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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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Egg Health & Ovarian Reserve Jan 10, 2024

Unexplained infertility

Greetings! I am a 39yo f, pmhx prolactinoma (dx 1/2023, medically managed now), ulcerative proctitis (on stelara, almost in remission) with 1 natural conception and loss at 8 weeks due to trisomy, now 3 failed IVF stim attempts. My AMH… — Lindsey A.

Dr. Geoffrey Sher answered

In my opinion, we need to have a detailed online consultation to discuss the following issues in detail: 1. Egg/embryo quality issues: and the influence of the protocol used for ovarian stimulation as well as diminishing ovarian reserve and advancing age.. 2. Implantation dysfunction as it might relate…
Ovarian Stimulation & OHSS Jan 8, 2024

Sobre la estimulación ovarica

Doctor ayúdeme tengo miedo de haber malogrado mi estimulación ovarica, en mi última inyección que era de ovidrel de 250, no supe ponérmela la inyecte dos veces porque no había puesto la dosis correcta y me di cuenta después de… — Isa F.

Dr. Geoffrey Sher answered

Please re-post this in English and I will respond promptly! Geoff Sher
Early Pregnancy & hCG Jan 2, 2024

withdrawal bleeding during estrogen and progesteron supplementation a week after FET

Dear Dr.Sher. I am an ENT doctor from Europe. I am diagnosed with PCOS and I have amenorrhea and no ovulation at all. One year ago my fertility doctor prescribed me Letrozol, because I wanted to conceive. Not only that… — Maria K.

Dr. Geoffrey Sher answered

It could be an implantation dysfunction due to another thin endometrium (endometrial insufficiency, 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 when…
IUI & Insemination Dec 20, 2023

Seeking advice – IUI + letrozole

Hi Dr. Sher, I listened to the podcast on IUI with you and Dr. Aimee, the egg whisperer and I wanted to reach out to you in hopes of seeking your advice. I am a 34 year old who is… — Mallory F.

Dr. Geoffrey Sher answered

My bigger concern is that you might have an immunologic inmmplantation dysfunction and if so , IUI alone wont bve effective. This could explain your losses too. Between 2% and 5% of women in their childbearing years deal with hypothyroidism, a condition that affects women more than men.…
Egg Health & Ovarian Reserve Dec 11, 2023

Stimulation poor responder

Advice on stimulation proctol please. Background: I’m 36y, normal BMI, pelvic and bowel endometriosis (lap confirmed and excised), high activated NK cells, persistently raised cardiolipin IgM titre, 3+ yr history primary infertility.5 failed embryo transfers. I did have brief chemical… — Maya G.

Dr. Geoffrey Sher answered

A. Understanding the impact of age and ovarian reserve on the success of in vitro fertilization (IVF) is crucial when it comes to reproductive health. This article aims to simplify and clarify these concepts, emphasizing their significance in the selection of ovarian stimulation protocols for IVF. By providing…
Egg Health & Ovarian Reserve Dec 11, 2023

Mistake on one dosage

Hi Dr Sher, On the 5th day of my FSH treatment with Gonal-F only, I made a mistake and used Pergoveris instead of Gonal-F (same dosage), It's the same follitropin alfa, but I am afraid of the LH surge, that… — Jennifer S.

Dr. Geoffrey Sher answered

I don't think it will be a problem. I would not cancel...but discuss with your own RE. Geoff Sher PLEASE SHARE THIS WITH OTHERS AND HELP SPREAD THE WORD!! Herewith are online links to 2 E-books recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your…
Hormones & Ovulation Dec 8, 2023

Ovidrel dosage on low BMI

Dear Dr. Sher, I am low BMI. Should I do 500mcg hCGr for trigger or is 250mcg enough? Thanks again for all the help, A.C. — Anne C.

Dr. Geoffrey Sher answered

500mcg Ovidrel! Geoff Sher PLEASE SHARE THIS WITH OTHERS AND HELP SPREAD THE WORD!! Herewith are online links to 2 E-books 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…
Egg Health & Ovarian Reserve Dec 7, 2023

Omnitrope dosage

Dear Dr. Sher, Should Omnitrope continue to be taken on the day of the trigger and the next day, all the way till egg retrieval day, or stop two days before, when FSH stops? And what's the optimal dosage? Thanks… — Anne C.

