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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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Page 53 of 68

Hormones & Ovulation Apr 3, 2023

Infertility

Hi doctor, I am 30 years old, I have been diagnosed as PCOS , I received 12 cycle ovulation induction by clomid and letroze ,I did not conceived, last time I did ICSI , they told me that the eggs… — Sary A.

Dr. Geoffrey Sher answered

Polycystic ovary syndrome (PCOS) is a common hormonal system disorder among women affecting between 5% and 10% of women of reproductive age worldwide. Women with PCOS may have enlarged ovaries that contain small collections of fluid — called follicles — located in each ovary as seen during an…
Ovarian Stimulation & OHSS Apr 3, 2023

Ivf medicine

I just began estrogen priming I took my estrogen patch I mistakenly took the leuproliide instead of the fyramodel when I realized it was the wrong injection I took the fyramadel will this effect the process — Tamamiea J.

Dr. Geoffrey Sher answered

I do not believe that one transgression will impact your cycle. Good Luck! Geoff Sher ADDITIONAL INFORMATION: I am attaching online links to two E-books which I recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your reading pleasure: 1.From In Vitro Fertilization to Family: A…
Embryos & Genetic Testing Apr 3, 2023

Ivf

PGS tested Ivf failed — Amna S.

Dr. Geoffrey Sher answered

Embryo karyotype (as assessed by PGS/PGT) is a very important determinant of "competency" (the ability to propagate a viable pregnancy) but it is by no means the only factor! Whenever a patient fails to achieve a viable pregnancy following embryo transfer (ET), the first question asked is why!…
Egg Health & Ovarian Reserve Apr 2, 2023

AMH and AFC

Good Morning. I am 31 and have a hormonal IUD. I had fertility testing done and my AMH came back as 0.18 however my AFC was 16. Estrogen 88 and FSH 2.35. I don’t know where I was in my… — Ashley H.

Dr. Geoffrey Sher answered

Your AFC, your age and your basal FSH all suggest to me that the AMH value might not br accurate. I would definitely repeat it!~ Good luck! Geoff Sher ADDITIONAL INFORMATION: I am attaching online links to two E-books which I recently co-authored with my partner at SFS-NY…
Early Pregnancy & hCG Mar 31, 2023

Early pregnancy test

I made a hcg test 5 days before my period and it was positive ( my last period was 1 of march and it is irregular but my last periods last in average 31 days and ovulation is happened at… — Salma O.

Dr. Geoffrey Sher answered

Regrettably! , this does not sound like a viable pregnancy! I hope I am wrong! Geoff Sher Measuring and interpreting Blood hCG to Assess Pregnancy Viability Following ART Treatments. Geoffrey Sher MD I know of no medical announcement associated with the degree of emotional anticipation and anguish as…
Early Pregnancy & hCG Mar 31, 2023

Gestation

If my HCG levels are 67777mlu/58mL how many weeks would I be? — Katrina R.

Dr. Geoffrey Sher answered

Measuring and interpreting Blood hCG to Assess Pregnancy Viability Following ART Treatments. Geoffrey Sher MD I know of no medical announcement associated with the degree of emotional anticipation and anguish as that associated with a pending diagnosis/confirmation of pregnancy following infertility treatment. In fact, hardly a day goes…
Egg Health & Ovarian Reserve Mar 31, 2023

Success at 43

Hello! I have recently turned 43 and wondering whether to keep trying IVF. Have done 5 cycles in the past 12 months. AMH is 30 and AFC ~35. But, only get around 7-12 eggs at a time and poor fertilisation… — Kristy D.

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,…
Embryos & Genetic Testing Mar 30, 2023

Monosomy

I have an embryo that has a monosomy but I would like to transfer it. I have had two clinics refuse to transfer. Specifically I have a 45 XX (-14) I figured it’s incompatible with life if results are accurate… — Charity H.

