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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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Page 39 of 68

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…
Embryos & Genetic Testing Aug 7, 2023

Embryo sizing is 6week (.27cm) while GS is 8weeks.

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 Aug 7, 2023

Trigger

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 Aug 7, 2023

Cyst at baseline

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 Aug 7, 2023

Fertility options

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 Aug 5, 2023

RIF

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 Aug 5, 2023

IVF FET PREP

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 Aug 5, 2023

RE: Recurrent Miscarriages

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 Aug 5, 2023

Repeated Implantation/Loss

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…

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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