– Geoffrey Sher, MD
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FYI - the website Metropolitan Acupuncture and the phone number separately listed on other sites do not function. Looking forward to hearing from you. Rita Raftery — Rita R.
Dr. Geoffrey Sher answered
Sorry, I don't get the issue here?
Age & Fertility
Hello Dr Sher I have diminished ovarian reserve. My AMH 2 yrs ago was 0.36. Its likely even lower now :( I have been a poor responder to high dose IVF with gonal-f (450 units) and menopur 150 units. Prior… — Yvette R.
Dr. Geoffrey Sher answered
It is primarily the egg (rather than the sperm) that determines the chromosomal integrity (karyotype) of the embryo, the most important determinant of egg/embryo competency”. A “competent” egg is therefore one that has a normal karyotype and has the best potential to propagate a “competent” embryo. In turn,…
IVF Failure & Pregnancy Loss
Hi Dr Sher. I'm 33 yrs old, and my husband is 40. I developed uterine scarring in 2019 after a D&C from an incomplete miscarriage. I was cleared to try again after several hysteroscopies. After 2 failed IVFs, I finally… — Rashida J.
Dr. Geoffrey Sher answered
I agree with you! Clearly you had post=pregnancy endometritis that compromised the basal (germinal layer) of you endometrium. This could absolutely explain your implantation dysfunction.Unfortunate, this kind of injury is often refractory to treatment but it is worth a try with vaginal Viagra and Estradiol to see if…
Egg Health & Ovarian Reserve
Hi Dr Sher, we are a couple aged 35 and 34. We had 2 natural pregnancies which resulted in first trimester miscarriages. We later found out that my husband has balanced translocation and I have low amh of about 0.8ng/ml… — Sofia C.
Dr. Geoffrey Sher answered
Whenever a patient fails to achieve a viable pregnancy following embryo transfer (ET), the first question asked is why! Was it simply due to, bad luck?, How likely is the failure to recur in future attempts and what can be done differently, to avoid it happening next time?.…
Male Infertility
Hello, I am a 38 year old woman who just completed a failed round of IVF today. I live in Canada and wonder if we don't have the IVF advancements perhaps as there is in the USA. I am healthy,… — Kristyn W.
Dr. Geoffrey Sher answered
Whenever a patient fails to achieve a viable pregnancy following embryo transfer (ET), the first question asked is why! Was it simply due to, bad luck?, How likely is the failure to recur in future attempts and what can be done differently, to avoid it happening next time?.…
Egg Health & Ovarian Reserve
Hello, I had a failed IVF cycle. I am 34, healthy (No smoking, healthy diet, yoga 3 times a week), BMI 22 and doing IVF due to male infertility reasons. My Dr gave me the short protocol, my body responded… — Rana N.
Dr. Geoffrey Sher answered
I do not believe that this is likely to be due to an intrinsic egg issue. It is likely due to the type of protocol used and/or the type and typing/dosage/timing of the "trigger". We really need to talk. I suggest you call my assistant, Patti Converse at…
Third-Party Reproduction
I had my first egg donor transfer at 43 years old and it was successful. Had a c-section with no complications. Now I am 47 years old and wanted to try once more. This time I have had 4 transfer… — Alicia C.
Dr. Geoffrey Sher answered
It is possible that with established menopause, the chronically low estradiol has suppressed endometrial estrogen receptors, rendering the lining refractory to short-term estrogen stimulation. In my opinion you s might try a few months of cyclical estrogen/progesterone therapy to try and prime the endometrium (reawaken estrogen receptor response).…
Egg Health & Ovarian Reserve
n online consultation with me to discuss.Hello, I'm almost 39yo with an amh of 0.3 and 6 follicles at baseline. Trying for a second child. Started a max dose ivf antagonist protocol and responded really fast, 7 days of stim… — Yasmin G.
