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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

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Dr. Geoffrey Sher

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Hormones & Ovulation Jul 6, 2023

Positive ANA and thyroid

I am currently undergoing IVF for PCOS, an ovulation. My first cycle I collected 26 eggs, 24 of which were mature and all fertilised and ended up with 12 day 5 blastocysts only 1 of low quality. First FET resulted… — Rebecca 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…
Hormones & Ovulation Jul 6, 2023

High E2 day 2

Hi Dr Sher, I got covid during my ivf cycle last month, so had to cancel D9 after taking corifollitropan alfa D3. I got my period early on D19 (usually have 28 day cycle) and my D2 E2 is 138… — Jess L.

Dr. Geoffrey Sher answered

Yes! It is very often due to a folliclular cyst! It should absorb in time. Alternatively it can be aspirated under local, trans-vaginally and the level will drop....Good luck! ADDITIONAL INFORMATION: I am attaching online links to two E-books which I recently co-authored with my partner at SFS-NY…
Early Pregnancy & hCG Jul 6, 2023

HCG TEST AFTER IUI

I HAVE MY IUI PROCEDURE ON 14 JUNE 2023. ON 27 JUNE 2023, I DID MY HCG TEST AND IT READS AS 74 mUL/ml. ON 01 JULY 2023, I DID MY SECONG HCG TEST AND IT READS AS 303.10 mUL/ml.… — Yeshna L.

Dr. Geoffrey Sher answered

Looks great to me! Good luck! Geoff Sher ADDITIONAL INFORMATION: I am attaching online links to two E-books which I recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your reading pleasure: 1.From In Vitro Fertilization to Family: A Journey with Sher Fertility Solutions (SFS) “…
Egg Health & Ovarian Reserve Jul 3, 2023

Synarel and DHEA

Hi, I have been a responding best to the long protocol where I start with Synarel on day 21. Because of low testosterone I’ve been taking DHEA for the last weeks. I read that DHEA can cause an increase in… — Linda B.

Dr. Geoffrey Sher answered

Synarel is a GnRH agonist. It is administered nasally. As such, absorption sometimes erratic. I prefer Lupron or decapeptyl which are administered intramuscularly. Dehydroepiandrosterone (DHEA), is steroid hormone produced by the adrenal glands and ovary. It is involved in producing the male hormones, androstenedione testosterone and also estrogen.…
Egg Health & Ovarian Reserve Jul 2, 2023

Human Growth Hormone Administration in IVF

Hi, very interesting article. I was using this hormone in my IVF treatment but I did not get results. It was administered one month before the egg retrieval and only for 30 days. Could this be the cause of it… — Alejandra G.

Dr. Geoffrey Sher answered

No! You (in my opinion) do not need to take the HGH for long. My patients start a week before ovarian stimulation commences. ADDITIONAL INFORMATION: I am attaching online links to two E-books which I recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your reading…
Early Pregnancy & hCG Jul 2, 2023

Hcg

Dear dr. Shed, I have 2 questions about my pregnancy. I have concerns about my Hcg levels which are rising higher than normal in 48h. At 4+2 weeks HCG is 2856. Is it normal? Are there any exact HCG result… — Timi G.

Dr. Geoffrey Sher answered

I don't think attending a concert will prejudice your pregnancy! Going through IVF is a major investment, emotionally, physically, and financially, for every patient or couple. One of the most crucial moments is receiving the result of the blood test for human chorionic gonadotropin (hCG) pregnancy. It's a…
Egg Health & Ovarian Reserve Jul 2, 2023

Empty follicles

Hi dear doctorI hope you are well ,why my All my three follicles was empty I used controlled ovarian stimulation thanks a lot — Feriba E.

Dr. Geoffrey Sher answered

Frequently, when following vigorous and often repeated flushing of follicles at egg retrieval they fail to yield eggs, it is ascribed to “Empty Follicle Syndrome.” This is a gross misnomer, because all follicles contain eggs. So why were no eggs retrieved from the follicles? Most likely it was…
Embryos & Genetic Testing Jun 29, 2023

PGT-A

Dear Dr. Sher, I recently underwent IVF, resulting in 2 complex aneuploid embryos - one with Trisomy 11 and 21 and the other with Monosomoy 15, 18, 19 and 22. No mitoscore values were reported. Is it worth considering transfer… — Vess V.

