– Geoffrey Sher, MD
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Embryos & Genetic Testing
Could this be a early sing of miscarriage? HGC levels have growth 35% form 3 days ago. — Daniela M.
Dr. Geoffrey Sher answered
I am afraid that bhis does not look promising. I hope I am proven wrong but I think you are likely t5o lose this pregnancy. Geoff Sher ADDITIONAL INFORMATION: I am attaching online links to two E-books which I recently co-authored with my partner at SFS-NY (Drew Tortoriello…
Ovarian Stimulation & OHSS
Do you recommend to trigger with 10,000 IU of Pregnyl ( containing HCG and LH) or Novarel ( containing only HCG ) for females over 40 with high LH? — Mia P.
Dr. Geoffrey Sher answered
T%hey are in fact identical and interchangeable. Either would be fine! Good luck! Geoff Sher ADDITIONAL INFORMATION: I am attaching online links to two E-books which I recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your reading pleasure: 1.From In Vitro Fertilization to Family: A…
Embryos & Genetic Testing
Hello Dr, At my baseline scan there was a cyst measured 11mm, i.e. borderline acceptable. Nurses took my blood to check oestradiol level in case Doctor wanted to check it - but the Doctor reported back and said blood test… — Cassidy O.
Dr. Geoffrey Sher answered
Especially since you are doing an FET and there has been no impact on your cycle thus far, I would tend to agree with your RE that the 10mm follicle/cyst is probably irrelevant! Good Luck! Geoff Sher ADDITIONAL INFORMATION: I am attaching online links to two E-books which…
Infertility Basics
My wife was diagnoses last year with Adenomyosis after having a miscarriage, and had a DNC. We've been having trouble getting pregnant ever since, and would like to know all options. We saw this on a show, and wondering if… — Adam L.
Dr. Geoffrey Sher answered
Adenomyosis is a condition where endometrial glands develop outside the uterine lining (endometrium), within the muscular wall of the uterus (myometrium). Definitive diagnosis of adenomyosis is difficult to make. The condition should be suspected when a premenopausal woman (usually>25 years of age) presents with pelvic pain, heavy painful…
Embryos & Genetic Testing
Hello, I am a healthy, active 34 year old who has been trying to conceive for 5 years. I’ve had 5 PGT tested embryos transferred with 4 implantation failures and one a very low chemical. One healthy embryo and one… — Devan K.
Dr. Geoffrey Sher answered
Indeed, I often deal with cases such as yours. Implantation dysfunction is unfortunately often overlooked as an important cause of IVF failure. In the pursuit of optimizing outcome with IVF, the clinician has a profound responsibility to meticulously assess and address this important issue if IVF success is…
Ovarian Stimulation & OHSS
I am doing my first FET prep cycle - I am on oral estrogen (2mg) and estrogen patches (0.1mg/day) I started at 2 patches and 1 pill per day and then gradually bumped up to 3 pills and 3 patches… — Mikie D.
Dr. Geoffrey Sher answered
There are different approaches to hormonal preparation of the uterine lining for FET. In my practice, the following is the approach I take.. I think using this might prevent the kind of response you experienced last time. Until less than 3 decades ago, most women undergoing IVF would…
Immunology & Implantation
Hello Dr. Sher I've been seeing Dr. Paschall here in Franklin TN, I believe she has been speaking with you about my case. I have had 20 missed/miscarriages over a 14 year span with my spouse but I have two… — LaPorche F.
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
Hi There, I had 12 'healthy' embryos from 2 retrevials . NO natural cycles all with. Progesterone, Esradiol, Prednisone, Baby Aspirin Did 3 transfers for these . 1st failed. - did ERA came back normal. 2nd. B.O. - needed two… — Katrina S.
Dr. Geoffrey Sher answered
Implantation dysfunction is unfortunately often overlooked as an important cause of IVF failure. In the pursuit of optimizing outcome with IVF, the clinician has a profound responsibility to meticulously assess and address this important issue if IVF success is to be optimized. This is especially relevant in cases…
Egg Health & Ovarian Reserve
Hello I read your blog and love the content. I am 36yrs old woman (AMH 29 pmol/L, AFC 14-20), obesity (BMI from 31-34 in the last year, used to be much more). My DHEA, testosterone, PRL were normal/low-normal/mid-range... FSH 7… — Petra V.
Dr. Geoffrey Sher answered
HGH will not do harm. I personally do not advocate routine use of DHEA. The journey of in vitro fertilization can be a rollercoaster of emotions for many patients. Often times they have to face the harsh reality that the number and quality of eggs retrieved has fallen…
Embryos & Genetic Testing
Hello Dr. Sher, I am a patient working with an IVF Clinic that holds 2 more of my PGT-A Euploid Embryos (using Donor Eggs and my husband's sperm), but we have unfortunately arrived at a crossroads where my smaller clinic… — Deanna T.
Dr. Geoffrey Sher answered
Of course we offer the service independent of whether the patient undergoes egg retrieval with us. Geoff Sher 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.…
Embryos & Genetic Testing
We had 20 eggs at Day 3, 10 of which were grade 1 or 2, the rest were grade 3 or 4. By Day 5 we only had 1 blastocyst of 4BB quality. What would cause such a high loss… — Cheryl M.
Dr. Geoffrey Sher answered
One of the commonest questions asked by patients undergoing IVF relates to the likelihood of their eggs fertilizing and the likely “quality of their embryos. This is also one of the most difficult questions to answer. On the one hand many factors that profoundly influence egg quality; such…
IVF Failure & Pregnancy Loss
Hi Sir, On 12th Day of period i have done TVS and one 30x23mm, one 16mm and 3/4 other smaller follicle on my right ovary. Will i be able to conceive with these? Thanks — Farjana Y.
Dr. Geoffrey Sher answered
The 30mm follicle is likely cystic and unlikely to house a good quality egg and the 16mm follicle is too immature to house a competent egg! Sorry! Geoff Sher ADDITIONAL INFORMATION: I am attaching online links to two E-books which I recently co-authored with my partner at SFS-NY…
Egg Health & Ovarian Reserve
Hello, I am considering treatment at a new clinic after a disappointing first attempt at IVF. I am 46 years old and tried using my own eggs. From my last blood test some two months ago I had an AMH… — Yasmin V.
Dr. Geoffrey Sher answered
You certainly could try again, but please know that age is a major factor affecting IVF outcome. Women over 44y of age are advised to do egg donation. Age should never be a barrier to hope and fulfillment when it comes to IVF. Many women in their early…
Early Pregnancy & hCG
Is it normal to have bleeding during IVF stimulation — Akanksha M.
Dr. Geoffrey Sher answered
In the very early stage of stimulation, it could simply be a result of the period that launched the cycle. However, if it occurs several days into stimulation...that is NOT normal. Geoff Sher ADDITIONAL INFORMATION: I am attaching online links to two E-books which I recently co-authored with…
Clinic & Practice
Hello! I am wondering what the process would be to book in for a frozen transfer this coming fall/winter. I currently have embryos stored in New York, Would it be possible to book a call with either Dr. Sher or… — Brittany M.
Dr. Geoffrey Sher answered
It would be our privilege to be of service: See Below! GS ADDITIONAL INFORMATION: I am attaching online links to two E-books which I recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your reading pleasure: 1.From In Vitro Fertilization to Family: A Journey with Sher…
