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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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Embryos & Genetic Testing Nov 2, 2023

embryo adoption

nd can use own eggs/embryos. I am a current patient. 2 failed ivf. High NK. Myself and husband have 2 variants of MTHFR I did intralipids in both. I was wondering if we would have better chances if we used… — Shontae S.

Dr. Geoffrey Sher answered

No, I do not think you need to go on Lovenox and use own eggs/embryos. Hereditary Clotting Defects (Thrombophilia) Geoffrey Sher MD 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…
Immunology & Implantation Oct 31, 2023

NK cell activation – endometriosis

My NK results from Fertilysis Greece came back within range but I read on this blog that sometimes women with endometriosis can have NK results that appear normal when they are in fact very elevated. I’m not sure if the… — Lucy T.

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…
Immunology & Implantation Oct 20, 2023

Pregnancy and Reproductive Immunology Protocol

Hello! I'm so grateful to come across this generous offering to answer questions :) I am 36 years old and currently 5W, 2D (gestational sac measures 5W, 5D). Natural pregnancy, B-HCG numbers strongly doubling. I have an RE in Chicago… — Tara S.

Dr. Geoffrey Sher answered

Ideally treatment for NKa+ should commence >10days prior to embryo transfer and be combined with a steroid (prednisone or dexamethasone). Starting this late might not work! I was the first to recommend IVIG for NKa+ and it works well but it is a blood product, it is very…
Embryos & Genetic Testing Oct 18, 2023

SET vs. DET

I read through your website in your opinion of how many embryos to transfer. Would your recommendation change in the case of multiple failed euploid transfers in someone under 35? I have done all of the recommended testing and have… — Tasha T.

Dr. Geoffrey Sher answered

If multiple euploid embryo transfers have failed, you likely have an implantation dysfunction and it wont matter whether you transfer 1 or 2 embryos...outcome would be the same. What is needed is ti identify and address the cause of the implantation failure (see below). IVF FAILURE WITH “NORMAL”…
Immunology & Implantation Oct 12, 2023

Hashimotos and IVF

Hi there, I have high TPO antibodies (around 300) and now about to embark on our IVF journey in a few weeks. It seems that I have POI and I'm 27 years old. I am currently on 100mg of Levothyroxine… — Georgina H.

Dr. Geoffrey Sher answered

Between 2% and 5% of women in their childbearing years deal with hypothyroidism, a condition that affects women more than men. This issue with the thyroid often leads to difficulties in getting pregnant or maintaining a pregnancy. Hypothyroidism in women often happens because the immune system attacks the…
Hormones & Ovulation Oct 9, 2023

Do Intralipids in IVF cause weight gain

I am 37, have low egg count and poor egg quality in the last 3 egg retreivals. There is mild adenomyosis and possible endometrioma on my scans. I don’t have any known autoimmune conditions. My fertility specialist feels I might… — Michaela T.

Dr. Geoffrey Sher answered

It should not cause weight gain. Geoff Sher Herewith are online links to 2 E-books recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your reading pleasure: 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…
Immunology & Implantation Oct 6, 2023

Reproductive Immunologist?

Hello there, and thank you for your generosity with responses and for publishing so many valuable resources! After RPL and testing high for immunoglobulin E, my IVF clinic is suggesting we enlist prednisone and lovenox as a means to prevent… — Sl T.

Dr. Geoffrey Sher answered

I was one of the pioneers into the field of ART-related reproductive immunology. Feel free to call my assistant, Patti Conve3rse (702-533-2691 to set up a consultation with me at your convenience. A RATIONAL BASIS FOR MANAGEMENT OF IMMUNOLOGIC CAUSES OF EMBRYO IMPLANTATION DYSFUNCTION Geoffrey Sher MD In…
Early Pregnancy & hCG Sep 26, 2023

LMWH injection

Dear dr. Sher! I have a question about Clexane. I'm 17 weeks pregnant, I've been injecting 0.4 clexane since the beginning, I started at about 67 kg and gained about 3 kg so far. I am on immune therapy due… — Timi G.

