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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 6 of 68

Egg Health & Ovarian Reserve May 29, 2025

Stimulation protocols for DOR in 45 yr old

I'm trying to write up the protocol outlined in one of your recent videos with the egg whisper to take to my Dr. whom is going to do my next cycle. We've started the HGH and we did the PRP… — Ariane B.

Dr. Geoffrey Sher answered

I would never presume tom tell your doctor what to do with regard to your stimulation. I can tell you that regardless of protocol, the chance of propagating euploid ("competent") eggs at 45y is very slim (!:2o eggs or so will end up being viable). Obviously if in…
Embryos & Genetic Testing May 29, 2025

Slow frozen

Dear Dr Sher! We have a patient who has 6 slow-frozen embryos. She wants to donated them to another family. WE attempted to find a recipient family for her; however, most fertility clinics do not want to accept slow frozen… — Alena W.

Dr. Geoffrey Sher answered

If they were frozen on day-3...indeed you could do that. But if they were frozen as blastocysts, the thaw-biopsy-refreeze can damage the embryos. Good luck Geoff Sher ADDITIONAL INFORMATION: Herewith are online links to 2 E-books recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your…
Immunology & Implantation May 29, 2025

Dexamethasone for FET

What would be the reason for using Dexamethasone (short 5 day course) leading up to FET vs using Prednisone? I feel like prednisone is more commonly prescribed for this purpose, but my doctor said there is no difference. I recently… — Renee G.

Dr. Geoffrey Sher answered

The two are by and large interchangeable. The steroid administration should start at the beginning of the cycle and continue to the 10th week. It should then be tailed off over 2 weeks. Geoff Sher _ In the world of assisted reproduction, when IVF fails repeatedly or without…
Early Pregnancy & hCG May 8, 2025

LIT in pregnancy

Hi Dr, My partner and I are a partial DQ Alpha match so had 2x LIT treatment, one before transfer and one at 6 weeks and ongoing intralipids bi-weekly. I am currently 15 weeks pregnant with scans looking good. I… — Victoria L.

Dr. Geoffrey Sher answered

UNDERSTANDING RECURRENT PREGNANCY LOSS ( RPL): CAUSES AND SOLUTIONS. When it comes to reproduction, humans face challenges compared to other mammals. A significant number of fertilized eggs in humans do not result in live births, with up to 75% failing to develop, and around 30% of pregnancies ending…
Immunology & Implantation May 8, 2025

Implantation Failure – BCL6, immature nk cells & APS

Hello Dr, After multiple implantation failure, I was diagnosed with anti-phospholipid syndrom (managed with daily asprin and in case of pregnancy clexane) but also high inflammation marker BCL6 (though no endometriosis) and immature NK cells / low local immune activation… — Kate F.

Dr. Geoffrey Sher answered

I have strong suspicion that you have an immunologic implantation dysfunction. 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…
Egg Health & Ovarian Reserve Apr 27, 2025

Lack of maturation of eggs in stimulation cycle

Dear Dr. Sher, I just watched your video on egg maturation and learned more than I have in over a year of reading and asking questions on this. My question also relates to egg maturation but specifically on why eggs… — Laura C.

Dr. Geoffrey Sher answered

When confronted with such an exaggerated response, doctors often trigger egg maturation by cutting the cycle short through triggering early. While this protects against OHSS, the eggs are oft yet not ready for maturation. This leads mto "poor egg yield and quality . Second, in such cases doctors…
Early Pregnancy & hCG Apr 27, 2025

betaHCG

Dear Dr.Sher, I have a missed miscarriage last year and I am pregnant again 6 weeks. My betas were doubling nice until they crossed the 10000 and drop from 53 h DT to 108 DT. At this point I am… — Alice D.