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…
Embryos & Genetic Testing Jun 29, 2023

When Should I Stop Lovenox?

Hi Dr. Sher, I am 41 years old and I am currently 8 weeks and 5 days pregnant through IVF and I need a second opinion when to stop Lovenox. Just to provide some background, I had two failed embryo… — Lena M.

Dr. Geoffrey Sher answered

I would continue all the way through pregnancy and the 1st 6 weeks thereafter. Thrombophilia (Hereditary Clotting Defect) is defined as the genetic predisposition to developing intravascular thrombosis. It is due to hypercoagulability of blood leading to impairment of initial vascularization that takes place during implantation. Thrombophilia affects…
Early Pregnancy & hCG Jun 29, 2023

HCG doubling question

Dear Dr. Sher, I would like to ask about my hcg blood test results. It was not only doubled but fourfold in 48h. On Monday I had 220,9 nmol and 2 days later that was 996 nmol. Does it mean… — Timea H.

Dr. Geoffrey Sher answered

No ! It looks good! Going through IVF is a major investment, emotionally, physically, and financially, for every patient or couple. One of the most crucial moments is receiving the result of the blood test for human chorionic gonadotropin (hCG) pregnancy. It's a big deal! The days after…
Hormones & Ovulation Jun 29, 2023

Multiple miscarriages

Dear Dr. Sher, I would like to ask you, if there is any possibility to "prevent" a miscarriage, or help my body to deliver a baby overall. Or any of your ideas just to help somehow. I'm 29 and in… — Ludmila K.

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…
Egg Health & Ovarian Reserve Jun 29, 2023

Please Help!

Dear Dr. Sehr, I’m almost 37 years old AMH 1,08 (measured under the pill, last measurement 09/21 was 3,5) Husband has OAT3, used zymot last Icsi. Had 4 ICSIs, 7 transfers, one MMC 9weeks, one MC six weeks. Last four… — Jana S.

Dr. Geoffrey Sher answered

I very respectfully disagree with your RE who informed you that only the best morphologic embryos should be biopsied. I also disagree with the use of "flare" (short)-DR protocols for women with diminished ovarian reserve (DOR). The journey of in vitro fertilization can be a rollercoaster of emotions…
Hormones & Ovulation Jun 28, 2023

Estrogen Priming in IVF

Hi Dr. I'm 39 with amh of 0.3 and going through my 3rd ivf cycle. Because of lab availability for PGS they are looking at delaying my priming and injections, starting my priming on CD19 (my cycle is 24 days)… — Yasmin G.

Dr. Geoffrey Sher answered

There are different philosophies regarding ovarian stimulation protocols. Of one thing I personally have no doubt about and that is that the protocol used needs to be tailored to the individual. I wish I could advise you directly but to do so I would need much more information.…
Egg Health & Ovarian Reserve Jun 27, 2023

Improving Maturity Rates and Blastocyst Development Rate

Hi Dr. Sher, I've been through 8 IVF cycles with two separate clinics. Overall, despite changes to protocols, I've encountered the same issues. The first issue is that, though my ovaries produce a good number of oocytes, not enough of… — J C.

Dr. Geoffrey Sher answered

I think we should talk. Please call my assistant, Patti Converse at 702-533-2691 and set up an online consultation with me. In the interim, please read the articles that I have written...below. A: EGG/ EMBRYO QUALITY IN IVF & HOW SELECTION OF THE IDEAL PROTOCOL FOR OVARIAN STIMULATION…
Ovarian Stimulation & OHSS Jun 26, 2023

IVF Antihistamine Protocol – FET for Endo

Hi Dr. Sher, I am a 34F, underwent IVF for UI/suspected endo (I have painful periods and hyperechoic cysts, which are 1-2 occasionally, that come and go on my ovaries). I did a Gonal F protocol with Luveris, Ovidril Trigger,… — Crystal B.

Dr. Geoffrey Sher answered

I am not in favor of natural cycle FET's. In my opinion, it is better to pinpoint the ideal window for implantation with hormonal preparation. Here is the protocol I use: IVF FET Protocol Until less than a decade ago, most women undergoing IVF would have embryos transferred…

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.

980 answers

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