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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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214 answers

Uterine & Endometrial Health

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Embryos & Genetic Testing Aug 15, 2025

Repeat failed implantations

I have experienced one miscarriage and four failed implantations with untested embryos. In my recent IVF cycle, I obtained one PGT-A–tested 5AB euploid embryo. I also underwent a hysteroscopy with a uterine biopsy to investigate the failed implantations, and all… — Fab W.

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…
Embryos & Genetic Testing Aug 15, 2025

Second transfer

Hello!! I wanted to inquire about a possible timeline for a second embryo transfer. My daughter was born via c section 11/19/24. We have been trying to conceive since January of this year. When would be an appropriate time to… — Samantha L.

Dr. Drew Tortoriello answered

Any cycle would be fine! FROZEN EMBRYO TRANSFER : ONE PREFERRED APPROACH AT SFS. Two decades ago, when women went through IVF (in vitro fertilization), they usually had their embryos put in the uterus right after the eggs were collected in the same cycle (known as "Fresh" Embryo…
Hormones & Ovulation Jul 12, 2025

FET

Hello! I had a recent FET just a few days ago. On the day oftransfer, my progesterone was 37 and estradiol was 1700. This estradiol level is considerably higher than it was for my last successful FET. So I am… — Eugenia T.

Dr. Geoffrey Sher answered

The E2 level, ideally, should be 500-100pg/ml on the day progesterone treatment starts. Endometrial thickness is measured also on the day progesterone starts. It needs to be >8mm with a trilaminar ultrsound appearance, The thickness on the day of transfer is not significant. See the article below, on…
Embryos & Genetic Testing Jun 23, 2025

Testing

I have a history of-two failed FET Embryos were not tested Embryos were not tested at 37 years old. I did two more rounds of IVF and I have now 7 euploids with CCRM I also did a lap to… — Michelle F.

Dr. Geoffrey Sher answered

They are wrong with regard to the Receptiva test. It is very helpful in diagnosing silent endometriosis which if present can be associated with an immunologic implantation dysfunction (IID) I am not a believer in Emma/Alice testing and ; The method of FET will not affect the risk…
Immunology & Implantation May 29, 2025

Dexamethasone for FET

What would be the reason for using Dexamethasone (short 5 day course) leading up to FET vs using Prednisone? I feel like prednisone is more commonly prescribed for this purpose, but my doctor said there is no difference. I recently… — Renee G.

Dr. Geoffrey Sher answered

The two are by and large interchangeable. The steroid administration should start at the beginning of the cycle and continue to the 10th week. It should then be tailed off over 2 weeks. Geoff Sher _ In the world of assisted reproduction, when IVF fails repeatedly or without…
Uterine & Endometrial Health Apr 1, 2025

Sclerotherapy

I am looking for a clinic that can perform sclerotherapy for endometrioma treatment. Is this something that you offer? — Jessica L.

Dr. Geoffrey Sher answered

I don' think it is available presently. WE used to use Tetracycline hydrochloride 5%...cant get it any longer. Sorry! Geoff Sher
Uterine & Endometrial Health Mar 21, 2025

U/S endometrium is 1.4 at day 4 of period

Dear Dr Sher, I live in Israel, am 40 years A old and having frozen embryo created with donor eggs as I have no ovarian reserve. No previous pregnancies or miscarriages. My endomerial lining measured on day 4 of my… — Ayelah B.

Dr. Geoffrey Sher answered

I need to have more information. An important consideration is "how long have you been estrogen-depleted". IOW how long have you been not having periods (amenorrhea). The reason I say this is that women who have been anesgtrogenic for >6moths, often have depletion of endometrial estrogen receptivity and…
Uterine & Endometrial Health Mar 10, 2025

Adenomyosis

The best Protocol For Ivf With Adenomyosis? — Julia P.

Dr. Geoffrey Sher answered

There is no specific protocol for adenomyosis. It would depend on your clinical situation. I suggest yo email my assistant, Patti Converse (concierge@sherivf.com) and ask her to set you up with an online consultation with me to discuss our case in detail; Geoff Sher Adenomyosis: A Guide to…
Immunology & Implantation Mar 6, 2025

RIF

Dear dr Sher, I got my first child 2020 via embryodonation (34 yo) on the first attempt with HRT. I had low AMH and endo. Since 2024 we had 3 more embryotransfers (1 was PGT-a) tested with the same male… — Anna L.

