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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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Uterine & Endometrial Health Jun 19, 2024

Progesterone type

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 Jun 19, 2024

Vaginal viagra suppositories

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 Jun 17, 2024

Frozen embryo transfer add on

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 Jun 17, 2024

Feeling confused

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 Jun 6, 2024

IVF treatment plan question with immunological problem

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 May 23, 2024

IVF medication regiment

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 May 12, 2024

Sildenafil Vaginal Suppositories

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 May 4, 2024

Recommendation?

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 Apr 29, 2024

Water in lining FET

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 Apr 10, 2024

Secondary Recurrent Pregnancy Loss and possible IID

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 Apr 2, 2024

Sclerotherapy

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 Mar 15, 2024

Recurrent Implantation Failure

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 Mar 11, 2024

Immature oocyte during endometriosis

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…
Uterine & Endometrial Health Mar 4, 2024

Thin endometrium luteal phase

Dear Dr. Sher, Thanks for creating this forum, I really appreciate. My periods are lighter since I gave birth to my daughter 8 months ago (no breastfeeding). My endometrium measured 9.3 mm the day before ovulation, 8.6 mm 2 days… — Alina D.

Dr. Geoffrey Sher answered

It is the thickness of the endometrium pre-ovulation that matters. Good luck! Geoff Sher 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…
Ovarian Stimulation & OHSS Mar 4, 2024

Irresponsive endometrium after Lupron

Hi Dr Geoffrey, I’ve been dealing with fertility issues for years (endometriosis, fibroids) and last year, after two unsuccessful embryo transfers (of genetically normal embryos), I decided to have a laparoscopy surgery to treat the endometriosis and remove the intramural… — Carolina G.

Dr. Geoffrey Sher answered

Asherman Syndrome is a medical condition characterized by severe intrauterine adhesions, also known as synechiae. These adhesions can cause significant damage to the basal layer of the endometrium, the part of the uterus responsible for developing the uterine lining (endometrium) under the influence of hormones like estrogen and…

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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