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.

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

Search the answers our doctors have already given

Fill in the following information and we’ll get back to you.

Answers from our doctors

Search 1,006 questions patients have already asked, or narrow them by topic.

137 answers

Immunology & Implantation

Clear all

Embryos & Genetic Testing Mar 4, 2024

Failed donor embryo FET

Hi there, I hope you are well. I had failed pgs tested 3AA embryo donation. Era receptive microbiom recently tested lactobacillus — 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…
Embryos & Genetic Testing Feb 16, 2024

High TNF alpha

What is the recommended transfer protocol for someone with high TNF Alpha. I was given prednisone but it did not work. Prior to transfer it was 45.0 and I was prescribed 25mg prednisone for a month but it increased to… — Private

Dr. Geoffrey Sher answered

Elevated TNF alpha indicates activated natural killer cell activity. A RATIONAL BASIS FOR MANAGEMENT OF IMMUNOLOGIC CAUSES OF EMBRYO 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…
Immunology & Implantation Feb 5, 2024

Natural Conception with NKa and DQa Partial Match

Hello Dr. Sher, I'm hoping you can provide me some insight and comfort. Quick history - I have had 6 early losses prior to 7 weeks over 4 years. After a lot of testing and trials with my RE, we… — Jessica B.

Dr. Geoffrey Sher answered

Anything is possible, and I hope it works out. However, it would be of no value in my opinion, to start with immunotherapy now. Intralipid therapy should be initiated 10-14 days before conception to be of significant help! Good luck and G-d bless! Geoff Sher
Embryos & Genetic Testing Jan 29, 2024

DQ-Alpha match & positive receptiva post lap

I hope you can advise me on the situation below. I had Pregmune testing completed in January 2023. It showed my husband and I have DQ alpha match: DQ Alpha - full match, DQ Beta - partial match, HLA-DRB1 -… — Vilma C.

Dr. Geoffrey Sher answered

From your description, it certainly sounds as if your failures are due to an implantation dysfunction...likely, an immunologic implantation dysfrunction (IID). If so, then you MUST have a concommitant natural killer cell activation (NKa). Even though endometriosis can result in an autoimmune IID, and a matchibng D alpha…
Immunology & Implantation Jan 22, 2024

IVF/Hashimotos

Hi Dr. Sher, I heard you on a recent episode of the Egg Whisperer. I am 35 and I was recently diagnosed with Hashimotos with very high antibodies ( 300 TPO and 900 TgAB). I recently had a failed FET… — Ana K.

Dr. Geoffrey Sher answered

A RATIONAL BASIS FOR MANAGEMENT OF IMMUNOLOGIC CAUSES OF EMBRYO IMPLANTATION DYSFUNCTION Geoffrey Sher MD 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…
Immunology & Implantation Jan 3, 2024

KIR & HLA-C mismatch

Hi Dr Sher, I’m at a crossroads and desperate for advice. I’m 34 and my husband and I did 3 rounds of IVF to bank 4 euploid embryos. While I have low amh/DOR — my euploid rate was 80%. I… — Mel M.

Dr. Geoffrey Sher answered

WE should talk: I suggest you call my assistant, Patti at 702-533-2691 and set up an online consultation with me. 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…
Immunology & Implantation Dec 31, 2023

HLA Matching and Other Immunological Issues

Hi Dr. Sher, I was initially given your name from a friend of mine who had complex fertility issues and great success under your care. I have tested pregnant five times over the past 18 months and either had chemical… — Danielle K.

Dr. Geoffrey Sher answered

This is problematic because you have a total match + NK cell activation. This makes the chance of you carrying your own baby very small regardless of you being treated with LIT/steroids; IVIG/steroids or Intralipid/steroids. We should talk. I suggest you contact my assistant, Patti Converse at702-533-261 and…
Embryos & Genetic Testing Dec 23, 2023

Multiple Chemical Pregnancies

Hi Dr. Sher, This has been a long journey. I did a fresh transfer at 38 (got 18 eggs, 5 to blast stage, but we did not test then), the fresh transfer resulted in a chemical. Had to take some… — Mary R.