Dr. Geoffrey Sher answered

We should really discuss this at length. It sounds to me as if you have an implantation dysfunction. Please read the article below and if interested in having an online consultation with me, contact my assistant, Patti Converse (concierge@sherivf.com) and set up an online consultation with me to…
Embryos & Genetic Testing Feb 23, 2025

RPL

I am a 42 year old women undergoing IVF treatment. I had a very successful egg retrieval (13 fertilized eggs, 9 blastocyst, after PGT-A testing: 3 euploid embryos and 1 low mosaic). We transfered our 3rd euploid embryo 2 weeks… — Lindsey M.

Dr. Geoffrey Sher answered

At 42y, IUI is definitely not the answer..please read below and thereupon (if so inclined) contact my assistant, Patti Converse (concierge@sherivf.com) and have her set up an online consultation with me. IMPLANTATION DYSFUNCTION Implantation dysfunction is often overlooked as a significant reason for IVF failure. This is especially…
Uterine & Endometrial Health Feb 2, 2025

Toxic Uterine Environment

I have had two failed FET 2nd FET protocol (estradiol, PIO, Aspirin , dexamethasone). I've had Hyseroscopy where polyps and scar tissue were removed. Now I'm being told that due to my endometriosis, now Adenomyosis is suspected but I will… — Tamieka G.

Dr. Geoffrey Sher answered

Respectfully. Nothing you are telling me add up. Read the article below and then call my assistant Patti and set up an online consultation with ne to discuss your case in detail and to set up a strategic approach. IMPLANTATION DYSFUNCTION Implantation dysfunction is often overlooked as a…
Egg Health & Ovarian Reserve Jan 29, 2025

Cyst at baseline for FET

Hi Dr. Sher, a resolving functional hemorrhagic cyst was found during ultrasound for my modified natural (Letrazole assisted) FET. I had delayed ovulation and they performed an ultrasound and found the cyst. On Friday, ultrasound showed cyst was 36 mm,… — Peg T.

Dr. Geoffrey Sher answered

Very respectfully, I would not enter an FET until the cyst is gone and you have had at least one interim natural cycle. I would also strongly recommend a medicated FET. FROZEN EMBRYO TRANSFER : ONE PREFERRED APPROACH AT SFS. Two decades ago, when women went through IVF…
Embryos & Genetic Testing Jan 11, 2025

Eight losses

Hello, my name is Vikki Carpenter. I am 40 years old and started IVF last year. I have one IVF failure (chemical), and 7 other chemical pregnancies before IVF. The pattern is virtually the same: I get pregnant and within… — Vikki C.

Dr. Geoffrey Sher answered

UNDERSTANDING RECURRENT PREGNANCY LOSS ( RPL): CAUSES AND SOLUTIONS. When it comes to reproduction, humans face challenges compared to other mammals. A significant number of fertilized eggs in humans do not result in live births, with up to 75% failing to develop, and around 30% of pregnancies ending…
Uterine & Endometrial Health Jan 11, 2025

Progesterone Levels

I went through a modified natural cycle that more or less turned into a medicated cycle since estrogen was added for the lining and also used vaginal progesterone and 1ml PIO On transfer day progesterone was >40.4 Estrogen 72 (… — Adriana L.

Dr. Geoffrey Sher answered

No! This has nothing to do with your progesterone level. Geoff Sher Herewith are online links to 2 E-books recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your reading pleasure: From In Vitro Fertilization to Family: A Journey with Sher Fertility Solutions (SFS) ; https://sherfertilitysolutions.com/sher-fertility-solutions-ebook.pdf…
Uterine & Endometrial Health Jan 11, 2025

Asynchronous endometrium with glandular-mucosal-hypotrophy

Dear Dr. Sher, I have a complicated medical history but I will try to keep it as short as possible. I am 35 years old and exactly a year ago I have undergone 3 ovarian stimulations that resulted in 6… — Constantina A.

Dr. Geoffrey Sher answered

Dear Constantina, It certainly sounds as if you have a probably implantation dysfunction + diminished ovarian reserve. It is not possible to cover this large and complex issue here. We need to talk. I suggest that you contact my assistant, "Patti" sat concierge@sherivf.com and set up an online…

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.

214 answers

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