Dr. Geoffrey Sher answered

No! It stops on the day of the "trigger". Good luck! Geoff Sher PLEASE SHARE THIS WITH OTHERS AND HELP SPREAD THE WORD!! Herewith are online links to 2 E-books recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your reading pleasure: 1. From In Vitro…
Egg Health & Ovarian Reserve Dec 7, 2023

Empty follicles

I am currently 33 years old and have already had 3 ICSIs. However, the first one was 5 years ago. Last year I stimulated for 2 days with 375 Gonal f and 75 Menopur and then with 225 Gonal f… — Monika O.

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 Dec 5, 2023

Endometrial cavity fluid

I’ve had ECF ever since a d&c and forcep removal of rpoc in Jan 2022. I’ve taken prophylactic abx, hysteroscopy with loa and normal lap, 2.5 months lupron and letrozole for adeno. Failed medicated FET. 1) should I do a… — Arielle M.

Dr. Geoffrey Sher answered

There is too much here to discuss with a short response. We should talk. If you are interested in having an online consultation with me, please contact my assistant, Patti Converse at 702-533-2691 or email her at
Egg Health & Ovarian Reserve Nov 30, 2023

Autoimmune Protocol

Hi Dr Sher I have recently discovered your work and am curious if you think I should pursue an autoimmune protocol for IVF. I'm 40 years old and have undergone 2 unsuccessful cycles of IVF this year. I have been… — Jen M.

Dr. Geoffrey Sher answered

The fact that you have conceived before does not rule out an immunologic implantation dysfunction (IID). If so, you endometriosis and hypothyroid states would favor an autoimmune IID rather than alloimmune. However since treatment differs for each of these, a diagnosis is imperative. Your diminished ovarian reserve merely…
Egg Health & Ovarian Reserve Nov 20, 2023

Protocolo para preservación

He realizado mi primer ciclo para vitrificar ovulos, sin embargo de 5 fólicos que han engordado sólo se ha podido obtener un óvulo maduro. Tengo 37 años y AMH de 0,33. En la ecografía se observaban 10 folículos. El tratamiento… — Maria M.

Dr. Geoffrey Sher answered

Please re-post your question in English! Geoff Sher PLEASE SHARE THIS WITH OTHERS AND HELP SPREAD THE WORD!! Herewith are online links to 2 E-books recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your reading pleasure: From In Vitro Fertilization to Family: A Journey with…
Egg Health & Ovarian Reserve Nov 20, 2023

Protocolo DOR

Primero agradecer su trabajo. Le escribo para saber según su opinión ¿Cuál es el mejor protocolo de medicamentos para una estimulación ovárica para mi con 37 años y 0,3 de antimulleriana? Con otras respuestas no consigo entender día a día… — Laura S.

Dr. Geoffrey Sher answered

Please post in English! Understanding the impact of age and ovarian reserve on the success of in vitro fertilization (IVF) is crucial when it comes to reproductive health. This article aims to simplify and clarify these concepts, emphasizing their significance in the selection of ovarian stimulation protocols for…
Ovarian Stimulation & OHSS Nov 17, 2023

Agonist/Antagonist Conversion Protocol (A/ACP):

Hello Dr Sher I’m 42 years old with an AMH of 4.4 pmol/L. How many units of Lupron/Puregon/Menopur /HGH would you recommend for me in this type of protocol? — Elizabeth M.

Dr. Geoffrey Sher answered

WE should talk! There are too many other factors to be considered! ADDRESSING ADVANCING AGE AND DIMINISHING OVARIAN RESERVE (DOR) IN IVF Geoffrey Sher MD Understanding the impact of age and ovarian reserve on the success of in vitro fertilization (IVF) is crucial when it comes to reproductive…
Egg Health & Ovarian Reserve Nov 13, 2023

Empty Follicle Syndrome

Hello- I was diagnosed with DOR at age 29 with AMH 0.3 (AMH stable x 3yr, FSH ~12), otherwise no reproductive abnormalities for myself or my husband. Over the past 2yr, I have completed 12 rounds of IVF - the… — Jen C.

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.…

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.

225 answers

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