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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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230 answers

Ovarian Stimulation & OHSS

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Ovarian Stimulation & OHSS Nov 21, 2024

Agonist/Antagonist/Leuprolide

Hi Dr. Sher, I loved your podcast with Dr. Aimee! I’m doing a3rd retrieval and had some thoughts/Q’s. I’m 36 years old, AMH 1.6. 1st retrieval 5 eggs - 3 mature - 3 fertilized - 2 euploid embryos. 2nd retrieval… — Grace D.

Dr. Geoffrey Sher answered

WE really should talk. I think I can both enlighten and help you. I am concerned by the low yield of eggs and think that the protocol used for ovarian stimulation should be evaluated and probably modified. I suggest that you call my assistant, Patti Converse (702-533-2691) and…
Ovarian Stimulation & OHSS Nov 14, 2024

Retrieval

I’m almost ready to trigger for egg retrieval, but I only have four mature follicles. There are ten follicles total, but they didn’t mature at the same rate and my doctor won’t wait for those to mature because they only… — Ellen C.

Dr. Geoffrey Sher answered

Respectfully, I do not think this strategy is appropriate. Timing is everything in IVF. WE should talk. I suggest you call my assistant, Patti (702-533-2691). and set up an online consultation with me. Geoff Sher PLEASE SHARE THIS WITH OTHERS AND HELP SPREAD THE WORD!! Herewith are online…
Egg Health & Ovarian Reserve Oct 30, 2024

Changes to a 4th cycle

I’m at a bit of a loss. Having ICSI for secondary infertility (1st child conceived naturally age 29) and just midway through my 3rd cycle. I have paid up for a 4th cycle already so I’m keen to get some… — Amy E.

Dr. Geoffrey Sher answered

WE would need to discuss this complex matter. I suggest you call my assistant, Patti Converse (702-533-2691 and set up an online consultation with me. Geoff Sher PLEASE SHARE THIS WITH OTHERS AND HELP SPREAD THE WORD!! Herewith are online links to 2 E-books recently co-authored with my…
Egg Health & Ovarian Reserve Oct 28, 2024

Advice for last IVF round

Dear Dr. Sher: Thank you for hosting this forum. I am just shy of 41 with social infertility and have had two failed IVF cycles. The first used an antagonist protocol at 300 IU gonadotropin and resulted in one whole… — Claire C.

Dr. Geoffrey Sher answered

Please read what follows and thereupon, might I suggest that we talk . Please call my assistant. Patti at 702-533-2691 and set up an online consultation with me to discuss. The journey of in vitro fertilization can be a rollercoaster of emotions for many patients. Often times they…
Embryos & Genetic Testing Oct 16, 2024

FET canceled due to a yeast infection (vaginal candidiasis)

My fresh embryo transfer was canceled two days before the procedure due to a yeast infection (vaginal candidiasis), and I’m wondering why this infection may have occurred. I haven’t had sexual intercourse or done anything specific that I believe could… — Hannah A.

Dr. Geoffrey Sher answered

In my opinion there is no reason to cancel FET because of a yeast infection. Geoff Sher
Egg Health & Ovarian Reserve Oct 7, 2024

“Empty follicles”

Dr. Sher, I have a problem with my right ovary. Every time if we have more than one follicle > 17 mm in diameter on this side, we cannot retrieve the eggs (experienced that 3 times). We tried multiple protocols,… — Patricia K.

Dr. Geoffrey Sher answered

I suggest you call my assistant "Patti" (702-533-2691) and set up an online consultation with me to discuss...see below. 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…
Egg Health & Ovarian Reserve Sep 30, 2024

Bad quality eggs

Dear Dr. Sher. I am out of options i feel. Unknown fertility problem, endometriosis. I am now 30 years old. For the last 5 years: 5 IVF/ICSI cycles, 65 mature eggs, 30 fertilized, 0 good blastocyst, only poor quality, nothing… — Maggy M.

Dr. Geoffrey Sher answered

Embarking on the journey of IVF often raises questions about the likelihood of success and the quality of embryos. While it’s challenging to predict outcomes due to various factors, there’s hope and information to guide you. Firstly, the key to fertilization potential lies in the chromosomal integrity of…
Egg Health & Ovarian Reserve Sep 19, 2024

poor egg quality

Im 37F no other medical history. AMH 2.01, Day 3 FSH 5.7, estradiol 56. Have done two cycles of IVF: First cycles I was on menopur (150) and gonal (initially 150 and bumped to 300) for about 11 days with… — Serena B.

