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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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159 answers

Egg Health & Ovarian Reserve

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Egg Health & Ovarian Reserve Feb 16, 2024

Stimulation Protocol for Severe DOR

I'm 40 about to turn 41 with what's been described as severe DOR, amh is dropping fast. 2 years ago it was .22, last april .08 and this past test (after my stimulation complications) it's now .03. Last year I… — Private

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 Feb 5, 2024

Canceling when antral follicle count is too low

Dear Dr. Sher, My periods are getting shorter (around 20 days). Since December, my doctor has been doing this: (already three consecutive times now) starts the Estradiol pretreatment, FSH, Ganirelix and Omnitrope and then stops after a couple of days,… — Anne C.

Dr. Geoffrey Sher answered

It sounds as if you have age related diminished ovarian reserve. Respectfully, your antral folicle count can be expected to be low and if you wish to try for a baby through IVF using your own eggs, the number of AFs will not improve and you will have…
Egg Health & Ovarian Reserve Jan 25, 2024

Atretic eggs

Good afternoon, I’m posting in English. Thank you very much for your answer. Last April my AMH was 0.04, even though I did my first IVF and got two follicles with two embryos. One of them ended up in a… — Carmen N.

Dr. Geoffrey Sher answered

“EMPTY FOLLICLE SYNDROME” “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…
Egg Health & Ovarian Reserve Jan 22, 2024

‘Empty’ follicles

Hello Dr. Sher, I just had an egg retrieval cycle where despite my follicles growing nicely and the clinic expecting to collect 15 eggs, they only retrieved 6 eggs, two of which have fertilised. Apparently, the ‘empty’ follicles contained cumulus… — Ruth A.

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…
Age & Fertility Jan 11, 2024

Fiv

Hola. Tengo 40 años y 0,73 Amh. Me sometí q un ciclo fiv con fostipur 300 y meriofert 150, luego cetrotide, me quedé embarazada pero lo perdí. Me han realizado otro ciclo pero me incluyeron femara y progynova y quitaron… — Rj C.

Dr. Geoffrey Sher answered

Please post in English!
Egg Health & Ovarian Reserve Jan 10, 2024

Unexplained infertility

Greetings! I am a 39yo f, pmhx prolactinoma (dx 1/2023, medically managed now), ulcerative proctitis (on stelara, almost in remission) with 1 natural conception and loss at 8 weeks due to trisomy, now 3 failed IVF stim attempts. My AMH… — Lindsey A.

Dr. Geoffrey Sher answered

In my opinion, we need to have a detailed online consultation to discuss the following issues in detail: 1. Egg/embryo quality issues: and the influence of the protocol used for ovarian stimulation as well as diminishing ovarian reserve and advancing age.. 2. Implantation dysfunction as it might relate…
Egg Health & Ovarian Reserve Jan 5, 2024

Human growth hormone dosage

Dear Dr. Sher, What is the ideal daily dosage for Omnitrope? Thanks for your kind and expert guidance, A.C. — Anne C.

Dr. Geoffrey Sher answered

There is no uniformity here. A dosage ranging from 8U per day to 20U per day is probably fine. I start the omnitrope with ovarian stimulation and discontinue on the day of the "trigger". Geoff Sher IVF and the use of Supplementary Human Growth Hormone (HGH) : Is…
Egg Health & Ovarian Reserve Jan 4, 2024

Multiple miscarriages

I am 30, my husband is 29. I was diagnosed with PCOS at 15. I had a miscarriage at age 20 at 8 weeks. Last year, I had three miscarriages (one at 6 weeks, 5 weeks and then at 4… — Kristina H.

