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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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Hormones & Ovulation Mar 24, 2023

2 failed cycles, No transfer

Hi Dr Sher I’m a 30 year old living in London. I have had 2 IVF cycles, but after both, all embryos stopped growing after 2-3 days post egg retrieval. I was also told I have mild PCO in my… — Abi S.

Dr. Geoffrey Sher answered

Very respectfully, this is not likely to be a uniform genetic issue. More than likely ity has to do with the protocol used for ovarian stimulation (see below). The importance of the IVF stimulation protocol on egg/embryo quality cannot be overstated. This factor seems often to be overlooked…
Egg Health & Ovarian Reserve Mar 19, 2023

Hormone levels during IVF

I am 36 years old and only freezing eggs. My AMH was just over 1 ng about a year ago, AFC usually 6-8. I have a long history of stage 4 endometriosis. 1. Could a disproportionately high estrogen to follicle… — Lilly G.

Dr. Geoffrey Sher answered

I do not believe tyhat an E2 of 3000pg/ml at peak, is potentially harmful. This having been said, the protocol used for ovarian stimulation is important, but without much more information in this regard, I cannot comment authoritatively. Av separate issue is the effect of endometriosis on IVF…
Hormones & Ovulation Mar 16, 2023

2 Failed FETs

Hi Dr Sher, first of all thank you for taking the time to read my question. I am 35 years old, and I just had my 2nd failed FET. On both occasions we transferred a 5aa hatching embryo non PGT… — Alisa W.

Dr. Geoffrey Sher answered

I think we should talk. P)lease consider calling my assistant, Patti Converse at 702-533-2691 to set up an online consultation with me. Geoff Sher Whenever a patient fails to achieve a viable pregnancy following embryo transfer (ET), the first question asked is why! Was it simply due to,…
Age & Fertility Mar 16, 2023

Pcos, AMH and menopause?

Hello Dr. I am turning 40 this year and have pcos. Can you explain why my AMH is still very high? 12 years ago it was 10 ng/ml, now it’s 6.85. I also used to have 15 follicles on each… — Amanda B.

Dr. Geoffrey Sher answered

It ism true thatvwo9men with PCOS have an increased risk of developing breast and ovarian cancer. However, this is by no means a great risk. You need to have regular check-up evaluations at least yearly, but I would not become paranoid about this. In the vast majority of…
Hormones & Ovulation Feb 26, 2023

IVF failure 1x

I just went through my 1st IVF transfer on 2/15/23, I have found out I failed. My uterus lining was 9+ , Embryo was 4AA. I am wondering if it’s my natural killer cells. I had Endometriosis and a Septate… — Marisa T.

Dr. Geoffrey Sher answered

Whenever a patient fails to achieve a viable pregnancy following embryo transfer (ET), the first question asked is why! Was it simply due to, bad luck?, How likely is the failure to recur in future attempts and what can be done differently, to avoid it happening next time?.…
Hormones & Ovulation Feb 3, 2023

BMI limit

Is there a bmi limit for IVF treatment? — Christie C.

Dr. Geoffrey Sher answered

Not really! 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) “ http://sherfertilitysolutions.com/sher-fertility-solutions-ebook.pdf “Recurrent Pregnancy Loss and Unexplained…
Hormones & Ovulation Feb 2, 2023

Fertility Inducing Medications

Hello! Do you use BMI as a metric for prescribing fertility inducing medication (Clomid/letrozole)? If so, what is the maximum BMI allowed? Thank you! — Audrey V.

Dr. Geoffrey Sher answered

No! By and large, I do not! 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)…
Hormones & Ovulation Jan 28, 2023

Laparoscopic Surgery or IVF?

I’m 31 with secondary infertility and been trying for 4 years with my husband. Three years ago I was diagnosed with hypothyroidism, hashimotos, pcos (before I was diagnosed I did 5 rounds of letrozle, and one IUI) and now endometriosis?… — Rachel B.

Dr. Geoffrey Sher answered

Unless the laparoscopy is intended to alleviate symptoms by ablating lesions, freeing pelvic adhesions or removing an ovarian endometrioma, I would NOT go that route. I would do IVF. When women with infertility due to endometriosis seek treatment, they are all too often advised to first try ovarian…
Hormones & Ovulation Jan 19, 2023

Trigger using HCG10,000 and Decapeptyl

Hi Dr Sher, my RE has asked me to trigger with both HCG 10,000 and Decapeptyl 1 ml. I find this strange. I understand that Dual Trigger is considered for cases where there might be risk of OHSS, but I… — Jenna H.