Dr. Geoffrey Sher answered

In my opinion, in the absence oft certain thrombophilias, or a history of thromboembolism, heparin therapy for suspected immunologic implantation dysfunction (IID) s rarely required beyond the 10th week. In the world of assisted reproduction, when IVF fails repeatedly or without explanation, it's often assumed that poor embryo…
Immunology & Implantation Sep 25, 2023

Reproductive Immunology/RPL

Hi there, I just turned 42 w an AMH of 1.33-1.71 and have been undergoing IVF treatments for over three years with some success - I was pregnant twice, both unviable and resulting in two D&Cs. This is in addition… — Shian T.

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…
Immunology & Implantation Sep 17, 2023

Positive APS and ANA antibodies

Good evening from the uk. We have 9 donor Sperm embryos frozen. 1, biochemical pregnancy and 2 failed transfers. (4AA biochemical, 4AB failed to implant, 5AA failed to implant. Had APS blood test and came back positive. Been put on… — Annabel M.

Dr. Geoffrey Sher answered

This is highly suggestive of an 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 endo-uterine surface lesions, thin…
Egg Health & Ovarian Reserve Sep 9, 2023

Low AMH

Dear Dr. Sher, I am 36-year-old, planning an IVF in a couple of months, but AMH today shows low 1.01 ng/ml. Do I have good chances? Planning to go through egg pooling, NGS and 1 embryo transfer. I want to… — Ola C.

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…
Early Pregnancy & hCG Sep 4, 2023

Failed euploid transfer

Dear dr Sher, Thank you so much giving me the option to ask you a question! I’m very curious about what your differential diagnosis/following steps would be. I’m 34 years old and we have been dealing with unexplained infertility for… — Eline L.

Dr. Geoffrey Sher answered

In my opinion, this sounds very much like an implantation dysfunction. >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> IVF FAILURE WITH “NORMAL” EMBRYOS: EXAMINING AND ADDRESSING ANATOMICAL AND IMMUNOLOGIC CAUSES. Geoffrey Sher MD Implantation dysfunction is often overlooked as a significant reason for IVF failure. This is especially true when IVF failure is unexplained,…
Embryos & Genetic Testing Aug 23, 2023

Slow Freeze Donated Embryos

Hi Dr Sher, My husband and I are using donated embryos from a clinic program after 8 rounds of failed IVF due to low AMH 0.19 & diminished ovarian reserve. I have endometriomas in my ovaries and am now 44… — Naz C.

Dr. Geoffrey Sher answered

It is important to understand that endometriosis can be associated with an autoimmune, immunologic implantation dysfunction in about 30% of cases (regardless of its severity). This should, in my opinion, be thoroughly evaluated before transferring any more of these embryos! In the world of assisted reproduction, when IVF…
Immunology & Implantation Aug 21, 2023

Endo and Lupron

Hello, I scored 1.8 on the Receptiva test, and had a laparoscopy two weeks ago that revealed pelvic and bowel adhesions, and a blocked tube (all likely caused by a past silent infection - not from endo?). They also found… — Mel P.

Dr. Geoffrey Sher answered

I personally do not advocate long acting Lupron for treating endometriosis-related infertility. When women with infertility due to endometriosis seek treatment, they are all too often advised to first try ovarian stimulation (ovulation Induction) with intrauterine insemination (IUI) ………as if to say that this would be just as…
Immunology & Implantation Aug 15, 2023

Lovenox for homogenous MTHFR 677CT

Hello, I am currently 18 weeks pregnant following a fresh IVF transfer. Would you advise that I stay on lovenox 0.4 during the whole pregnancy since I have the following genetic mutations? - homogenous MTHFR 677CT - heterozygous PAI 4G/5G… — Kim D.

Dr. Geoffrey Sher answered

Yes! You will need Lovenox throughout pregnancy and until the 6th week post-delivery. Respectfully, I am not pro-using progesterone throughout pregnancy. 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…

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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