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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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Dr. Geoffrey Sher

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Egg Health & Ovarian Reserve May 30, 2023

Low maturity rate related to retrieval timing?

Hello - I have gone through 5 rounds of freezing embryos with limited success, primarily due to very low maturity rates of my eggs (~25%). For example, I recently retrieved 27 eggs, similar in size, dr. pushed the size greater… — Rebecca P.

Dr. Geoffrey Sher answered

The problem is far more likely to be related to the protocol used for ovarian stimulation. The importance of the IVF stimulation protocol on egg/embryo quality cannot be overstated. This factor seems often to be overlooked or discounted by t IVF practitioners who use a “one-size-fits-all” approach to…
Hormones & Ovulation May 30, 2023

Implantation issues h

Hi I’m 27 years old with lean pcos. I have had 2 good quality blastocyst transfers, both giving me faint BFP on 5 days past transfer which slowly goes to negative by 12-13 days past transfer. I don’t have endometritis,… — Saira I.

Dr. Geoffrey Sher answered

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 embryo implantation, which begins about six or seven days after fertilization, involves a complex interaction…
Hormones & Ovulation May 30, 2023

Implantation issues h

Hi I’m 27 years old with lean pcos. I have had 2 good quality blastocyst transfers, both giving me faint BFP on 5 days past transfer which slowly goes to negative by 12-13 days past transfer. I don’t have endometritis,… — Saira I.

Dr. Geoffrey Sher answered

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 embryo implantation, which begins about six or seven days after fertilization, involves a complex interaction…
Uterine & Endometrial Health May 30, 2023

Endometrial Lining, Chronic Endometritis and Light Periods

Hi Dr Sher, I am preparing to do a FET this cycle with a modified natural protocol. At my previous appointment my lining was only 5.1 but after 2 days of estrogen it increased to a 7.9 and I used… — Lauren R.

Dr. Geoffrey Sher answered

In my opinion, chronic endometritis as a cause of implantation dysfunction is unlikely. THE IMPACT OF A THIN UTERINE LINING ON EMBRYO IMPLANTATION: THE BENEFITS OF VIAGRA THERAPY Geoffrey Sher MD Back in 1989, I conducted a study that examined how the thickness of a woman's uterine lining,…
Immunology & Implantation May 30, 2023

3rd miscarriage – subchorionic hematoma

Hi Dr Sher, Thanks for all the wonderful work that you do! I've just had my third miscarriage, I have no living children. This was my first IVF pregnancy. Our embryo was genetically tested and I was on an immune… — Beth Y.

Dr. Geoffrey Sher answered

Please be aware that in my opinion for IL/steroids to be of benifit , timing and dosage administration is crucial. The IL must be administered starting 10-14 days prior to embryo transfer. Administration starting just prior to transfer is not helpful. UNDERSTANDING RECURRENT PREGNANCY LOSS ( RPL): CAUSES…
Uterine & Endometrial Health May 24, 2023

Post uterine lining check bleed

Hi Dr. Sher, I finished a uterine lining check mid April for admittance to a refund insurance plan and we got to 9 mm thickness on oral, patch and shot forms of estrogen. This was after a previous mock cycle… — Jessica S.

Dr. Geoffrey Sher answered

I am not sure I fully comprehend what you are telling me. It seems that you are on a natural cycle FET, that t after 6 about days of bleeding you started to experience a clear discharge (probably a sign of an estrogen effect) which is appropriate) which…
Hormones & Ovulation May 24, 2023

Letrozole + HRT for ovulation induction

I am 40-year-old female trying to get pregnant. My estrogen levels and my AMH are rather low and my follicular phase very long of 27 days. Before going for IVF I am trying to improve my ovulation. My gynecologist gave… — Lucie M.

Dr. Geoffrey Sher answered

This is a very unconventional approach that I both do not advocate nor use. The protocol used for ovarian stimulation in women with DOR is very important. Consider the following: It is primarily the egg (rather than the sperm) that determines the chromosomal integrity (karyotype) of the embryo,…
Ovarian Stimulation & OHSS May 24, 2023

IVF protocol

Hello there! I’m currently on my first cycle of IVF after 4 failed attempts of IUI. I have been prescribed 150 units of gonal f, and 75 units of menopur. At my first scan on day 6 of being on… — Steevie D.