Dr. Geoffrey Sher answered
Respectfully, In my opinion neither mini-IVF nor clomiphene is good in women with diminished ovarian reserve. It is primarily the egg (rather than the sperm) that determines the chromosomal integrity (karyotype) of the embryo, the most important determinant of egg/embryo competency”. A “competent” egg is therefore one that…
Egg Health & Ovarian Reserve
Hello Dr Sher. I am a 34 yo F with spouse 43 yo M. G0P0, dx with unexplained infertility. BMI 22, no PMH and no male factors based on SA. Placed on levothyroxine during initial work up to bring TSH… — Aradhna S.
Dr. Geoffrey Sher answered
I think we should talk! Please consider calling my assistant, Patti Converse at 702-533-2691 and setting up an online consultation with me to discuss your case in detail.: One of the commonest questions asked by patients undergoing IVF relates to the likelihood of their eggs fertilizing and the…
Immunology & Implantation
I have had several miscarriages the last 2 after IVF but I've never been tested for autoimmune implantation dysfunction even though I have Lupus, Celiac disease, and Rheumatoid arthritis. I have 2 frozen embryos and am 47. My current husband… — Sabrina P.
Dr. Geoffrey Sher answered
When it comes to reproduction, humans are the poorest performers of all mammals. In fact we are so inefficient that up to 75% of fertilized eggs do not produce live births, and up to 30% of pregnancies end up being lost within 10 weeks of conception (in the…
Immunology & Implantation
Hi Dr. Sher, I’m writing you at a complete loss and low point in my treatment. I am 34. My husband is 41. We started to try to conceive when I was age 31 and within 3 months, I became… — Alyssa J.
Dr. Geoffrey Sher answered
There is very likely to be an implantation dysfunction. We should talk. I suggest you call my assistant, Patti Converse (702-533-02691 and set up an online consultation with me. Implantation dysfunction is unfortunately often overlooked as an important cause of IVF failure. In the pursuit of optimizing outcome…
Embryos & Genetic Testing
Dear Dr. Sher, Thank you very much for your prompt response. Maybe I should have told you a bit of my story. I am 37 years old and last year I had 3 abortions (week 7+5, week 5 and week… — Lis A.
Dr. Geoffrey Sher answered
Please contact my assistant Patti (702-533-2691) after the Easter weekend and set up an online consultation with me to discuss in detail. Geoff Sher
Immunology & Implantation
I would like you, please to help me to understand our results from KIR HLA-C test: My KIR: KIR2DL1: positive KIR2DL2: negative KIR2DL3: positive KIR2DL4: positive KIR2DL5: positive KIR2DS1: positive KIR2DS2: negative KIR2DS3: negative KIR2DS4: positive KIR2DS5 : positive KIR3DL1:… — Lis A.
Dr. Geoffrey Sher answered
I am sorry...these are not the tests I would advise/order to look for an alloimmune , immunologic implantation dysfunction. Alone, the results would be of negligible help to me. Geoff Sher In the United States, effective treatment of NK/CTL activation associated with either alloimmune or autoimmune implantation dysfunction…
Ovarian Stimulation & OHSS
Hello Dr. Sher, Further to my question about OHSS…are there any long term implications such as cancer? — Yael G.
Dr. Geoffrey Sher answered
Not to my knowledge! Geoff Sher
Immunology & Implantation
Hello, I am wondering whether I should have intralipids with my next IVF cycle (donor egg). I have Hashimotos and have heard that the soy in intralipids can aggravate Hashimotos. In my last cycle my TSH rose from 1.6 to… — Gemma B.
Dr. Geoffrey Sher answered
__ Between 2% and 5% of women of the childbearing age have reduced thyroid hormone activity (hypothyroidism). Women with hypothyroidism often manifest with reproductive failure i.e. infertility, unexplained (often repeated) IVF failure, or recurrent pregnancy loss (RPL). The condition is 5-10 times more common in women than in…
