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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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Search 1,006 questions patients have already asked, or narrow them by topic.

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  1. Embryos & Genetic Testing

    High TNF alpha

    What is the recommended transfer protocol for someone with high TNF Alpha. I was given prednisone but it did not work. Prior to transfer it was 45.0 and I was prescribed 25mg prednisone for a month but it increased to… — Private

    Dr. Geoffrey Sher answered

    Elevated TNF alpha indicates activated natural killer cell activity. A RATIONAL BASIS FOR MANAGEMENT OF IMMUNOLOGIC CAUSES OF EMBRYO IMPLANTATION DYSFUNCTION In the world of assisted reproduction, when IVF fails repeatedly or without explanation, it's often assumed that poor embryo quality is the main culprit. However, this view…

  2. Ovarian Stimulation & OHSS

    Suggested ivf protocol

    Dear doctor Sher I am a 44.5 femal, suffering from secondary repeated miscarriages due to alloiimunity (dq-alpha gene match + extremly elevated nk cells). Right now I am going through the 7th miscarriage. I had the 6th miscarriage on October… — Irit B.

    Dr. Geoffrey Sher answered

    Clearly you are a candidate for gestational surrogacy, provided that you have competent, euploid embryos available to transfer. Using a gestational surrogate for transfer of such a blastocyst, is pretty straight forward. Most IVF programs that do FET can advise appropriately. However, be sure that the blastocyst transferred…

  3. Hormones & Ovulation

    Failed ivf cycle

    Hello doctor; i am 32 yo female, amh 1.59 ng/ml. Partner 32 years old with varicocele, 0 morphology and very low count. (Impossible to check for dna fragmentation) I am Insulin resistant, on metformin 750 for 5 months now with… — Nino K.

    Dr. Geoffrey Sher answered

    There clearly is both male factor infertility and diminished ovarian reserve (DOR). Both issues need to be thoroughly evaluated and addressed. The cause of the male factor will need further testing and the DOR requires a very individualized approach to ovarian stimulation...(see below). I strongly suggest that you…

  4. Immunology & Implantation

    Natural Conception with NKa and DQa Partial Match

    Hello Dr. Sher, I'm hoping you can provide me some insight and comfort. Quick history - I have had 6 early losses prior to 7 weeks over 4 years. After a lot of testing and trials with my RE, we… — Jessica B.

    Dr. Geoffrey Sher answered

    Anything is possible, and I hope it works out. However, it would be of no value in my opinion, to start with immunotherapy now. Intralipid therapy should be initiated 10-14 days before conception to be of significant help! Good luck and G-d bless! Geoff Sher

  5. Egg Health & Ovarian Reserve

    Canceling when antral follicle count is too low

    Dear Dr. Sher, My periods are getting shorter (around 20 days). Since December, my doctor has been doing this: (already three consecutive times now) starts the Estradiol pretreatment, FSH, Ganirelix and Omnitrope and then stops after a couple of days,… — Anne C.

    Dr. Geoffrey Sher answered

    It sounds as if you have age related diminished ovarian reserve. Respectfully, your antral folicle count can be expected to be low and if you wish to try for a baby through IVF using your own eggs, the number of AFs will not improve and you will have…

  6. Early Pregnancy & hCG

    Hcg blood test

    My period is usually iregular. I started my last one december 15 . And now my period is late by 11 days. I took two at home test which were both negative and today I did a blood test that… — Leopolina D.

    Dr. Geoffrey Sher answered

    So Sorry! This does not look good! Going through IVF is a major investment, emotionally, physically, and financially, for every patient or couple. One of the most crucial moments is receiving the result of the blood test for human chorionic gonadotropin (hCG) pregnancy. It's a big deal! The…

  7. Embryos & Genetic Testing

    Multiple failures after live birth from IVF

    My first FET in 2020 was successful and resulted in the birth of my son. Since 2022, I have had four more FETs: the first one failed to implant and the next three implanted but miscarried between 5-6 weeks. The… — Kelsey H.

    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…

  8. Embryos & Genetic Testing

    DQ-Alpha match & positive receptiva post lap

    I hope you can advise me on the situation below. I had Pregmune testing completed in January 2023. It showed my husband and I have DQ alpha match: DQ Alpha - full match, DQ Beta - partial match, HLA-DRB1 -… — Vilma C.

    Dr. Geoffrey Sher answered

    From your description, it certainly sounds as if your failures are due to an implantation dysfunction...likely, an immunologic implantation dysfrunction (IID). If so, then you MUST have a concommitant natural killer cell activation (NKa). Even though endometriosis can result in an autoimmune IID, and a matchibng D alpha…

  9. Embryos & Genetic Testing

    Embryos tested

    Hi! I’am 42 and I did the first stimulation for IVF. I obtained 2 embryos that I tested. I don't know what this result means, are they viable? Which one is good? First has these anomalies +8p, +12, +22, the… — Ioana I.

    Dr. Geoffrey Sher answered

    In my opinion, they are not viable! Geoff Sher

  10. IVF Failure & Pregnancy Loss

    3 miscarriages back to back

    I have a unicornuate uterus. I have had three miscarriages back to back. All of which end at 5 weeks. The second resulted in a D&C due to the embryo not growing. I'm currently going through the same issue. My… — Krista W.

    Dr. Geoffrey Sher answered

    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 within the first 10 weeks (first trimester). Recurrent pregnancy…

  11. Embryos & Genetic Testing

    Heavy lifting after embryo transfer

    Hi Dr Sher. I had an embryo transfer last Saturday. I rested for 2 days and then went back to the gym on Monday and Tuesday and exercised as normal. This includes weightlifting. I have however been reading that lifting… — Natalie S.

    Dr. Geoffrey Sher answered

    Exercising is not harmful BUT it is not wise to push yourself with over-demanding effort until a diagnosis of pregnancy can be made.Hopefully no harm was done! Good luck! Geoff Sher

  12. Egg Health & Ovarian Reserve

    Atretic eggs

    Good afternoon, I’m posting in English. Thank you very much for your answer. Last April my AMH was 0.04, even though I did my first IVF and got two follicles with two embryos. One of them ended up in a… — Carmen N.

    Dr. Geoffrey Sher answered

    “EMPTY FOLLICLE SYNDROME” “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…

  13. IVF Failure & Pregnancy Loss

    Atresia ovocitos

    Tengo muy muy baja ovárica. He realizado 4 tratamientos FIV, el primero con letrozol y pergoveris (225 cada dos días) en el que obtuvimos 2 ovocitos maduros de dos folículos, llegaron a embrión los dos, implantamos uno pero acabó en… — Carmen N.

    Dr. Geoffrey Sher answered

    I would be happy to respond but I don't speak Spanish. So, could you re-post this in English please! Geoff Sher

  14. Third-Party Reproduction

    Donación de ovulos

    Cómo hago para donar ovulos

    Dr. Geoffrey Sher answered

    Please post in English! Geoff Sher

  15. Uterine & Endometrial Health

    Endometrioma Sclerotherapy

    Hi, I have a 5cm endometrioma on my right ovary. Do you perform sclerotherapy of these? Thanks — Anusha F.

    Dr. Geoffrey Sher answered

    I used to, but no longer have access to the sclerosant! Sorry! Geoff Sher 702-533-2691

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