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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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  1. Immunology & Implantation

    DQ Alpha testing

    Dear Dr Sher, I am a 33 year old European woman currently TTC. I had my first conception success in 2022, in about 9 months period time and had a pregnancy loss before 8 weeks. Since then I was not… — Elia F.

    Dr. Geoffrey Sher answered

    The complete match is only a problem if in addition you have activated natural killer cells. ...see below. Geoff Shedr In the world of assisted reproduction, when IVF fails repeatedly or without explanation, it's often assumed that poor embryo quality is the main culprit. However, this view oversimplifies…

  2. Immunology & Implantation

    Do you think my problem is immunological?

    Dear Dr Sher, I have a history of 5 natural pregnancies complicated by pre-eclampsia, 2 previous csection births. After my last birth via csection, i have had 3 first trimester miscarriages. I'm now undergoing ivf with donor eggs due to… — Lisa W.

    Dr. Geoffrey Sher answered

    It is indeed possible that you have acquired an immunologic implantation dysfunction. In the world of assisted reproduction, when IVF fails repeatedly or without explanation, it's often assumed that poor embryo quality is the main culprit. However, this view oversimplifies the situation. The process of embryo implantation, which…

  3. Immunology & Implantation

    RE: Recurrent Miscarriages

    Hello Dr. Sher I've been seeing Dr. Paschall here in Franklin TN, I believe she has been speaking with you about my case. I have had 20 missed/miscarriages over a 14 year span with my spouse but I have two… — LaPorche F.

    Dr. Geoffrey Sher answered

    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 within the first 10 weeks (first trimester). Recurrent pregnancy…

  4. Embryos & Genetic Testing

    Repeated Implantation/Loss

    Hi There, I had 12 'healthy' embryos from 2 retrevials . NO natural cycles all with. Progesterone, Esradiol, Prednisone, Baby Aspirin Did 3 transfers for these . 1st failed. - did ERA came back normal. 2nd. B.O. - needed two… — Katrina S.

    Dr. Geoffrey Sher answered

    Implantation dysfunction is unfortunately often overlooked as an important cause of IVF failure. In the pursuit of optimizing outcome with IVF, the clinician has a profound responsibility to meticulously assess and address this important issue if IVF success is to be optimized. This is especially relevant in cases…

  5. Embryos & Genetic Testing

    Do You Offer Reproductive Immunology As A Separate Specialty/Service?

    Hello Dr. Sher, I am a patient working with an IVF Clinic that holds 2 more of my PGT-A Euploid Embryos (using Donor Eggs and my husband's sperm), but we have unfortunately arrived at a crossroads where my smaller clinic… — Deanna T.

    Dr. Geoffrey Sher answered

    Of course we offer the service independent of whether the patient undergoes egg retrieval with us. Geoff Sher In the world of assisted reproduction, when IVF fails repeatedly or without explanation, it's often assumed that poor embryo quality is the main culprit. However, this view oversimplifies the situation.…

  6. Immunology & Implantation

    Treatment for autoimmune issues

    Hello I found your article very interesting and I believe it is relevant to my own fertility situation. What treatments are available for autoimmune disorders causing failure of very early pregnancy? Thanks very much in advance Emma — Emma G.

    Dr. Geoffrey Sher answered

    Treatment Options for Immunologic Implantation Dysfunction (IID): Intralipid (IL) Therapy: IL is a mixture of soybean lipid droplets in water, primarily used for providing nutrition. When administered intravenously, IL supplies essential fatty acids that can activate certain receptors in NK cells, reducing their cytotoxic activity and enhancing implantation.…

  7. Egg Health & Ovarian Reserve

    Sjogren’s Syndrome and Fertility

    Hello Dr Sher, I am currently going through IVF in Phoenix, AZ. I am prepping for my first egg retrieval and I am very concerned that my Sjogren's Syndrome will affect my success and/or, if successful, might cause implantation failure.… — Roma T.

    Dr. Geoffrey Sher answered

    Sjogren Syndrome is likely an autoimmune condition and can be associated with an autoimmune, immunologic implantation dysfunction (IID), in my opinion.See below: In the world of assisted reproduction, when IVF fails repeatedly or without explanation, it's often assumed that poor embryo quality is the main culprit. However, this…

  8. Embryos & Genetic Testing

    Implantation dysfunction

    I saw your interview on THE EGG WISPERER podcast and really appreciated your information and inspiration. We have been trying to conceive for about 6 years now (age 37) with no children, have low AMH (last tested about 18 months… — Ponda C.

    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…

  9. Hormones & Ovulation

    Positive ANA and thyroid

    I am currently undergoing IVF for PCOS, an ovulation. My first cycle I collected 26 eggs, 24 of which were mature and all fertilised and ended up with 12 day 5 blastocysts only 1 of low quality. First FET resulted… — Rebecca M.

    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…

  10. Embryos & Genetic Testing

    When Should I Stop Lovenox?

    Hi Dr. Sher, I am 41 years old and I am currently 8 weeks and 5 days pregnant through IVF and I need a second opinion when to stop Lovenox. Just to provide some background, I had two failed embryo… — Lena M.

    Dr. Geoffrey Sher answered

    I would continue all the way through pregnancy and the 1st 6 weeks thereafter. Thrombophilia (Hereditary Clotting Defect) is defined as the genetic predisposition to developing intravascular thrombosis. It is due to hypercoagulability of blood leading to impairment of initial vascularization that takes place during implantation. Thrombophilia affects…

  11. Egg Health & Ovarian Reserve

    What to do / what not to do

    Hello, I’m 39, low AMH (0.3), Hashimoto (in thyroid med) and had 2 failed IVF’s. What are the do’s and don’ts for moving forward? — Katie H.

    Dr. Geoffrey Sher answered

    The journey of in vitro fertilization can be a rollercoaster of emotions for many patients. Often times they have to face the harsh reality that the number and quality of eggs retrieved has fallen short of their expectations. Then, should fertilization of these eggs not propagate chromosomally normal…

  12. Embryos & Genetic Testing

    IVF

    Hi, I'm 33, ttc for 2.5 years and no joy. Progressive sperm — Maggie C.

    Dr. Geoffrey Sher answered

    think we should talk. Please call my assistant, Patti Converse (702-533-2691) and set up ,an online consultation to discuss. 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…

  13. Embryos & Genetic Testing

    Ivf

    Unexplained infertility I underwent failed frozen transfer 5 times with 7 blastocyst. However conceived in the 1st fet with day 3 embryo. Did hysteroscopic.No issues found in uterus. Husband sperm also good However,i did test my auto immune(ANA) out of… — Jes J.

    Dr. Geoffrey Sher answered

    _ In the world of assisted reproduction, when IVF fails repeatedly or without explanation, it's often assumed that poor embryo quality is the main culprit. However, this view oversimplifies the situation. The process of embryo implantation, which begins about six or seven days after fertilization, involves a complex…

  14. Immunology & Implantation

    Prednisone

    When is the standard timeline to wean off of prednisone? — K M.

    Dr. Geoffrey Sher answered

    10 weeks! 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 Journey with Sher Fertility Solutions (SFS) “ http://sherfertilitysolutions.com/sher-fertility-solutions-ebook.pdf “Recurrent Pregnancy Loss…

  15. Immunology & Implantation

    Hashimoto’s & Repeat Implantation Failure

    Hi Dr. Sher, I am on the verge of giving up. I have just gone through 4 failed egg donor transfers. I have Hashimotos, so for the last 2 transfers my doctor put me on Prednisone, low dose aspirin, Neupogen,… — Shannon 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…

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