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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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Dr. Geoffrey Sher

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Immunology & Implantation Aug 15, 2023

Lovenox for homogenous MTHFR 677CT

Hello, I am currently 18 weeks pregnant following a fresh IVF transfer. Would you advise that I stay on lovenox 0.4 during the whole pregnancy since I have the following genetic mutations? - homogenous MTHFR 677CT - heterozygous PAI 4G/5G… — Kim D.

Dr. Geoffrey Sher answered

Yes! You will need Lovenox throughout pregnancy and until the 6th week post-delivery. Respectfully, I am not pro-using progesterone throughout pregnancy. Thrombophilia (Hereditary Clotting Defect) is defined as the genetic predisposition to developing intravascular thrombosis. It is due to hypercoagulability of blood leading to impairment of initial vascularization…
Embryos & Genetic Testing Aug 15, 2023

Optimal trigger

Hi Dr Sher, apologies to bother you again, your insights are so helpful and I'm worried this IVF round isn't going to work! It's a Euploid embryo being transferred that I don't want to wast. We're doing a modified natural… — Cassidy O.

Dr. Geoffrey Sher answered

No! It sounds as if the timing will still be OK! Good luck! Geoff Sher
Embryos & Genetic Testing Aug 15, 2023

Is there an optimal timing of the trigger/embryo transfer on a modified natural cycle

I went in for a scan today in anticipation of doing a modified natural cycle, it's day 10 - LH levels are rising -I've not reached ovulation yet, LH normally surges on day 14 for me. The lining was trilaminar… — Cassidy O.

Dr. Geoffrey Sher answered

Candidly, I am not a fan of modified natural cycle FET's. However, the time to trigger is just before the onset of the natural LH surge.; This is determined by the size (20+mm) of the dominaqnt follicle and bloopd E2. (150pg/ml+ or 300+ if there are >2 dominant…
Ovarian Stimulation & OHSS Aug 15, 2023

Ovidrel only trigger

I am 42, 2.15 AMH, did the first cycle with Decapeptyl only and got all empty follicles. Then did three more cycles with dual trigger and got no euploids. Should I try an Ovidrel only trigger? 500 or 250? (I… — Anne 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. The…
Clinic & Practice Aug 14, 2023

Reproductive Endocrinologists_Refer by Dr. Amy Huang

To whom it may be concerned, I am Dr. Amy Huang's patient. After more than one year of getting pregnancy naturally, we decided to move forward with other options. I got referral from Dr. Huang and would like to make… — Yuyan Q.

Dr. Geoffrey Sher answered

Thanks for contacting me. Please call 702-533-2691 and ask my assistant, Patti Converse, to set you up with an online consultation with me. Geoff Sher 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…
IVF Failure & Pregnancy Loss Aug 14, 2023

Miscarriage

Hello... My name is Claire...I've had 3 pregnancy losses ..one was at 6weeks and the rest were chemical pregnancies they exited even before I noticed I was pregnant..my gyna did thyroid.. diabetes and immune disorder test with my blood and… — Claire L.

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…
Embryos & Genetic Testing Aug 12, 2023

Second hand infertility

Hi, I came across your podcast about implantation issues. I went thru infertility issues for 4 years (Ivf wasn’t covered) 19iuis- I had a miscarriage in the 2nd trimester- 3 chemical pregnancies and 2 miscarriages ending before 9 weeks we… — Lauren B.

Dr. Geoffrey Sher answered

Clearly you have recurrent pregnancy loss...likely due to an implantation dysfunction (anatomical or immunologic.However, I would need much more information to be able to comment authoritatively. When it comes to reproduction, humans face challenges compared to other mammals. A significant number of fertilized eggs in humans do not…
Egg Health & Ovarian Reserve Aug 11, 2023

Failing to achieve an euploid

Dear Dr. Sher, 42 year old here desperately wanting to be mother for the first time! 6 year unknown infertility, 99 lbs, 5'6'', eat healthy, taking COQ10 and prenatal, very healthy and no disease illnesses in the past. My AMH… — Anne 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…
Egg Health & Ovarian Reserve Aug 11, 2023

PGTA/Endometriosis

Hi, quick background info- 37 years old, husband is 48 years old. I have stage 4 endometriosis with bilateral endometriomas about 4-5 cm on both ovaries. AMH of 3.8, FSH 5.5, Estradiol 45. Sperm analysis is above normal. I just… — Marie F.

Dr. Geoffrey Sher answered

When women with infertility due to endometriosis seek treatment, they are all too often advised to first try ovarian stimulation (ovulation Induction) with intrauterine insemination (IUI) ………as if to say that this would be just as likely to result in a baby as would in vitro fertilization (IVF).…
Early Pregnancy & hCG Aug 11, 2023

hcg numbers

hello, i am very concerned about my heavy bleeding despite being pregnant. my hcg numbers went from 624 to 737 in 5 days. is this normal — Ruth J.

Dr. Geoffrey Sher answered

Sadly, this suggests that the pregnancy is non-viable. Geoff Sher 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 Sher Fertility Solutions (SFS) ; http://sherfertilitysolutions.com/sher-fertility-solutions-ebook.pdf Recurrent Pregnancy…
Immunology & Implantation Aug 11, 2023

DQ Alpha testing

Dear Dr Sher, I am a 33 year old European woman currently TTC. I had my first conception success in 2022, in about 9 months period time and had a pregnancy loss before 8 weeks. Since then I was not… — Elia F.

Dr. Geoffrey Sher answered

The complete match is only a problem if in addition you have activated natural killer cells. ...see below. Geoff Shedr 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…
Hormones & Ovulation Aug 11, 2023

Ivf

Hello my name is James my wife and I been trying to conceive for the last year . The clinic we went said my wife would have to lose 60lbs before treatment. What is the Bmi requirements at your clinic… — James C.

Dr. Geoffrey Sher answered

Obviously women that are much overweight will have more difficulty in pregnancy. However we have no absolute BMI cut=-off requirements presently! Geoff Sher 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…
Ovarian Stimulation & OHSS Aug 11, 2023

Cyst

I had follicle measuring 15mm with estrogen 155 and 5 days later estrogen dropped to 106. This is from natural cycle using no stimulation. The clinic wanted to aspirate and fertilize then decided not to due drop in estrogen and… — Jumna P.

Dr. Geoffrey Sher answered

Your RE made the right decision. That follicle would not have propagated a good egg! Geoff Sher 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 Sher…
Embryos & Genetic Testing Aug 8, 2023

Balanced translocation & IVF Chemical Pregnancy

Hello Dr. Sher, After having two miscarriages (1 natural and 1 IUI), I found out that I have a robertsonian balanced translocation (13:14). My RE said that my best bet would be to do IVF with PGT-SR testing. I did… — Caitlin D.

Dr. Geoffrey Sher answered

The fact that the embryo transferred was euploid does not guarantee that it is was normal. There are genetic and metabolic factors that also can play a role. As for the low yield of "competent embryos, that likely has to do with the protocol used for ovarian stimulation.…
Immunology & Implantation Aug 7, 2023

Do you think my problem is immunological?

Dear Dr Sher, I have a history of 5 natural pregnancies complicated by pre-eclampsia, 2 previous csection births. After my last birth via csection, i have had 3 first trimester miscarriages. I'm now undergoing ivf with donor eggs due to… — Lisa W.

Dr. Geoffrey Sher answered

It is indeed possible that you have acquired an immunologic implantation dysfunction. 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…

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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