserve Apr 27, 2025

Lack of maturation of eggs in stimulation cycle

Dear Dr. Sher, I just watched your video on egg maturation and learned more than I have in over a year of reading and asking questions on this. My question also relates to egg maturation but specifically on why eggs… — Laura C.

Dr. Geoffrey Sher answered

When confronted with such an exaggerated response, doctors often trigger egg maturation by cutting the cycle short through triggering early. While this protects against OHSS, the eggs are oft yet not ready for maturation. This leads mto "poor egg yield and quality . Second, in such cases doctors…
Egg Health & Ovarian Reserve Apr 27, 2025

Empty folicals

Hi, I'm on my first round of ivf due to same sex relationship. Im from the UK. I have just had my first egg retrieval and I'm bitterly disappointed with the amount of egg they collected. I'm 37, amh 14.1,… — Katie M.

Dr. Geoffrey Sher answered

Empty Follicle Syndrome" is a misleading term because follicles always contain eggs. However, some eggs may have difficulties detaching and being retrieved. This is more likely to happen when multiple attempts are needed to retrieve an egg from a follicle, indicating the egg may have chromosomal abnormalities. The…
Ovarian Stimulation & OHSS Apr 10, 2025

FxPOI

Any advise would be appreciated for my 2 daughters recently diagnosed with fxpoi. 30 year old tried 2 cycles, the first down regulated before starting stims, range of doses were tried and a follicle slowly grew but was empty at… — Simone H.

Dr. Geoffrey Sher answered

I would need to consult directly with your daughters re ovarian stimulation. If you are interested, please reach outv to my assistant, Patti Converse (702-533-2691 ). Below is an article I wrote on Fragile-X FYI. Fragile X syndrome: Which IVF Candidates Should be Tested and How Should Results…
Hormones & Ovulation Feb 28, 2025

suppressedLH

To start the IVF cycle,myclinic putme birth control.lowered LH almost undetectable. is this oversuppression?do you expect LH go up with start of menopur? we are doing a5 day washout period after stopping the birth control. — Carmela R.

Dr. Geoffrey Sher answered

When I prescribe the BCP it is for at least 10 days. Thereupon I overlap with Lupron to promote antral follicle growth through exposure to early Lupron-induced FSH. If you do not overlap with such a GnRH-agonist, the woman's ovaries will often be suppressed. Feel free to reach…
Embryos & Genetic Testing Feb 11, 2025

Article; IVF: FACTORS AFFECTING EGG/EMBRYO “COMPETENCY” DURING CONTROLLED OVARIAN STIMULATION (COS)

Quick question- sperm and egg cells, don' t they contain 23 chromosomes only as they are germ cells (Haploid cells) , and not 2x 23 as mentioned in this article? — Theivanya U.

Dr. Geoffrey Sher answered

Both sperm and eggs start off with 46 chromosomes. Then during meiosis (reproductive maturational division, the divide their chromosomes in half to 23 (the haploid number). The fusion of the sperm and the egg thereupon reconstitutes the chromosomes in the embryo to 46(the diploid number). Geoff Sher Herewith…
Egg Health & Ovarian Reserve Jan 23, 2025

Fertility at 41

Hello Dr Sher, I am a physician G3P2 who has gone through 6 cycles of IVF for my 3rd child. (My elder two are 11 and 9 who were naturally conceived and delivered NSVD). I have done luteal phase stimulation… — Heena P.

Dr. Geoffrey Sher answered

Thank you for reaching out to me. We should talk. I recommend that you contact my assistant, Patti Converse at concierge@sherivf.com and set up an online consultation with me to discuss. In the meanwhile, please see below. Geoff Sher ADDRESSING ADVANCING AGE AND DIMINISHING OVARIAN RESERVE (DOR) IN…
Immunology & Implantation Jan 16, 2025

Repeated Implantation Failures and MC

Good morning Dr. Sher, My name is Xuandao ("Dao") Nguyen, I'm 42 yo and currently in round 4 of IVF at my local clinic here in Atlanta (ACRM). I want to give you a brief summary of my case and… — Xuandao N.

Dr. Geoffrey Sher answered

In my opinion, you have a likely implantation dysfunction . It could be anatomical or immunologic. I suggest you contact my assistant, Patti at concierge@sherIVF.com to set up an online consultation with me. Implantation dysfunction is often overlooked as a significant reason for IVF failure. This is especially…
Ovarian Stimulation & OHSS Jan 11, 2025

Egg Retrieval Process

How many eggs can be retrieved during the egg retrieval/ egg freezing process? How many tend to remain viable (% wise)? How long can the eggs be frozen for and does the egg viability decline after a certain time frame? — Xxxxxx

Dr. Geoffrey Sher answered

This all varies depending on age, ovarian reserve and the cause of an underlying infertility issue. Below find information on egg Banking:. Feel free to call my assistant, Patti and set up an online consultation with me. EGG BANKING: “The bottom line is that because of the traumatic…
Egg Health & Ovarian Reserve Jan 11, 2025

Dor Diagnosis

I’ve been diagnosed with Dor. First antagonist cycle only ended up with 4 follicles on trigger day after 10days of stimming. However, e2 never got above 380 and seemed to have dipped on trigger day to 373. Clinic still proceeded… — Avie H.

Dr. Geoffrey Sher answered

There is a great deal to discuss! I suggest that you contact my assistant, Patti (concierge@sherIVF.com ) and set up a time to discuss online. ADDRESSING ADVANCING AGE AND DIMINISHING OVARIAN RESERVE (DOR) IN IVF Understanding the impact of age and ovarian reserve on the success of in…
Ovarian Stimulation & OHSS Jan 11, 2025

Unsure about priming protocol estrace//ganarelix

Hello Dr Sher, I am a scientist and as I often do i studied all mechanisms of action of IVF drugs. I have done natural start cycles but recently had leading follicles. AMH of 1.33 40 years old 6-9 afc… — Cecilia P.

Dr. Geoffrey Sher answered

There is so much to talk about. i think I can provide information that will be of help. I suggest you contact my assistant, Patti (702-533-2691) and set up an online consultation with me to discuss.. In the meanwhile,...see below. EGG/ EMBRYO QUALITY IN IVF & HOW SELECTION…

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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