Dr. Geoffrey Sher answered

The rate of follicle growth to reach full development is not important here. Rather, it is that they develop fully and that the timing of an adequate hCG trigger is well decided. I cannot respond as to whether or to what extent the dosages should be altered. For…
Male Infertility May 22, 2023

Sperm

Hello Dr. Sher, I just had my egg retrieval on Friday and everything went well other than the fact that I developed mild-moderate OHSS. 25 eggs were retrieved, 18 mature, and of the 18, 16 were fertilized. I just looked… — Evelyn M.

Dr. Geoffrey Sher answered

No, it is not possible to "purify the sperm manually. I know you are cussed on a possible sperm issue. However, it is far more likely to be an underlying ovarian stimulation issue. One of the commonest questions asked by patients undergoing IVF relates to the likelihood of…
Ovarian Stimulation & OHSS May 22, 2023

Egg Retrieval

Hi doctor Sher During my egg retrieval yesterday they only found some cumulus cells no oocytes. What does this mean? Can there be cumulus cells without eggs? — Gauri P.

Dr. Geoffrey Sher answered

There is in my opinion no such entity as “Empty Follicle Syndrome”. All follicles contain eggs. Failure to access those eggs at ER can often be a result of the protocol used for controlled ovarian stimulation (COS. Not infrequently, when following vigorous and often repeated flushing of follicles…
Hormones & Ovulation May 22, 2023

PCOS But regular period

Hi Dr Sher I am diagnosed with pcos but my cycles are regular but I was not able to conceive despite trying for 2 years. After every ovulation my basal body temperature increased and progesterone also increased ( my gynecologist… — Teresa M.

Dr. Geoffrey Sher answered

I need much more information to provide an authoritative response . Please call my assistant, Patti at 702-533-2691 and set op an online consultation with me to discuss. ADDITIONAL INFORMATION: I am attaching online links to two E-books which I recently co-authored with my partner at SFS-NY (Drew…
Uterine & Endometrial Health May 22, 2023

Sclerotherapy for ovarian endometrioma

Hi there, I'm super interested in ethanol sclerotherapy for my ovarian endometriomas as an alternative to laparoscopic surgery. I'd like to book a consultation if possible please? Thanks! — Wencke S.

Dr. Geoffrey Sher answered

We don"t use ethanol, we use tetracycline hydrochloride and unfortunately this is no longer available . Feel free to call my assistant, Patti to set up an online consultation with me to discuss (PH: 702-533-2691) Geoff Sher ADDITIONAL INFORMATION: I am attaching online links to two E-books which…
Uterine & Endometrial Health May 22, 2023

Lining Thickness

We will be transferring an embryo to a GC soon. It is possible for the lining to be TOO thick that the transfer may need to be canceled? I know too think is an issue, but am wondering if too… — Mary P.

Dr. Geoffrey Sher answered

In the absence of endometrial pathology, the lining cannot be too thick to be a problem. 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…
Egg Health & Ovarian Reserve May 22, 2023

Egg quality

I have gone through ovrian drilling for pcos before three months.. m not able to get pregnant and i have quality issue with my eggs how can i improve the quality pls suggest any diet plan — Kitty K.

Dr. Geoffrey Sher answered

There is like more to this than dietary control. I would need to know much more to be authoritative, but women with PCOS need a very individualized approach to ovarian stimulation. We should talk. Call my assistant, Patti (702-533-02691 and set up an online consultation with me to…
Ovarian Stimulation & OHSS May 18, 2023

Overmature Follicles?

Hi Dr. Sher, I am writing to you because I am extremely upset at the negligence of my clinic and am looking for some insight. The clinic upped my meds of rekovelle and menopur and decided to wait 3 days… — Kristin C.

Dr. Geoffrey Sher answered

Of course I cannot say with certainty, but in my experience follicles >22mm will commonly produce poor quality eggs. I believe in triggering when several follicles reach 20-22mm. After this cycle is over, I suggest we talk. If interested, please contact my assistant Patti Converse at 702-533-2691 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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