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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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Page 46 of 68

Ovarian Stimulation & OHSS May 30, 2023

Fertility

I've done fertility treatment before. Two rounds of letrozole. Wanted to try another round of letrozole — Takida H.

Dr. Geoffrey Sher answered

Perhaps we should talk first. 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) “ http://sherfertilitysolutions.com/sher-fertility-solutions-ebook.pdf “Recurrent Pregnancy Loss and…
Hormones & Ovulation May 30, 2023

Clomid

Hello, I was treated with Clomid day 5-9 and I am 36 years old. I failed to get pregnant 5 months and was prescribed this because of pcos. At the ultrasound at 12 days I had 4 mm endometrium and… — Erin K.

Dr. Geoffrey Sher answered

Clomiphene citrate (Clomid, Serophene) is the most popular agent used for inducing ovulation and in the 1980’s was also the most widely used method for COH in preparation for In Vitro Fertilization (IVF). Clomiphene citrate is a synthetic hormone that deceives the hypothalamus into thinking that the body's…
Embryos & Genetic Testing May 30, 2023

Day 5 Early Blasts

Hi Dr. Sher, I just received my day 5 call and the nurse said I have 14 early blasts (and one more developing). Is this good news or should they all have reached blastocyst stage by now? Is it likely… — Alysha G.

Dr. Geoffrey Sher answered

As long as they reach expanded blastocyst stage by day 6, you should still be OK Good luck! 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 30, 2023

IVF with low ovarian reserve

Hello, I am 40 yr old female with low ovarian reserve. I responded poorly to my first protocol OCP/antagonist. That cycle was cancelled and I was restarted on estrogen priming antagonist protocol with clomid and omnitrope adjuncts. I cleared my… — Amanda M.

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 May 30, 2023

ZP1 mutation

Dr Sher My doctor says I have to undergo genetic testing to confirm if I have ZP1 mutation. My blood works and hormone level are within normal range. She says the eggs are killed before retrieval as there is abnormal/no… — Rana A.

Dr. Geoffrey Sher answered

Perhaps we should talk before you proceed along those lines . 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…
Egg Health & Ovarian Reserve May 30, 2023

To IVF again or not…

Aloha Dr. Sher! I just finished a second IVF cycle that was a total failure. I just turned 41, AMH .6, FSH 15, AFC 5. I had three follicles that were 17-20 at trigger but only retrieved one egg that… — Katie W.

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…
IVF Failure & Pregnancy Loss May 30, 2023

Recurring chemical pregnancies

Dear doctor, I want to ask you about recurrimg pregnencies I have been faced with over a year now. I just had a third one with the same scenario like the previous ones. In week 4 I sudenly lose the… — Šejla 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…
Immunology & Implantation May 30, 2023

Hashimoto’s & Repeat Implantation Failure

Hi Dr. Sher, I am on the verge of giving up. I have just gone through 4 failed egg donor transfers. I have Hashimotos, so for the last 2 transfers my doctor put me on Prednisone, low dose aspirin, Neupogen,… — Shannon B.

Dr. Geoffrey Sher answered

_ Between 2% and 5% of women of the childbearing age have reduced thyroid hormone activity (hypothyroidism). Women with hypothyroidism often manifest with reproductive failure i.e. infertility, unexplained (often repeated) IVF failure, or recurrent pregnancy loss (RPL). The condition is 5-10 times more common in women than in…
Egg Health & Ovarian Reserve May 30, 2023

Infertility

I had stimulation done and during it it had antral follicles growing and got to 21,19 15,13 on day 11 ,with a high dose of 4501u ,on day 11 it was stepped down to 225iu as I complained of feeling… — Abigail R.

Dr. Geoffrey Sher answered

__ 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 ovarian stimulation. My experience is that the use of individualized/customized COS protocols can greatly improve…
Early Pregnancy & hCG May 30, 2023

Beta-HCG rise

I tested positive 9 days post ovulation. On the day of my expected period, I did a blood test and got 82 miu/ml, I was scheduled for a second test because of my previous miscarriages, I went in for my… — Buthaina E.

Dr. Geoffrey Sher answered

Repeat the test at 2 day intervals 1 or 2 times to see if the hCG starts to double again...and reads below: 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…
Embryos & Genetic Testing May 30, 2023

Agnes Buczek/Brogowska Follow up to visit

Good morning Dr. Tortoriello, I am just following up to our last visit. I am wondering if the blood results came back in and also I received a Horizon Advanced Screening kit and I was wondering if that was an… — Agnes B.

Dr. Geoffrey Sher answered

Please call Patti at 702-533-2691 to discuss and get clarification. Geoff Sher
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,…

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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