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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.

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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165 answers

Egg Health & Ovarian Reserve

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Egg Health & Ovarian Reserve Dec 11, 2023

Stimulation poor responder

Advice on stimulation proctol please. Background: I’m 36y, normal BMI, pelvic and bowel endometriosis (lap confirmed and excised), high activated NK cells, persistently raised cardiolipin IgM titre, 3+ yr history primary infertility.5 failed embryo transfers. I did have brief chemical… — Maya G.

Dr. Geoffrey Sher answered

A. 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…
Egg Health & Ovarian Reserve Dec 11, 2023

Mistake on one dosage

Hi Dr Sher, On the 5th day of my FSH treatment with Gonal-F only, I made a mistake and used Pergoveris instead of Gonal-F (same dosage), It's the same follitropin alfa, but I am afraid of the LH surge, that… — Jennifer S.

Dr. Geoffrey Sher answered

I don't think it will be a problem. I would not cancel...but discuss with your own RE. 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…
Egg Health & Ovarian Reserve Dec 8, 2023

Suspected endometriosis and low AMH.

I have suspected endometriosis and very low ovarian reserve. Should I do a laparoscopy for endometriosis, then PRP therapy to increase my ovarian reserve before I retry IVF? Will this help? My last two attempts at IVF have only ever… — Aqsa G.

Dr. Geoffrey Sher answered

Unless you need surgery because of intractable symptoms or you require surgical treatment of ovarian endometriomas, I would not advocate laparoscopy at all. Your miscarriages could well be due to endometriosis-induced , immunologic implantation dysfunction. When women with endometriosis-related infertility seek treatment, they are often advised to try…
Egg Health & Ovarian Reserve Dec 7, 2023

Omnitrope dosage

Dear Dr. Sher, Should Omnitrope continue to be taken on the day of the trigger and the next day, all the way till egg retrieval day, or stop two days before, when FSH stops? And what's the optimal dosage? Thanks… — Anne C.

Dr. Geoffrey Sher answered

No! It stops on the day of the "trigger". Good luck! 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: 1. From In Vitro…
Egg Health & Ovarian Reserve Dec 7, 2023

Empty follicles

I am currently 33 years old and have already had 3 ICSIs. However, the first one was 5 years ago. Last year I stimulated for 2 days with 375 Gonal f and 75 Menopur and then with 225 Gonal f… — Monika O.

Dr. Geoffrey Sher answered

“Empty Follicle Syndrome" is a misleading term because follicles always contain eggs. However, some eggs may have difficulties detaching and being retrieved. This is more likely to happen when multiple attempts are needed to retrieve an egg from a follicle, indicating the egg may have chromosomal abnormalities. The…
Egg Health & Ovarian Reserve Dec 5, 2023

Positive lads after 4th lit treatment

Dear Dr. Sher, Thank you for your answer. I did take ivig before pregnancy was diagnosed. Took 30g ivig on ovulation and on positive hgc test but it faild to relax my immune system. I refuse to take steroids as… — Irit L.

Dr. Geoffrey Sher answered

I Did 3 lit treatments 1.5 years ago. Lads were negative. After the last pregnancy loss I did the 4th lit. Finally lad became weak positive 40%. Do you think that positive lads gives me a better chance to carry a pregnancy? A: I do not believe this…
Egg Health & Ovarian Reserve Nov 30, 2023

Hipogonadismo hipogonadotrópico

Buenas tardes tras azoospermia y un mes tomando citrato de clomifeno por tener la lsh fsh y testosterona baja me he realizado una analitica y han subido los tres parametros, ¿ eso quiere decir que el seminograba mejorara? Gracias un… — Danie L.

Dr. Geoffrey Sher answered

Please post your inquiry in English! 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: 1. From In Vitro Fertilization to Family: A Journey…
Egg Health & Ovarian Reserve Nov 30, 2023

Autoimmune Protocol

Hi Dr Sher I have recently discovered your work and am curious if you think I should pursue an autoimmune protocol for IVF. I'm 40 years old and have undergone 2 unsuccessful cycles of IVF this year. I have been… — Jen M.

