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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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Embryos & Genetic Testing Nov 20, 2023

Embryo grading

other Hi Dr. Sher, I have two embryos frozen on day 3 (not day 5 for some reason). . One embryo is 8 cell grade 1 and the other is 10 cell grade 1. Are these good quality embryos? What… — Sherry P.

Dr. Geoffrey Sher answered

This is very much dependent on your age and the clinical underlying circumstances. While ordinarily anything better than a 5c day-3 embryo are positive feature3s, there are many other considerations. If you wanted better comfort, I would suggest these 2 embryos be thawed, carried to blastocyst and biopsied…
Egg Health & Ovarian Reserve Nov 20, 2023

Protocolo para preservación

He realizado mi primer ciclo para vitrificar ovulos, sin embargo de 5 fólicos que han engordado sólo se ha podido obtener un óvulo maduro. Tengo 37 años y AMH de 0,33. En la ecografía se observaban 10 folículos. El tratamiento… — Maria M.

Dr. Geoffrey Sher answered

Please re-post your question in English! 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 partner at SFS-NY (Drew Tortoriello MD)....... for your reading pleasure: From In Vitro Fertilization to Family: A Journey with…
Egg Health & Ovarian Reserve Nov 20, 2023

Protocolo DOR

Primero agradecer su trabajo. Le escribo para saber según su opinión ¿Cuál es el mejor protocolo de medicamentos para una estimulación ovárica para mi con 37 años y 0,3 de antimulleriana? Con otras respuestas no consigo entender día a día… — Laura S.

Dr. Geoffrey Sher answered

Please post in English! Understanding the impact of age and ovarian reserve on the success of in vitro fertilization (IVF) is crucial when it comes to reproductive health. This article aims to simplify and clarify these concepts, emphasizing their significance in the selection of ovarian stimulation protocols for…
Ovarian Stimulation & OHSS Nov 17, 2023

Agonist/Antagonist Conversion Protocol (A/ACP):

Hello Dr Sher I’m 42 years old with an AMH of 4.4 pmol/L. How many units of Lupron/Puregon/Menopur /HGH would you recommend for me in this type of protocol? — Elizabeth M.

Dr. Geoffrey Sher answered

WE should talk! There are too many other factors to be considered! ADDRESSING ADVANCING AGE AND DIMINISHING OVARIAN RESERVE (DOR) IN IVF Geoffrey Sher MD Understanding the impact of age and ovarian reserve on the success of in vitro fertilization (IVF) is crucial when it comes to reproductive…
Uterine & Endometrial Health Nov 17, 2023

endometrioma

Hello, I am trying to conceive and have been told the issue is I have a 5cm endometrioma. I am hoping to have this aspirated before starting any treatments. I do not want surgery to remove it as they want… — Danille M.

Dr. Geoffrey Sher answered

Advanced endometriosis is often associated with ovarian endometriotic cysts, known as endometriomas. In my opinion, such cysts, if numerous or sizable (>1cm) can and often do activate the surrounding ovarian connective tissue to locally produce excessive amounts of male hormones such as testosterone. This effect can often not…
Immunology & Implantation Nov 17, 2023

APS diagnosis, 1 successful FET, 3 failed FETs

Hi Dr. Sher, I'm here because, like many women who come to you, I have had multiple failed FETs. I did IVF back in 2017 due to male Factor infertility, azoospermia. I was 30 years old and my embryos were… — Kimberly N.

Dr. Geoffrey Sher answered

This very much sounds like an implantation dysfunction 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 & Endometrial Health Nov 17, 2023

Endometrial Hyperplasia

Hi Dr Sher I’m 43 year old woman with PCOS and Type 2 Diabetes and have endometrial hyperplasia atypia. My doctor initially recommend a hysterectomy but I would like to have a family. I realise I will likely require IVF… — Lou M.

Dr. Geoffrey Sher answered

The commonest form of EH in women with PCOS is cystic glandular hyperplasia and this is not commonly associated with atypia and is not premalignant. It can be suppressed with progestational therapy and alone does not preclude pregnancy. Another form of hyperplasia that sometimes occurs with PCOSi s…
Egg Health & Ovarian Reserve Nov 13, 2023

Empty Follicle Syndrome

Hello- I was diagnosed with DOR at age 29 with AMH 0.3 (AMH stable x 3yr, FSH ~12), otherwise no reproductive abnormalities for myself or my husband. Over the past 2yr, I have completed 12 rounds of IVF - the… — Jen C.

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.…
IVF Failure & Pregnancy Loss Nov 13, 2023

recurrent pregnancy loss

Hi- I have recurrent unexplained pregnancy loss: Recently got a positive test and have the following HCG results… The third draws doubling time threw me off a bit but today had a good rise… any insight into what to expect… — Olivia D.

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…
Egg Health & Ovarian Reserve Nov 11, 2023

Egg quality

Hi, dr. Sher! Is it true, that a quality of eggs can be worse in a second cycle, if you do one stimulation after another? My doctor said I shold wait a month for another stimulation because of that. Thank… — Polona B.

Dr. Geoffrey Sher answered

No! I do not believe so! In my opinion, the most important determinants are age, ovarian reserve and the protocol used for ovarian stimulation. The journey of in vitro fertilization can be a rollercoaster of emotions for many patients. Often times they have to face the harsh reality…
Cost & Insurance Nov 10, 2023

Ya

Es necesario tener seguro — Saylin N.

Dr. Geoffrey Sher answered

Please post in English! Geoff Sher
Uterine & Endometrial Health Nov 10, 2023

First Dose of Progesterone in Oil

Hello. I am 45 and I am days away from medicated FET. I did a mock FET first, and then I was cancelled during my last FET round (right at the end) because I ovulated. So I waited, scheduled a… — Michelle R.

Dr. Geoffrey Sher answered

In my opinion, your errors were minor and in any case, you apparently corrected for them in a timely manner. I do not think you have compromised your chances at all! Good luck! Geoff Sher
Egg Health & Ovarian Reserve Nov 8, 2023

CAPA-IVM

s ago. Hi! I read about an IVF alternative called CAPA-IVM from this article: https://www.sciencealert.com/ivf-alternative-first-baby-born-in-australia-through-cheaper-safer-fertility-treatment I want to know if you offer this procedure or, if not, can you recommend a place that does it in the US? Thanks! — Liz C.

Dr. Geoffrey Sher answered

CAPA-IVM is Biphasic In-Vitro Maturation. of eggs. It is a technical variation on conventional maturation of early eggs (in vitro maturation) that was introduced in Australia about 4y ago.. It has not taken hold in this country as it does not offer any real advantage , in my…
Uterine & Endometrial Health Nov 7, 2023

Viagra

When is best time to start and stop Viagra through vigaina. — Okeoma N.

Dr. Geoffrey Sher answered

THE IMPACT OF A THIN UTERINE LINING ON EMBRYO IMPLANTATION: THE BENEFITS OF VIAGRA THERAPY Geoffrey Sher MD Back in 1989, I conducted a study that examined how the thickness of a woman's uterine lining, known as the endometrium, affected the successful implantation of embryos in IVF patients.…
Early Pregnancy & hCG Nov 6, 2023

Hcg levels

I don't seem to understand these hcg levels. I did a blood test the first time and it showed that my hcg levels were on 6105 and I am 5 weeks pregnant. I did a test again a week after… — Nomonde M.

Dr. Geoffrey Sher answered

Ideally the level should have increased. Repeat the hCG again. Geoff Sher TIMING AND INTERPRETATION OF hCG BLOOD PREGNANCY TESTS Geoffrey Sher MD 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…

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.

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