Dr. Geoffrey Sher answered

Respectfully, I do not concur with the suggested approach. You have recurrent pregnancy loss. I suggest you read the articles I wrote , below and then seriously consider calling my assistant, Patti Converse at 702-533-to set up an online consultation with me to discuss your case in detail.…
Egg Health & Ovarian Reserve Jan 2, 2024

Natural Ivf

Hello. 3 years ago I underwent a standard ivf. 13 follicles, 11 oocytes, 9 mature, 6 fertilized, 2 blasts, one very poor quality, one hatching AA resulting in my daughter. Now I am 39 years old, AMH 2,68 and I… — Helen C.

Dr. Geoffrey Sher answered

I would urge you not to do NC IVF. Consider the following options: Mini-IVF is a procedure that involves ovarian stimulation with oral fertility drugs such as clomiphene or letrozole to promote the development of follicles, for egg extraction. This is on the pretext that Mini-IVF, involves the…
Egg Health & Ovarian Reserve Dec 11, 2023

Stimulation poor responder

Advice on stimulation proctol please. Background: I’m 36y, normal BMI, pelvic and bowel endometriosis (lap confirmed and excised), high activated NK cells, persistently raised cardiolipin IgM titre, 3+ yr history primary infertility.5 failed embryo transfers. I did have brief chemical… — Maya G.

Dr. Geoffrey Sher answered

A. 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…
Egg Health & Ovarian Reserve Dec 11, 2023

Mistake on one dosage

Hi Dr Sher, On the 5th day of my FSH treatment with Gonal-F only, I made a mistake and used Pergoveris instead of Gonal-F (same dosage), It's the same follitropin alfa, but I am afraid of the LH surge, that… — Jennifer S.

Dr. Geoffrey Sher answered

I don't think it will be a problem. I would not cancel...but discuss with your own RE. Geoff Sher PLEASE SHARE THIS WITH OTHERS AND HELP SPREAD THE WORD!! Herewith are online links to 2 E-books recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your…
Egg Health & Ovarian Reserve Dec 8, 2023

Suspected endometriosis and low AMH.

I have suspected endometriosis and very low ovarian reserve. Should I do a laparoscopy for endometriosis, then PRP therapy to increase my ovarian reserve before I retry IVF? Will this help? My last two attempts at IVF have only ever… — Aqsa G.

Dr. Geoffrey Sher answered

Unless you need surgery because of intractable symptoms or you require surgical treatment of ovarian endometriomas, I would not advocate laparoscopy at all. Your miscarriages could well be due to endometriosis-induced , immunologic implantation dysfunction. When women with endometriosis-related infertility seek treatment, they are often advised to try…
Egg Health & Ovarian Reserve Dec 7, 2023

Omnitrope dosage

Dear Dr. Sher, Should Omnitrope continue to be taken on the day of the trigger and the next day, all the way till egg retrieval day, or stop two days before, when FSH stops? And what's the optimal dosage? Thanks… — Anne C.

Dr. Geoffrey Sher answered

No! It stops on the day of the "trigger". Good luck! Geoff Sher PLEASE SHARE THIS WITH OTHERS AND HELP SPREAD THE WORD!! Herewith are online links to 2 E-books recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your reading pleasure: 1. From In Vitro…
Egg Health & Ovarian Reserve Dec 7, 2023

Empty follicles

I am currently 33 years old and have already had 3 ICSIs. However, the first one was 5 years ago. Last year I stimulated for 2 days with 375 Gonal f and 75 Menopur and then with 225 Gonal f… — Monika O.

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…
Egg Health & Ovarian Reserve Dec 5, 2023

Positive lads after 4th lit treatment

Dear Dr. Sher, Thank you for your answer. I did take ivig before pregnancy was diagnosed. Took 30g ivig on ovulation and on positive hgc test but it faild to relax my immune system. I refuse to take steroids as… — Irit L.

Dr. Geoffrey Sher answered

I Did 3 lit treatments 1.5 years ago. Lads were negative. After the last pregnancy loss I did the 4th lit. Finally lad became weak positive 40%. Do you think that positive lads gives me a better chance to carry a pregnancy? A: I do not believe this…

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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