– Geoffrey Sher, MD
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Early Pregnancy & hCG
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
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
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
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
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
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
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
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
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
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
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…
Ovarian Stimulation & OHSS
At the last scan before my retrieval, one of my ovaries was found to be adhered to the back of my uterus. I have no history of infection or STIs. Is this indicative of endometriosis? — Grace D.
Dr. Geoffrey Sher answered
Very possibly Yes! Endometriosis is a condition where the lining of the uterus grows in other places besides its usual spot inside the uterus. It can affect the Fallopian tubes, ovaries, and bowel and on rare occasions can even disseminate beyond the pelvis and abdominal cavity. While it…
IVF Failure & Pregnancy Loss
Hi, I just had my 3rd failed FET. 1st one was negative, second one we got pregnant but resulted in a chemical (pregnant for 5 days, we used Letrozole), 3rd one completly negative. I am very confused and loosing hope.… — Erin C.
Dr. Geoffrey Sher answered
__ If you've undergone in vitro fertilization (IVF) and didn't achieve a successful pregnancy, you may be wondering why. It's important to know that IVF outcomes can be unpredictable, but there are factors that can affect your chances. Let's explore some common reasons for IVF failure in simpler…
Embryos & Genetic Testing
Hello Dr. Tortoriello, My name is Jeffrey Dorr and I am a US physician (neuroradiologist) living overseas in Japan. My wife is 41 yo, and has undergone fertility treatment here in Japan for the last 16 months, including 6 rounds… — Jeffrey D.
Dr. Geoffrey Sher answered
Dear Dr Dorr, We do not manage patients during pregnancy.We only address reproductive dysfunction. Might I I suggest that you reach out to an obstetrician to look after your wife while you are in NY. If you need help in finding one., please let me know and I…
Embryos & Genetic Testing
Hello, I was wondering what the recommended parameters are for TSH/T4 level prior to FET. I have no issues with thyroid and my most recent TSH level was 3.6 and T4 1.3, just wondering if these are good numbers for… — Julie M.
Dr. Geoffrey Sher answered
Your TSH is modestly elevated. In my opinion this is an indication to evaluate for antithyroid antibodies, which if present, could suggest an underlying autoimmune, immunologic implantation dysfunction linked to activation of uterine natural killer cells (NKa). This should be addressed in advance of undergoing FET in my…