Dr. Geoffrey Sher answered

Respectfully, I do agree with you, but this is something you need to discuss with your treating RE “Triggering” Egg Maturation in IVF: Comparing urine-derived hCG, Recombinant DNA-hCG and GnRH-agonist: Geoffrey Sher MD Ideal egg development sets the scene for optimal egg maturation that occurs 36-42h prior to…
Hormones & Ovulation Jan 18, 2023

Dropping LH Levels, no ovulation yet but growing follicles

Hi Dr. I am undergoing a few rounds of cycle monitoring with medicated timed intercourse while I wait for my turn for funded IVF ( I live in Canada). I took Letrozole on days 2-6 of my cycle and went… — Jackie B.

Dr. Geoffrey Sher answered

Letrozole increases blood LH. 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) “ http://sherfertilitysolutions.com/sher-fertility-solutions-ebook.pdf “Recurrent…
Hormones & Ovulation Jan 7, 2023

Clarification on Article

Can I please get clarification on what this means: Churchill and Comstock (2017) conclude:" In our preliminary observations, the non- receptive ERA group had similar live birth rates compared to the receptive ERA group. It appears the majority of the… — Jamie B.

Dr. Geoffrey Sher answered

Endometrial Receptivity Array (ERA): Is There an actual There, There? Geoffrey Sher MD The blastocyst and the endometrium are in a constant state of cross-talk. In order for successful implantation to take place, the blastocyst must be at the appropriate stage of development, and needs to signal a…
Hormones & Ovulation Jan 7, 2023

38 and ovulation infection meds

I’m 38 years old and having difficulty conceiving. I developed Ashermans (moderate) in 2020. I got lysis of adhesions and conceived my daughter shortly after at 36 years old. I ovulate and haven’t regular cycles. My doctor is giving me… — Sarah E.

Dr. Geoffrey Sher answered

Respectfully, . After Ashernan's, endometrial thickness poses a real problem in many cases. In my opinion, Tamoxifen will make matters worse as far as the uterine lining is concerned. Look this up in my book, From In Vitro Fertilization to Family: A Journey with Sher Fertility Solutions (SFS)…
Egg Health & Ovarian Reserve Dec 12, 2022

DHEA & Testosterone Levels

Hello, I am wondering what you thoughts were on my situation. I just turned 39 and I have “lean” pcos. I have one living child conceived 6 years ago through medicated timed intercourse. Since then I have had a few… — Stephanie W.

Dr. Geoffrey Sher answered

Here is an article I wrote on PCOS an IVF: Polycystic ovary syndrome (PCOS) is a common hormonal system disorder among women affecting between 5% and 10% of women of reproductive age worldwide. Women with PCOS may have enlarged ovaries that contain small collections of fluid — called…
Hormones & Ovulation Dec 2, 2022

Infertility/Recurrent loss

Hello Dr. Sher, Thank you for taking the time to answer my questions. I have 1 daughter (age 16) then loss my son at 23 weeks gestation 2 years later, had 3 ectopic pregnancies and 4 chemical pregnancies. I've had… — Janeé B.

Dr. Geoffrey Sher answered

Your underlying PCOS does not explain the losses (chemical or ectopic). You likely have an underlying secondary implantation dysfunction which could be an autoimmune and/or alloimmune, immunologic implantation dysfunction (IID). The presentation suggests that it possibly is more likely the latter. Endometriosis is associated with an IID in…
Hormones & Ovulation Nov 25, 2022

2 IVF failures and 1 cancellation

I’m 36 (insulin resistant & subclinical hypothyroidism + DOR 4.0 pmol) I have been trying for 4.5 years, I have completed two ivf cycles (Gonal F 450 and Menopur 150) First ivf cycle with Testosterone gel, which resulted in 3… — Mychelle G.

Dr. Geoffrey Sher answered

There are several possible factors :Diminished ovarian reserve: Protocol selection for ovarian stimulation; Male factor; egg quality; implantation dysfunction (possibly related to an autoimmune, immunologic implantation dysfunction.(IID) such as Thyroid autoimmune disease and underlying ndometriosis. Obviously I cannot address all these here. I suggest we talk....SO, I invite…

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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