– Geoffrey Sher, MD
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Uterine & Endometrial Health
Buenas noches, me han descubierto un itsmocele no muy grande... (creo). Lo malo es q esta a menos de 2mm de la pared vaginal y utero (no estoy muy segura si es asi). La cuestión es que no quieren operarme… — María D.
Dr. Geoffrey Sher answered
Please re-post in English and I will gladly respond! Geoff Sher
Hormones & Ovulation
Hi Dr. Sher, First off thank you for what you do & all of the valued information you provide people. Good information is hard to find on infertility. Here is my scenario: I am currently 39 y/o Female and my… — Holly B.
Dr. Geoffrey Sher answered
Hi Holy, Thank you for that detailed letter. I really would need to talk to you after receiving all relevant information. It does sound as if a male factor might be involved but I cannot vouch for this without more detail. It is possible (in spite of US…
Uterine & Endometrial Health
Is sub cutaneous progesterone as effective as intra muscular? Can there be a case of too much progesterone If progesterone gel, oral and sub cutaneous forms are administered together for luteal support? — Sreevidhya V.
Dr. Geoffrey Sher answered
Here is the Luteal Phase support I advocate. Luteal support: commences on day-1 , 6 days prior to the FET, with intramuscular progesterone in oil (PIO) at an initial dose of 75-100 mg (-Day 1). Daily administration- is continued until late in the evening of Day 5 (…
Uterine & Endometrial Health
Hi there I am from the UK and have been prescribed vaginal viagra suppositories but finding it impossible to find a pharmacy that can obtain it or make it up. Could you advise how the suppositories are made? Presumably they… — Helena G.
Dr. Geoffrey Sher answered
I really do not know how you could get access in the UK. I suggest you contact MD-RX Pharmacy in Encino, CA . They might be able to advise you.. Good Luck! Geoff Sher Ask for Robert Makhane and mention my name when you talk with him..
Embryos & Genetic Testing
Hello Dr. Sher, Hope you are doing well.. 1. What is your view about hcg booster shots between ovulation induction and transfer for modified natural transfer? Does it have positive effect on endometrium before transfer? If yes what will be… — Sreevidhya V.
Dr. Geoffrey Sher answered
What is your view about hcg booster shots between ovulation induction and transfer for modified natural transfer? Does it have positive effect on endometrium before transfer? If yes what will be the ideal protocol and dose for hcg booster? A: I do not advocate this! 2. What is…
Early Pregnancy & hCG
I happened to take a test and it was positive i started having pains and irregular spotting i consulted with the health providers and so far i recieved to opinion the first Dr suspected an ealry pregnancy as he could… — Philisiwe P.
Dr. Geoffrey Sher answered
There is no specific hCG level that differentiated between and IUP and an ectopic. However, the level should double every 2 days with normal intrauterine pregnancy ...in the early stage of pregnancy. If it rises more slowly, that suggests a possible failing pregnancy or an ectopic. An US…
Early Pregnancy & hCG
Dear Dr Sher, I am a 35 years old woman and I have fallopian tube blockage. I have had 4 IVF cycles, 3 were unsuccessful, the second was successful (at the beginning hcg:5000, progesterone: 34), but unfortunately I had to… — Flora K.
Dr. Geoffrey Sher answered
It seems highly likely that you do have an immunologic implantation dysfunction. Your endometrial cytoikine and NK cell elevation are suggestive. However, the cause must firsdt be identified before treatment can be defined for FET. This will require a detailed assessment (see below). A RATIONAL BASIS FOR MANAGEMENT…
Immunology & Implantation
I am seeing Dr Klitz at Cny fertility. I have had two filled IUI and two filled IVF. I have no health history besides a tilted uterus. My husband, sperm mythology is low and abnormal, but does have some normal… — Victoria S.
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 terms.…
Uterine & Endometrial Health
Hello, I am reaching out to inquire about the availability and effectiveness of Sildenafil Vaginal Suppositories. My wife is currently consulting with her doctor regarding a concern with endometrial thinning. Her doctor recommended the use of Sildenafil in the form… — Bader M.
Dr. Geoffrey Sher answered
Back in 1989, I conducted a study that examined how the thickness of a woman's uterine lining, known as the endometrium, affected the successful implantation of embryos in IVF patients. The study revealed that when the uterine lining measured less than 8mm in thickness by the day of…
Embryos & Genetic Testing
Hello, I recently had my first FET ever with a PGT tested normal donor egg embryo. I had such high hopes, but it unfortunately did not stick. When my lining was checked a week before the FET, it was 8.7.… — Bree M.
Dr. Geoffrey Sher answered
Two decades ago, when women went through IVF (in vitro fertilization), they usually had their embryos put in the uterus right after the eggs were collected in the same cycle (known as "Fresh" Embryo Transfer). Freezing embryos at that time was risky, with about 30% not surviving the…
Uterine & Endometrial Health
Looking for baby#2. After Csection we try to use same protocol. I use to reach 10-14 in lining very fast. No issues for transfer. Now is been 5FET cycles cancel so far. Endometritis detected on the beginning. Lots of antibiotics.… — Ana K.
Dr. Geoffrey Sher answered
WE should talk. I think I can be of help here. Please call my assistant, Patti Converse at 702-533-2691 and set up an online consultation with me to discuss. Back in 1989, I conducted a study that examined how the thickness of a woman's uterine lining, known as…
Immunology & Implantation
Hi Dr Sher, I am 40 years old and have suffered with a number of early pregnancy losses in the past year, all conceived naturally. I have a 3 year old son who was conceived easily with no issues during… — Bronagh M.
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…
Uterine & Endometrial Health
Hello, I have multiple ovarian Endometriomas. I was wondering if you offer sclerotherapy? How far are you booking out? I already have diminished ovarian reserve. Would having this done hurt my reserve more? — Lindsey W.
Dr. Geoffrey Sher answered
I am no longer offering this because the ideal sclerosant (tetracycline hydrochloride) is no longer accessible. So,sorry. GS
Embryos & Genetic Testing
Hello Dr. Sher at my current clinic I have gone through 4 transfers with PGT-A normal embryos. My first transfer resulted in a chemical pregnancy, but the following transfers did not implant at all. The tests I have done are… — Ashley P.
Dr. Geoffrey Sher answered
In my opinion this is almost certainly an implantation dysfunction. Bear in mind that in 30% of cases, endometriosis is associated with an immunologic implantation dysfunction. Implantation dysfunction is often overlooked as a significant reason for IVF failure. This is especially true when IVF failure is unexplained, or…
Uterine & Endometrial Health
Hello! I hope i will hear back from you. I was 24 years old during my first ivf. We’ve retrieved 11 oocyte and all of them were immature. During second ivf 6 oocyte 3rd ivf, (long protocol) retrieved 9 oocyte,… — Jesica S.
Dr. Geoffrey Sher answered
I respectfully differ. In my opinion, unless you still have sizable endometriotic cysts (endometriomas) in your ovaries or you have significantly reduced ovarian reserve, I doubt that the endometriosis itself explains your poor egg/embryo quality. Given your young age, I suspect that the protocol used for ovarian stimulation…