Dr. Geoffrey Sher answered

Human embryo development occurs through a process that encompasses reprogramming, sequential cleavage divisions and mitotic chromosome segregation and embryonic genome activation. Chromosomal abnormalities may arise during germ cell and/or preimplantation embryo development and represents a major cause of early pregnancy loss. About a decade ago, I and my…
Egg Health & Ovarian Reserve Mar 29, 2023

Genuine Empty Follicle Syndrome

Hello Dr Sher, thank you for your very thorough response. I forgot to mention with my AMH being 15 which is satisfactory for my age do you think I will ever be able to have a child naturally ? Thank… — Laura K.

Dr. Geoffrey Sher answered

Possibly...but I would need much more information to provide an authoritative opinion. Geoff Sher
Egg Health & Ovarian Reserve Mar 29, 2023

Genuine Empty Follicle Syndrome

Hello Dr Sher, thank you for your very thorough response. I forgot to mention with my AMH being 15 which is satisfactory for my age do you think I will ever be able to have a child naturally ? Thank… — Laura K.

Dr. Geoffrey Sher answered

Possibly...but I would need much more information to provide an authoritative opinion. Geoff Sher
Egg Health & Ovarian Reserve Mar 28, 2023

Genuine Empty Follicle Syndrome

Hello Dr Sher I have just completed my 2nd ivf which failed due to my 13 follicles in egg collection being empty. The consultant diagnosed me with genuine empty follicle syndrome. I am 36 years old with a AMH of… — Laura K.

Dr. Geoffrey Sher answered

_ Frequently, when following vigorous and often repeated flushing of follicles at egg retrieval they fail to yield eggs, it is ascribed to “Empty Follicle Syndrome.” This is a gross misnomer, because all follicles contain eggs. So why were no eggs retrieved from the follicles? Most likely it…
Uterine & Endometrial Health Mar 28, 2023

Lining Thickness for FET

In 2020 (age 42), we had 2 natural pregnancies at 6-8 weeks and miscarried naturally. In 2021, we tried IVF, we had 2 cycles that gave us 11 embryos, only 1 grew and it was abnormal. In July of 2022,… — Tracy W.

Dr. Geoffrey Sher answered

It was as far back as 1989, when I first published a study that examined the correlation between the thickness of a woman’s uterine lining (the endometrium), and the subsequent successful implantation of embryos in IVF patients. This study revealed that when the uterine lining measured
IVF Failure & Pregnancy Loss Mar 27, 2023

Laparoscopy for endometriosis after failed ivf

Hi Dr. Sher , I have scheduled a robotic assisted laparoscopy to remove the endometriomas off of my ovaries based on your advice last year . My procedure description is “robotic assisted laparoscopy , lysis of adhesions , resection /… — Mindy D.

Dr. Geoffrey Sher answered

I think we should talk! Please call my assistant, Patti Converse at 702-533-2691 and set up an online consultation with me to discuss! When women with infertility due to endometriosis seek treatment, they are all too often advised to first try ovarian stimulation (ovulation Induction) with intrauterine insemination…
Egg Health & Ovarian Reserve Mar 25, 2023

Am I a lost cause?

Dear doctor Sher, I am 33 years old and my husband is 36. After 5 months of trying to conceive (that was back in November 2022), we decided to visit a fertility specialist in Switzerland where we are currently located.… — Alexandra C.

Dr. Geoffrey Sher answered

Hi Alexandra, Yes indeed, based on your AMH blood level, you have prematurely developed diminished ovarian reserve (DOR) and this means you have very much reduced egg population (which cannot be replenished) and accordingly will propagate very few follicles. In addition, women with DOR often have an adverse…
Hormones & Ovulation Mar 24, 2023

2 failed cycles, No transfer

Hi Dr Sher I’m a 30 year old living in London. I have had 2 IVF cycles, but after both, all embryos stopped growing after 2-3 days post egg retrieval. I was also told I have mild PCO in my… — Abi S.

Dr. Geoffrey Sher answered

Very respectfully, this is not likely to be a uniform genetic issue. More than likely ity has to do with the protocol used for ovarian stimulation (see below). The importance of the IVF stimulation protocol on egg/embryo quality cannot be overstated. This factor seems often to be overlooked…

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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