Dr. Geoffrey Sher answered

The fact that you have conceived before does not rule out an immunologic implantation dysfunction (IID). If so, you endometriosis and hypothyroid states would favor an autoimmune IID rather than alloimmune. However since treatment differs for each of these, a diagnosis is imperative. Your diminished ovarian reserve merely…
Egg Health & Ovarian Reserve Nov 27, 2023

preparation for ivf

Dear Dr. George I am a 36-year-old female struggling with fertility issues and preparing for IVF. My recent tests have shown an AMH level of 5 pmol/L in UK units, indicating possible low ovarian reserve. I typically experience late ovulation… — Maria S.

Dr. Geoffrey Sher answered

WHY DID MY IVF FAIL: HOW CAN I OPTIMIZE THE CHANCE OF SUCCEEDING NEXT TIME ROUND Geoffrey Sher MD If you've undergone in vitro fertilization (IVF) and didn't achieve a successful pregnancy, you may be wondering why. It's important to know that IVF outcomes can be unpredictable, but…
Egg Health & Ovarian Reserve Nov 27, 2023

Empty follicles

Hi. I did multiple rounds of egg freezing and two times although 6 follicles showed on ultrasound the lab retrieved just one. The doctor said i should consider donor eggs. I did these procedures in Lebanon and i was wondering… — J H.

Dr. Geoffrey Sher answered

“Empty Follicle Syndrome" is a misleading term because follicles always contain eggs. However, some eggs may have difficulties detaching and being retrieved. This is more likely to happen when multiple attempts are needed to retrieve an egg from a follicle, indicating the egg may have chromosomal abnormalities. The…
Egg Health & Ovarian Reserve Nov 20, 2023

Protocolo para preservación

He realizado mi primer ciclo para vitrificar ovulos, sin embargo de 5 fólicos que han engordado sólo se ha podido obtener un óvulo maduro. Tengo 37 años y AMH de 0,33. En la ecografía se observaban 10 folículos. El tratamiento… — Maria M.

Dr. Geoffrey Sher answered

Please re-post your question in English! 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 Family: A Journey with…
Egg Health & Ovarian Reserve Nov 20, 2023

Protocolo DOR

Primero agradecer su trabajo. Le escribo para saber según su opinión ¿Cuál es el mejor protocolo de medicamentos para una estimulación ovárica para mi con 37 años y 0,3 de antimulleriana? Con otras respuestas no consigo entender día a día… — Laura S.

Dr. Geoffrey Sher answered

Please post in English! 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…
Egg Health & Ovarian Reserve Nov 13, 2023

Empty Follicle Syndrome

Hello- I was diagnosed with DOR at age 29 with AMH 0.3 (AMH stable x 3yr, FSH ~12), otherwise no reproductive abnormalities for myself or my husband. Over the past 2yr, I have completed 12 rounds of IVF - the… — Jen C.

Dr. Geoffrey Sher answered

_ “Empty Follicle Syndrome" is a misleading term because follicles always contain eggs. However, some eggs may have difficulties detaching and being retrieved. This is more likely to happen when multiple attempts are needed to retrieve an egg from a follicle, indicating the egg may have chromosomal abnormalities.…
Egg Health & Ovarian Reserve Nov 11, 2023

Egg quality

Hi, dr. Sher! Is it true, that a quality of eggs can be worse in a second cycle, if you do one stimulation after another? My doctor said I shold wait a month for another stimulation because of that. Thank… — Polona B.

Dr. Geoffrey Sher answered

No! I do not believe so! In my opinion, the most important determinants are age, ovarian reserve and the protocol used for ovarian stimulation. The journey of in vitro fertilization can be a rollercoaster of emotions for many patients. Often times they have to face the harsh reality…
Egg Health & Ovarian Reserve Nov 8, 2023

CAPA-IVM

s ago. Hi! I read about an IVF alternative called CAPA-IVM from this article: https://www.sciencealert.com/ivf-alternative-first-baby-born-in-australia-through-cheaper-safer-fertility-treatment I want to know if you offer this procedure or, if not, can you recommend a place that does it in the US? Thanks! — Liz C.

Dr. Geoffrey Sher answered

CAPA-IVM is Biphasic In-Vitro Maturation. of eggs. It is a technical variation on conventional maturation of early eggs (in vitro maturation) that was introduced in Australia about 4y ago.. It has not taken hold in this country as it does not offer any real advantage , in my…

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.

165 answers

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