Dr. Geoffrey Sher answered

I am not overly concerned. The le3vels often tail off somewhat around this time. Do an US confirmation ASAP. Good luck! Geoff Sher
Early Pregnancy & hCG Apr 27, 2025

Mold/mycotoxin antibodies

Hi! I have a history of recurrent miscarriage but also have 2 living children. I’ve been exposed to mold in the past so had recent testing done. Many of my IgE antibodies to mold/mycotoxins were high, suggesting a current mold… — Sarah R.

Dr. Geoffrey Sher answered

I honestly doubt that this is what has caused your miscarriages,. But discuss it with your primarybcare OB/GYN. Geoff Sher
Hormones & Ovulation Apr 27, 2025

TSH

Hello, I was wondering what the recommended parameters are for TSH level prior to FET. My most recent TSH level was 4.01, just wondering if these are good numbers for going into transfer. I’m 35 and low AMH(0.98). Just want… — Maria S.

Dr. Geoffrey Sher answered

Your elevated TSH could indicate an underlying hypothyyroid state which could be due to an autoimmune condition andf your low AMH points towards iminished ovarian reserve (DOR: 1. Thyroid Autoimmunity (TAI) & Immunologic Implantation Dysfunction (IID) Between 2% and 5% of women of the childbearing age have reduced…
Early Pregnancy & hCG Apr 27, 2025

To know much about my IVF journey

Thank you for receive me, what if my LH level is higher (15,45 mIU/ml on Day 3 of menstrual cycle — Paola U.

Dr. Geoffrey Sher answered

I would need much more information. If you would like to discuss your case with me , email my assistant (702-533-2691 and set up an online consultation with me,
Egg Health & Ovarian Reserve Apr 27, 2025

Empty folicals

Hi, I'm on my first round of ivf due to same sex relationship. Im from the UK. I have just had my first egg retrieval and I'm bitterly disappointed with the amount of egg they collected. I'm 37, amh 14.1,… — Katie M.

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…
Ovarian Stimulation & OHSS Apr 10, 2025

FxPOI

Any advise would be appreciated for my 2 daughters recently diagnosed with fxpoi. 30 year old tried 2 cycles, the first down regulated before starting stims, range of doses were tried and a follicle slowly grew but was empty at… — Simone H.

Dr. Geoffrey Sher answered

I would need to consult directly with your daughters re ovarian stimulation. If you are interested, please reach outv to my assistant, Patti Converse (702-533-2691 ). Below is an article I wrote on Fragile-X FYI. Fragile X syndrome: Which IVF Candidates Should be Tested and How Should Results…
Early Pregnancy & hCG Apr 1, 2025

FET

Hi Dr Sher I’m 38 y/o and and going through fertility treatment using donor sperm. I have just had an unsuccessful fresh ICSI embryo transfer (6 eggs retrieved, 6 fertilised, grade A embryo transferred, 3 embryos frozen grades B B… — Liz D.

Dr. Geoffrey Sher answered

I Thank you for sharing your IVF treatment details. From what you’ve described, you are 38 years old and have recently undergone your second IVF cycle, during which three cleaved embryos of reasonable quality were transferred, but unfortunately, conception did not occur. In your first cycle, a single…
IVF Failure & Pregnancy Loss Apr 1, 2025

MOLAR PREGNANCY PREVENTION

MY WIFE HAD 2 CONSECUTIVE COMPLETE MOLAR PREGANANCIES AT AGE 24 AND 25. THEN SHE APPROACHED IVF, AND RETURNED A MALE EMBRYO BASED ON DR. SHER'S ARRICLE IN 2016 AS SOLUTION TO PREVENT A COMPLETE MOLE. MY QUESTION NOW, IS… — Ahmad A.

Dr. Geoffrey Sher answered

Not to my knowledge! Sorry! Geoff Sher
Uterine & Endometrial Health Apr 1, 2025

Sclerotherapy

I am looking for a clinic that can perform sclerotherapy for endometrioma treatment. Is this something that you offer? — Jessica L.

Dr. Geoffrey Sher answered

I don' think it is available presently. WE used to use Tetracycline hydrochloride 5%...cant get it any longer. 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.

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