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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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165 answers

Egg Health & Ovarian Reserve

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Age & Fertility Mar 18, 2024

4th cycle advice – 40yo with normal AMH

Dear Dr Sher, I’d like some advice regarding protocol choice for what will be my 4th IVF-ICSI cycle. I am in the UK. I have no medical problems, but I do have a BMI of 33 (prev 43), I have… — Elizabeth T.

Dr. Geoffrey Sher answered

WE really should talk. If interested, please call my assistant, Patti Converse (702-533-2691) and set up an online consultation with me. In the interim, please review the articles below. GS Overcoming Age Barriers in IVF and Embracing New Pathways to Parenthood: Unlocking the Possibilities. Age should never be…
Egg Health & Ovarian Reserve Mar 11, 2024

FX DOR

Hi Dr. Sher, I'm 32 and am a Fragile X premutation carrier (90 repeats) with diminished ovarian reserve (AMH 0.44, on whatever scale the US uses). I just did my first stim cycle starting birth control on day 2 of… — Caitlin F.

Dr. Geoffrey Sher answered

Respectfully, In my opinion what you were on was a "microflare" protocol. I suspect that this might have been a factor. We should talk. I suggest that you contact my assistant, Patti Converse at 702-533-2691 and set up an online consultation with me to discuss in depth. EGG/…
Egg Health & Ovarian Reserve Mar 6, 2024

Follicular cyst and FSH stimulation

Dear Dr. Sher, I am 43 years old and am trying for the last time, after five unsuccessful attempts (I have reached the euploid stage before). This time I have 9 antral follicles, but I also have a follicular cyst.… — Anne C.

Dr. Geoffrey Sher answered

I see no reason not to proceed with the cycle! 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: From In Vitro Fertilization to…
Egg Health & Ovarian Reserve Feb 25, 2024

Egg Retrieval with Immature Eggs

I got 29 eggs during my egg retrieval but was told that only 5 were mature. I am trying to understand why my maturity rate was so low. I triggered when 10+ follicles were at 20mm, and many at 18mm.… — Stephanie T.

Dr. Geoffrey Sher answered

Embarking on the journey of IVF often raises questions about the likelihood of success and the quality of embryos. While it’s challenging to predict outcomes due to various factors, there’s hope and information to guide you. Firstly, the key to fertilization potential lies in the chromosomal integrity of…
Egg Health & Ovarian Reserve Feb 22, 2024

Low Amh

Hello doctor , I’m 33yrs old ….AMH came back .56 and progesterone on day 3 was 16.6 and I had chemical pregnancy in 2020….i don’t have kids and I’m not going to have any kids naturally …so even ivf is… — A C.

Dr. Geoffrey Sher answered

The AMH is NOT too low for IVF. In fact IVF is indicated but the protocol used for ovarian stimulation must be tailored. Understanding the impact of ovarian reserve on the success of in vitro fertilization (IVF) is crucial when it comes to reproductive health. This article aims…
Egg Health & Ovarian Reserve Feb 20, 2024

IVF consultation

1.3, 2.1cm Trigger was 10000 IU Gonasi HP (hCG) and on day 11. Only 1 mature egg was retrieved, and fertilised using ICSI. My day 3 update is a slow growing embryo of 3 cells with some fragmentation. I don't… — Vessie V.

Dr. Geoffrey Sher answered

"Empowering Choices: Embryo Banking vs. Egg Banking for Fertility Preservation" It's crucial for women to make informed decisions about preserving their fertility. Delaying trying to conceive, relying on egg freezing, or assuming the biological clock can be paused are misconceptions. As women age, egg quality declines, affecting the…
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…

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.

165 answers

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