– Geoffrey Sher, MD
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Uterine & Endometrial Health
Hello, I have multiple ovarian Endometriomas. I was wondering if you offer sclerotherapy? How far are you booking out? I already have diminished ovarian reserve. Would having this done hurt my reserve more? — Lindsey W.
Dr. Geoffrey Sher answered
I am no longer offering this because the ideal sclerosant (tetracycline hydrochloride) is no longer accessible. So,sorry. GS
Embryos & Genetic Testing
Hello Dr. Sher at my current clinic I have gone through 4 transfers with PGT-A normal embryos. My first transfer resulted in a chemical pregnancy, but the following transfers did not implant at all. The tests I have done are… — Ashley P.
Dr. Geoffrey Sher answered
In my opinion this is almost certainly an implantation dysfunction. Bear in mind that in 30% of cases, endometriosis is associated with an immunologic implantation dysfunction. Implantation dysfunction is often overlooked as a significant reason for IVF failure. This is especially true when IVF failure is unexplained, or…
Uterine & Endometrial Health
Hello! I hope i will hear back from you. I was 24 years old during my first ivf. We’ve retrieved 11 oocyte and all of them were immature. During second ivf 6 oocyte 3rd ivf, (long protocol) retrieved 9 oocyte,… — Jesica S.
Dr. Geoffrey Sher answered
I respectfully differ. In my opinion, unless you still have sizable endometriotic cysts (endometriomas) in your ovaries or you have significantly reduced ovarian reserve, I doubt that the endometriosis itself explains your poor egg/embryo quality. Given your young age, I suspect that the protocol used for ovarian stimulation…
Uterine & Endometrial Health
Dear Dr. Sher, Thanks for creating this forum, I really appreciate. My periods are lighter since I gave birth to my daughter 8 months ago (no breastfeeding). My endometrium measured 9.3 mm the day before ovulation, 8.6 mm 2 days… — Alina D.
Dr. Geoffrey Sher answered
It is the thickness of the endometrium pre-ovulation that matters. Good luck! Geoff Sher Back in 1989, I conducted a study that examined how the thickness of a woman's uterine lining, known as the endometrium, affected the successful implantation of embryos in IVF patients. The study revealed that…
Ovarian Stimulation & OHSS
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
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
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…
Uterine & Endometrial Health
Good afternoon Dr. Tortoriello, I'm doing a fifth stimulated frozen embryo transfer due to thin lining issues and now have the best lining I've ever had of 8.7 mm, trilaminar. I expect to do my trigger injection tonight and start… — Eliana G.
Dr. Drew Tortoriello answered
Here is my suggested/personal approach to FET: Two decades ago, when women went through IVF (in vitro fertilization), they usually had their embryos put in the uterus right after the eggs were collected in the same cycle (known as "Fresh" Embryo Transfer). Freezing embryos at that time was…
Embryos & Genetic Testing
I hope you can advise me on the situation below. I had Pregmune testing completed in January 2023. It showed my husband and I have DQ alpha match: DQ Alpha - full match, DQ Beta - partial match, HLA-DRB1 -… — Vilma C.
Dr. Geoffrey Sher answered
From your description, it certainly sounds as if your failures are due to an implantation dysfunction...likely, an immunologic implantation dysfrunction (IID). If so, then you MUST have a concommitant natural killer cell activation (NKa). Even though endometriosis can result in an autoimmune IID, and a matchibng D alpha…
Egg Health & Ovarian Reserve
Good afternoon, I’m posting in English. Thank you very much for your answer. Last April my AMH was 0.04, even though I did my first IVF and got two follicles with two embryos. One of them ended up in a… — Carmen N.
Dr. Geoffrey Sher answered
“EMPTY FOLLICLE SYNDROME” “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…
Uterine & Endometrial Health
Hi, I have a 5cm endometrioma on my right ovary. Do you perform sclerotherapy of these? Thanks — Anusha F.
Dr. Geoffrey Sher answered
I used to, but no longer have access to the sclerosant! Sorry! Geoff Sher 702-533-2691
Embryos & Genetic Testing
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…
Embryos & Genetic Testing
Hi. I have 4 abnormally PGS tested donated embryos. The normally tested ones either didn’t implant or I miscarried. I even did the ERA scratch, and other testing to make sure my uterus was good. Anyway, can abnormal embryos be… — Gina T.
Dr. Geoffrey Sher answered
Abnormal, non-mosaic embryos (aneuploid should not be transferred. IVF FAILURE WITH “NORMAL” EMBRYOS: EXAMINING AND ADDRESSING ANATOMICAL AND IMMUNOLOGIC CAUSES. 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…
Ovarian Stimulation & OHSS
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
Uterine & Endometrial Health
Hi I was trying to do a treatment on another facility I have two frozen embryos. I want to know if I could do the Polypectomy at your office and do my check up on your office. I don’t know… — Tania L.
Dr. Geoffrey Sher answered
Absolutely this can be done. AND it is easy to relocate embryos to us. We do so all the time from all over the world. We in large part help facilitate this for you! G-d bless! Geoff Sher Herewith are online links to 2 E-books recently co-authored with…