Dr. Geoffrey Sher answered

On the face of it, this sounds very much like3 "implantation dysfunction). Implantation dysfunction is often overlooked as a significant reason for IVF failure. This is especially true when IVF failure is unexplained, or when there are recurring pregnancy losses or underlying issues with the uterus, such as…
Immunology & Implantation Dec 20, 2023

FET + Intralipids + Medrol + Heparin = Miscarriage

Hi Dr. Sher, I listened to your podcast on RPL with Dr. Aimee on The Egg Whisperer. I'm 44F, I've had 2 FET's with 2 tested 4AA embryos. Both implanted, both failed to grow. I was on the kitchen sink… — Marissa D.

Dr. Geoffrey Sher answered

WE need to talk. Might I recommend that you call my assistant, Patti Converse at 702-533-2691 to set up an online consultation with me to discuss. Geoff Sher
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…
Embryos & Genetic Testing Nov 30, 2023

Immune System issues

I just had a miscarriage at 5 weeks 4 days of a tested normal embryo 5 day AA PGT . And I tried to get pregnant for over 10 years. I was told I had an immunity disorder years ago,… — Sheyla M.

Dr. Geoffrey Sher answered

Implantation dysfunction is often overlooked as a significant reason for IVF failure. This is especially true when IVF failure is unexplained, or when there are recurring pregnancy losses or underlying issues with the uterus, such as endo-uterine surface lesions, thin uterine lining (endometrium), or immunological factors. IVF success…
Egg Health & Ovarian Reserve Nov 30, 2023

Autoimmune Protocol

Hi Dr Sher I have recently discovered your work and am curious if you think I should pursue an autoimmune protocol for IVF. I'm 40 years old and have undergone 2 unsuccessful cycles of IVF this year. I have been… — Jen M.

Dr. Geoffrey Sher answered

The fact that you have conceived before does not rule out an immunologic implantation dysfunction (IID). If so, you endometriosis and hypothyroid states would favor an autoimmune IID rather than alloimmune. However since treatment differs for each of these, a diagnosis is imperative. Your diminished ovarian reserve merely…
Immunology & Implantation Nov 28, 2023

Repeated miscarriages

Dear Dr. Sher, Just had my 6th miscarriage, natural conception with ivig and lit. I am disgnosed with partial dq-alpha gene match (0301) and elevated nk cells. We have a 4.5 years old son concieved naturaly and easily. My miscarriages… — Irit L.

Dr. Geoffrey Sher answered

Firstly, In order for treatment with IVIG or intralipid to work optimally, it must begin long before pregnancy is established. From your report it sounds as if the IVIG therapy only started after the pregnancy was diagnosed and that is too late. Second, treatment must of necessity also…
Immunology & Implantation Nov 27, 2023

Lmit treatment

Hi my wife and I have a partial dq alpha gene match our first child was Ivf my wife did intralipids and steroids clexane we conceived our son naturally 9 months after our daughter was born and she went back… — Dean W.

Dr. Geoffrey Sher answered

You were very lucky to conceive and have a successful pregnancy without using IVF with your immunotherapy. You are best advised to combine the two for this attempt! IMMUNOLOGIC IMPLANTATION DYSFUNCTION (IID) There is a growing recognition that problems with the immune function in the uterus can lead…
Immunology & Implantation Nov 22, 2023

Dq alpha

Hi my husband and I got told we are a partial match in dq alpha I am 05:05 and he is 05:01 has my doctor made an error as I thought he would have to have the exact same 05:05… — Daniela G.

Dr. Geoffrey Sher answered

No! This is indeed a partial DQ alpha match and is only relevant if in addition to this match, you haver activated natural killer cells: IMMUNOLOGIC IMPLANTATION DYSFUNCTION (IID) There is a growing recognition that problems with the immune function in the uterus can lead to embryo implantation…

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.

137 answers

Location

Follow Us