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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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Page 35 of 68

Immunology & Implantation Sep 25, 2023

Reproductive Immunology/RPL

Hi there, I just turned 42 w an AMH of 1.33-1.71 and have been undergoing IVF treatments for over three years with some success - I was pregnant twice, both unviable and resulting in two D&Cs. This is in addition… — Shian T.

Dr. Geoffrey Sher answered

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 oversimplifies the situation. The process of embryo implantation, which begins about six or seven days after fertilization, involves a complex interaction…
Embryos & Genetic Testing Sep 25, 2023

IVF protocol

My name is Polona, I'm 50 and I've done four IVF cycles, all in North Cyprus, two of them when I was 48 and two of them at 50, for the last one I changed clinics. I’m planning to do… — Polona B.

Dr. Geoffrey Sher answered

Dear Polona, I cannot in good faith support a decision to do IVF with own eggs at 50y of age. The chance of success is virtually zero, regardless of ovarian reserve. You should exclusively be focused on egg donation. Understanding the impact of age and ovarian reserve on…
Embryos & Genetic Testing Sep 25, 2023

What is left to try?

Hello, I’m at 38 year old, female with low ovarian reserve and type 1 diabetes. My partner has male infertility, requiring tese. We had a successful IVF pregnancy with a day 3 embryo in 2018. For the last two years… — Alexa A.

Dr. Geoffrey Sher answered

We need to talk. Whenever a patient fails to achieve a viable pregnancy following embryo transfer (ET), the first question asked is why! Was it simply due to, bad luck?, How likely is the failure to recur in future attempts and what can be done differently, to avoid…
Uterine & Endometrial Health Sep 25, 2023

Lining 1 week prior to transfer

Hello I’m concerned because my ultrasound yesterday 9-22 had my lining at 6.2. My doctor gave me the green light to continue but I’m worried my lining isn’t good enough to go through the transfer and I can’t afford to… — Rachel R.

Dr. Geoffrey Sher answered

Respectfully, I would not do an ET with a lining
Early Pregnancy & hCG Sep 23, 2023

Pregnancy

Recently I have found out that I'm pregnant. My hcg level was 702 5 days ago. And It is 872 today. Is it normal or is baby developing too slowly. — Maria T.

Dr. Geoffrey Sher answered

This is a very attenuated rise. Sadly , it looks as if this pregnancy will likely not be viable. So sorry, 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.…
Hormones & Ovulation Sep 23, 2023

BMI for egg retrieval

Hi there, I am wondering what your opinion is on why so many reproductive endocrinologists tell women with high BMIs that they cannot do IVF (or sometimes even IUI?) I have a BMI of about 55 but have had a… — Cailey S.

Dr. Geoffrey Sher answered

I am not tat concerned about the ER. I am more concerned about technical problems in performing ET and the effect of a high BMI on pregnancy! Geoff Sher Herewith are online links to 2 E-books recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your…
Clinic & Practice Sep 22, 2023

Referral please

I am 42yrs old.Have 1 daughter 19yrs.Finished round 1 of ivf treatment,got 2follicles measuring 20mm 1 in each ovary.During retrieval was informed that the follicles were empty.I live in Kenya,Can you please refer me to a Doctor in Kenya you… — Susan I.

Dr. Geoffrey Sher answered

Sorry, I do not have any names to give you of doctors in Kenya. See the article below about "Empty Follicle Syndrome". Implications of “Empty Follicle Syndrome and “Premature Luteinization” Geoffrey Sher Frequently, when following vigorous and often repeated flushing of follicles at egg retrieval they fail to…
Ovarian Stimulation & OHSS Sep 22, 2023

Protocol question

Hi Dr. T, Thank you so much for your quick response to my other question. I’m trying to make a decision as to whether to begin my second cycle with my current doctor or not and was wondering if I… — Bree M.

Dr. Geoffrey Sher answered

ADDRESSING ADVANCING AGE AND DIMINISHING OVARIAN RESERVE (DOR) IN IVF 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…
Ovarian Stimulation & OHSS Sep 22, 2023

Benefit to back to back cycles

Hi Dr. Sher, Is there a big benefit to doing back to back cycles of egg retrieval? I’m questioning whether I want to stay with my current clinic or switch to a new one. But switching means that I will… — Bree M.

Dr. Geoffrey Sher answered

There are different views. However in my opinion, there are with very few exceptions no advantage in doing back-to back stimulation cycles. I always recommend taking at least 1 resting cycle between attempts to rest the ovaries. Good Luck! Geoff Sher PLEASE SHARE THIS WITH OTHERS AND HELP…
Early Pregnancy & hCG Sep 20, 2023

HCG Slowing

Hi doctor Sher! I used to go to your clinic when I lived in NYC, but now I'm living in the UK and the early obstetric care on the NHS is pretty limited and I have no one to ask… — Amanda C.

Dr. Geoffrey Sher answered

It is NOT abnormal for the rise in hCG to slow down after several weeks into pregnancy! Good luck! 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…
Embryos & Genetic Testing Sep 20, 2023

RPL

Hi Dr. Sher We started trying for a baby a year ago. Fast forward to now and I've had 2 chemical pregnancies, 1 missed miscarriage (embryos heart stopped at 6 weeks 3 days) and now a blighted ovum (gestational sac… — Marie N.

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 Sep 20, 2023

Flare Protocol for Low Ovarian Reserve

Hi Dr. Sher, I have gone through 2 ivf cycles and one FET done so far - i had 5 eggs retrieved in first cycle , 4 fert, resulting in 1 euploid embryo . Second cycle - 8 follicles, 6… — Sujana G.

Dr. Geoffrey Sher answered

Women with DOR , often have excessive LH-induced ovarian testosterone production which in my opinion can be hazardous to egg development. Lupron induces a rapid increase in LH release and in the setting of DOR further prejudices egg development. When Lupron is given at the very start of…
Uterine & Endometrial Health Sep 17, 2023

Wrong Progesterone Dosage!!

Hello Dr.S I am in full on panic mode. I am 5 weeks 3 days pregnant. I am supposed to be taking 400 mgs of prog (suppositories) 200 mgs x 2 daily. I just realized that the clinic accidently gave… — Hannah H.

Dr. Geoffrey Sher answered

I can understand your concern/confusion...but respectfully, I think 100-200mg daily is quite adequate. Sincerely, Geoff Sher
Early Pregnancy & hCG Sep 17, 2023

Hcg levels

My first levels were 509 and the 48 hr window only went up to 592. What does that mean ? — Jessica C.

Dr. Geoffrey Sher answered

Sadly, this does not look good. Repeat the beta hCG test in 2 days to see if it doubles. 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…
Immunology & Implantation Sep 17, 2023

Positive APS and ANA antibodies

Good evening from the uk. We have 9 donor Sperm embryos frozen. 1, biochemical pregnancy and 2 failed transfers. (4AA biochemical, 4AB failed to implant, 5AA failed to implant. Had APS blood test and came back positive. Been put on… — Annabel M.

Dr. Geoffrey Sher answered

This is highly suggestive of 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…

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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