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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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214 answers

Uterine & Endometrial Health

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Uterine & Endometrial Health Mar 11, 2024

Immature oocyte during endometriosis

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 Mar 4, 2024

Thin endometrium luteal phase

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 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…
Uterine & Endometrial Health Feb 23, 2024

Re: progesterone level before FET transfer

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 Jan 29, 2024

DQ-Alpha match & positive receptiva post lap

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 Jan 25, 2024

Atretic eggs

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 Jan 23, 2024

Endometrioma Sclerotherapy

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 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…
Embryos & Genetic Testing Jan 22, 2024

Abnormally tested embryos

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 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
Uterine & Endometrial Health Dec 15, 2023

Polypectomy

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…
Uterine & Endometrial Health Dec 15, 2023

Endometrioma cyst

Hello:) I have an endometrioma cyst on my right ovary the drs want to do laparoscopy surgery but it runs the risk of getting good ovarian tissue and since I only have the right ovary I don’t want to do… — Lizeth C.

Dr. Geoffrey Sher answered

It is excellent alternative but unfortunately the medication needed to be injected into the cyst is no longer available. I wish I could help you! Geoff Sher Here is an article I wrote some time ago! • Effect of Advanced Endometriosis with Endometriotic cysts (Endometriomas) on IVF Outcome…
Uterine & Endometrial Health Dec 14, 2023

Sclerotherapy

Hello Dr. Sher, I'm a 31 year old married G0 recently diagnosed with bilateral endometriomas: left 1.8x1.4 cm, right 9.8x8.4 cm. Currently on Lo Loestrin as treatment. I have never attempted to conceive but am very worried about future fertility… — Cotter C.

Dr. Geoffrey Sher answered

I no longer have access to a facility where this procedure can be performed and I do not know who to refer you to? Sorry! 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.

214 answers

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