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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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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…
Early Pregnancy & hCG Sep 15, 2023

hcg and progesterone halved value in 2 days

On 12 dpt, hcg level was in 300 and Progesterone was in 90s.. 2 days later, HCG level halved and so did progesterone... I know I have to wait for next lab.. I'm scared... would I be losing this? — N B.

Dr. Geoffrey Sher answered

Sadly, this does not look good! Sorry Geoff Sher
Sep 11, 2023

es

estoy ligada perolo se como y como es labforme de pagobpara el tratamiento — Lenny V.

Dr. Geoffrey Sher answered

Please redraft your question in English! Geoff Sher
Early Pregnancy & hCG Sep 11, 2023

Beta HCG Levels

Hi Doctor. I did a modified natural FET. Last wednesday, I was 9dp5dt and my hcg was 330. At 11dp5dt it was 890. I was told to come back 3 days later (which was this morning, since my clinic was… — Trish P.

Dr. Geoffrey Sher answered

In my opinion, you are still likely to be on a "safe track". I suggest you wait 10 days and do an US for confirmation. Going through IVF is a major investment, emotionally, physically, and financially, for every patient or couple. One of the most crucial moments is…
Early Pregnancy & hCG Sep 10, 2023

Progesterone dropped at 6-7 weeks while on pessaries

Hi Dr Sher, Im currently 7 weeks pregnant and beta hcg was last measured at 6+5 weeks and was 35000. However, my progesterone has dropped from a high of 73nmol (about 22ng) to 50nmol (around 16ng). This drop has come… — Dani C.

Dr. Geoffrey Sher answered

I really do not believe this will be an issue. A P4 of 16ng/ml at this stage is still adequate. Good luck! 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…
Early Pregnancy & hCG Sep 9, 2023

Beta

Hi Dr. Sher, I had my beta yesterday at 9dp5dt and it came back at 328. Does a higher baseline hcg level impact the likihood of a successful ongoing pregnancy? I ask because I tested today with a pregnancy test… — Chevon P.

Dr. Geoffrey Sher answered

Measuring and interpreting Blood hCG to Assess Pregnancy Viability Following ART Treatments. Geoffrey Sher MD I know of no medical announcement associated with the degree of emotional anticipation and anguish as that associated with a pending diagnosis/confirmation of pregnancy following infertility treatment. In fact, hardly a day goes…
Uterine & Endometrial Health Sep 9, 2023

Lubion injections of progesterone

Hello Dr Sher, I hope you’re well. I am pleased to say that I got my first pregnancy confirmed on Monday, beta levels/ rises are healthy so far. I’m using Lubion instead of PIO for progesterone support and I’m concerned… — Cassidy O.

Dr. Geoffrey Sher answered

Congratulations Cassidy, The needle size (although unnecessarily large) will in no way adversely effect delivery of the medication or outcome. Good luck! Geoff Sher
Egg Health & Ovarian Reserve Sep 9, 2023

Low AMH

Dear Dr. Sher, I am 36-year-old, planning an IVF in a couple of months, but AMH today shows low 1.01 ng/ml. Do I have good chances? Planning to go through egg pooling, NGS and 1 embryo transfer. I want to… — Ola C.

Dr. Geoffrey Sher answered

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 IVF. By providing you…
Early Pregnancy & hCG Sep 4, 2023

Failed euploid transfer

Dear dr Sher, Thank you so much giving me the option to ask you a question! I’m very curious about what your differential diagnosis/following steps would be. I’m 34 years old and we have been dealing with unexplained infertility for… — Eline L.

Dr. Geoffrey Sher answered

In my opinion, this sounds very much like an implantation dysfunction. >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> IVF FAILURE WITH “NORMAL” EMBRYOS: EXAMINING AND ADDRESSING ANATOMICAL AND IMMUNOLOGIC CAUSES. Geoffrey Sher MD Implantation dysfunction is often overlooked as a significant reason for IVF failure. This is especially true when IVF failure is unexplained,…
Uterine & Endometrial Health Sep 4, 2023

Progesterone Timing and Receptivity

Hi Doctor. I am worried about my uterine receptivity and progesterone exposure. I'm in the TWW after a modified natural cycle. On a Monday my follicle was 17mm. and my doctor told me to trigger the next day not expecting… — Albena T.

Dr. Geoffrey Sher answered

I do not think the surge or the "trigger" with Ovidrel will change the timing of the FET. But to be quite honest, I personally prevent FET's in hormone replacement cycles to better pinpoint the ideal window of implantation. Prior to 2 decades ago, most women undergoing IVF…
Infertility Basics Sep 1, 2023

Unexplained infertility

Hi Dr Sher, Having heard some of your talks online, I felt reinvigorated and am now determined to find out the cause of my infertility. I am 25 years old and my husband is 29. We had been trying for… — Layla A.

Dr. Geoffrey Sher answered

Given your age and history, I would not be at all surprised if this were an implantation dysfunction (possibly immunologic). See the urticles below . In my opinion, you should delay doing another FET until there is a diagnosis. Infertility affects y 10%-15% of couples who are unable…
Ovarian Stimulation & OHSS Aug 31, 2023

Eggs disintegrate

is it possible 10 hours after egg retrieval your eggs can disintegrate and if so, how is that possible? — Mckeeya B.

Dr. Geoffrey Sher answered

It is most unusual but it can happen due to an egg issue or due to a laboratory dysfunction. In my opinion the most important remedy is to use an individualized protocol for ovarian stimulation to try and protect egg development during stimulation. The journey of in vitro…

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.

Latest answers

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