Dr. Geoffrey Sher answered

In my opinion, you are young enough and have a normal ovarian reserve, such that egg quality should not likely be an inherent problem. In such cases, it is very often the protocol used for ovarian stimulation that plays a role here. It needs to be individualized to…
Embryos & Genetic Testing Sep 3, 2024

Failed FET

Hi Dr. Sher, You did my egg retrieval 3 years ago, and we welcomed our beautiful daughter 2 years ago. We just did another transfer of 1 pgt embryo for a baby boy, and it failed. We only have 1… — Megan L.

Dr. Geoffrey Sher answered

We should talk. Please call my assistant, Patti (702-533-2691) and set up an online consultation to discuss. Geoff Sher
Egg Health & Ovarian Reserve Aug 26, 2024

Same Agonist/Antagonist Conversion Protocols with Very Different AFC 6 Months Apart

Dr. Sher, I convinced my IVF doctor to let me use your agonist/antagonist conversion protocol with Zomacton (using Ganirelix to replace Lupron and keep using it until trigger date). My March cycle resulted in 4 eggs retrieved, 3 fertilized, unfortunately… — Meredith S.

Dr. Geoffrey Sher answered

There can be a very rapid decline in AFC at your age . This is because of inevitable decline in ovarian reserve and in egg quality. If you wish, you coulkd call my assistant Patti Converse at 702-533-2691 and set up an online consultation with me to discuss…
Egg Health & Ovarian Reserve Aug 26, 2024

Protocol for second round after low maturity in the first

Hi Dr Sher, We recently embarked on IVF after 1x TFMR at 24 weeks for genetic disorder (22q syndrome) of which neither me or my partner are carriers followed by 3x chemical miscarriage around 4.5/5 weeks. Our first cycle was… — Victoria L.

Dr. Geoffrey Sher answered

We should talk. There is no doubt in my my mind that the protocol used for ovarian stimulation has to be individualized to optimize egg/embryo "competency. I invite you to call 702-533-2691 and ask my assistant, Patti Converse, to set up an online consultation with me to discuss.…
Egg Health & Ovarian Reserve Aug 16, 2024

CoQ10

I am 43 years old with AMH of 3. My egg retrieval was yesterday. My HCG trigger did not absorb after 7 days of Stims and no priming starting on day 5 of my period. I was given 150 meno… — Kristin H.

Dr. Geoffrey Sher answered

The COQ10 likely had nothing to do with your follicle development. However, the protocol used for ovarian stimulation and/or its implementation, probably underlies your issue.We should talk: Please call my assistant, Patti Converse (702-533-2691 and set up an online consultation with me. EGG/ EMBRYO QUALITY IN IVF &…
Egg Health & Ovarian Reserve Aug 12, 2024

Protocol

Hi, I am 44 with an Amh between 2.3 and 3 ng/ml, we had failed Icsis but always blastocysts. Would you also recommend the protocol you normally describe here or at the egg whisperer podcast in my case? Last year… — M M.

Dr. Geoffrey Sher answered

Your normal AMH at 44y comes as a surprise but that is decidedly in your favor. However, independently, age impacts egg "competency" and it is the egg (rather than the sperm that is most important in propagating normal "competent" embryos. Age should never be a barrier to hope…
Ovarian Stimulation & OHSS Jul 26, 2024

Trigger shot

Why is a 10,000 HCG trigger better than a 5,000 my clinic recent triggered me with only 5,000 and they say I have DOR. We also did a mini stim with letrozole and menopure. Which I am reading you don’t… — Vern T.

Dr. Geoffrey Sher answered

To optimize response, all available hCG receptors in the cells of the follicle should be occupied to insure an optimal response. In many cases, 5,000U hCG wont do the trick. Since there is no down-side or risk in giving 10,000U there is n in my opinion safer to…
Ovarian Stimulation & OHSS Jul 24, 2024

Agonist/antagonist conversion protocol

Hello, I am a patient with DOR at ACFS in Scottsdale, AZ. Would you be willing to send me the written agonist/antagonist conversion protocol in detail so my doctor can follow it? I am 34 with an AMH of 0.8… — Kathleen T.

Dr. Geoffrey Sher answered

I cannot post a detailed protocol here. Your Re is free to call us to discuss this at will (702-533-2691). ADDRESSING DIMINISHING OVARIAN RESERVE (DOR) IN IVF Understanding the impact of ovarian reserve on the success of in vitro fertilization (IVF) is crucial when it comes to reproductive…

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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