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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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Egg Health & Ovarian Reserve Mar 6, 2024

Follicular cyst and FSH stimulation

Dear Dr. Sher, I am 43 years old and am trying for the last time, after five unsuccessful attempts (I have reached the euploid stage before). This time I have 9 antral follicles, but I also have a follicular cyst.… — Anne C.

Dr. Geoffrey Sher answered

I see no reason not to proceed with the cycle! Geoff Sher PLEASE SHARE THIS WITH OTHERS AND HELP SPREAD THE WORD!! 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…
Ovarian Stimulation & OHSS Mar 4, 2024

Irresponsive endometrium after Lupron

Hi Dr Geoffrey, I’ve been dealing with fertility issues for years (endometriosis, fibroids) and last year, after two unsuccessful embryo transfers (of genetically normal embryos), I decided to have a laparoscopy surgery to treat the endometriosis and remove the intramural… — Carolina G.

Dr. Geoffrey Sher answered

Asherman Syndrome is a medical condition characterized by severe intrauterine adhesions, also known as synechiae. These adhesions can cause significant damage to the basal layer of the endometrium, the part of the uterus responsible for developing the uterine lining (endometrium) under the influence of hormones like estrogen and…
IVF Failure & Pregnancy Loss Mar 4, 2024

Next Steps

aI am a 36 y.o. female with PCOS. I have had 2 miscarriages at 6 weeks (1 from an IVF transfer recently and 1 from letrozole round several years ago) , and 2 failed IVF transfers that failed to implant.… — Christy L.

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…
IVF Failure & Pregnancy Loss Feb 25, 2024

Recurrent Implantation Failure

Hello! I am a 24 y.o. female, Gravida 0, AMH 0.2-0.8, four failed IUI’s, and now 4 failed transfers with 5 embryos never implanting. I’ve done two ERA’s (both postreceptive at 96 and 72 hours) but we’ve ignored these results… — Delaney D.

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…
Egg Health & Ovarian Reserve Feb 25, 2024

Egg Retrieval with Immature Eggs

I got 29 eggs during my egg retrieval but was told that only 5 were mature. I am trying to understand why my maturity rate was so low. I triggered when 10+ follicles were at 20mm, and many at 18mm.… — Stephanie T.

Dr. Geoffrey Sher answered

Embarking on the journey of IVF often raises questions about the likelihood of success and the quality of embryos. While it’s challenging to predict outcomes due to various factors, there’s hope and information to guide you. Firstly, the key to fertilization potential lies in the chromosomal integrity of…
Ovarian Stimulation & OHSS Feb 21, 2024

What is the likelihood of my pregnancy succeeding

I had my first blood test done my levels are around 57 and they couldnt see anything on an ultrasound they had me wait 4 days to do repeat testing and my numbers are only at 71 — Shelby N.

Dr. Geoffrey Sher answered

This is a slow rise and the likelihood is that the pregnancy will not survive! However, repeat th hCG test in 2 days to see if it doubles as it should. So sorry! Going through IVF is a major investment, emotionally, physically, and financially, for every patient or…
Egg Health & Ovarian Reserve Feb 20, 2024

IVF consultation

1.3, 2.1cm Trigger was 10000 IU Gonasi HP (hCG) and on day 11. Only 1 mature egg was retrieved, and fertilised using ICSI. My day 3 update is a slow growing embryo of 3 cells with some fragmentation. I don't… — Vessie V.

Dr. Geoffrey Sher answered

"Empowering Choices: Embryo Banking vs. Egg Banking for Fertility Preservation" It's crucial for women to make informed decisions about preserving their fertility. Delaying trying to conceive, relying on egg freezing, or assuming the biological clock can be paused are misconceptions. As women age, egg quality declines, affecting the…
Egg Health & Ovarian Reserve Feb 16, 2024

Stimulation Protocol for Severe DOR

I'm 40 about to turn 41 with what's been described as severe DOR, amh is dropping fast. 2 years ago it was .22, last april .08 and this past test (after my stimulation complications) it's now .03. Last year I… — Private

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 Feb 16, 2024

High TNF alpha

What is the recommended transfer protocol for someone with high TNF Alpha. I was given prednisone but it did not work. Prior to transfer it was 45.0 and I was prescribed 25mg prednisone for a month but it increased to… — Private

Dr. Geoffrey Sher answered

Elevated TNF alpha indicates activated natural killer cell activity. A RATIONAL BASIS FOR MANAGEMENT OF IMMUNOLOGIC CAUSES OF EMBRYO IMPLANTATION DYSFUNCTION 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…
Ovarian Stimulation & OHSS Feb 14, 2024

Suggested ivf protocol

Dear doctor Sher I am a 44.5 femal, suffering from secondary repeated miscarriages due to alloiimunity (dq-alpha gene match + extremly elevated nk cells). Right now I am going through the 7th miscarriage. I had the 6th miscarriage on October… — Irit B.

Dr. Geoffrey Sher answered

Clearly you are a candidate for gestational surrogacy, provided that you have competent, euploid embryos available to transfer. Using a gestational surrogate for transfer of such a blastocyst, is pretty straight forward. Most IVF programs that do FET can advise appropriately. However, be sure that the blastocyst transferred…
Hormones & Ovulation Feb 6, 2024

Failed ivf cycle

Hello doctor; i am 32 yo female, amh 1.59 ng/ml. Partner 32 years old with varicocele, 0 morphology and very low count. (Impossible to check for dna fragmentation) I am Insulin resistant, on metformin 750 for 5 months now with… — Nino K.

Dr. Geoffrey Sher answered

There clearly is both male factor infertility and diminished ovarian reserve (DOR). Both issues need to be thoroughly evaluated and addressed. The cause of the male factor will need further testing and the DOR requires a very individualized approach to ovarian stimulation...(see below). I strongly suggest that you…
Embryos & Genetic Testing Jan 22, 2024

IVF Question

I'm almost 40 y/o. I've had 4 failed IUIs and two egg retrievals, resulting in only 1 euploid from 47 total eggs retrieved. My fertilization and blast rates are "average" to above average, but my maturity rates are very low.… — Jessica W.

Dr. Geoffrey Sher answered

"Empowering Choices: Embryo Banking vs. Egg Banking for Fertility Preservation" It's crucial for women to make informed decisions about preserving their fertility. Delaying trying to conceive, relying on egg freezing, or assuming the biological clock can be paused are misconceptions. As women age, egg quality declines, affecting the…
Age & Fertility Jan 16, 2024

Question regarding EFS

Hello. I hope you are well, Dr. Sher. In the rate event that you are reading this, I wanted to see if I might be able to receive your insight. I have just completed my first attempt at egg retrieval… — Kristin B.

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…
Age & Fertility Jan 11, 2024

Fiv

Hola. Tengo 40 años y 0,73 Amh. Me sometí q un ciclo fiv con fostipur 300 y meriofert 150, luego cetrotide, me quedé embarazada pero lo perdí. Me han realizado otro ciclo pero me incluyeron femara y progynova y quitaron… — Rj C.

Dr. Geoffrey Sher answered

Please post in English!
Ovarian Stimulation & OHSS Jan 10, 2024

Inflammation

Hi Dr. Sher, I had a hscore of 3.4 on Receptiva dx but had a lap done afterwards that showed 0 endometriosis. Why should I lower estrogen with Lupron if there is no endometriosis? — Crystal M.

Dr. Geoffrey Sher answered

Respectfully, I do not see a reason! Geoff Sher

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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