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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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137 answers

Immunology & Implantation

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Immunology & Implantation Aug 21, 2023

Endo and Lupron

Hello, I scored 1.8 on the Receptiva test, and had a laparoscopy two weeks ago that revealed pelvic and bowel adhesions, and a blocked tube (all likely caused by a past silent infection - not from endo?). They also found… — Mel P.

Dr. Geoffrey Sher answered

I personally do not advocate long acting Lupron for treating endometriosis-related infertility. 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 (IUI) ………as if to say that this would be just as…
Immunology & Implantation Aug 15, 2023

Lovenox for homogenous MTHFR 677CT

Hello, I am currently 18 weeks pregnant following a fresh IVF transfer. Would you advise that I stay on lovenox 0.4 during the whole pregnancy since I have the following genetic mutations? - homogenous MTHFR 677CT - heterozygous PAI 4G/5G… — Kim D.

Dr. Geoffrey Sher answered

Yes! You will need Lovenox throughout pregnancy and until the 6th week post-delivery. Respectfully, I am not pro-using progesterone throughout pregnancy. 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…
Immunology & Implantation Aug 11, 2023

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…
Immunology & Implantation Aug 7, 2023

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…
Immunology & Implantation Aug 5, 2023

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…
Embryos & Genetic Testing Aug 5, 2023

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…
Embryos & Genetic Testing Aug 5, 2023

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.…
Immunology & Implantation Jul 22, 2023

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.…
Egg Health & Ovarian Reserve Jul 22, 2023

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…
Embryos & Genetic Testing Jul 22, 2023

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…
Hormones & Ovulation Jul 6, 2023

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…
Embryos & Genetic Testing Jun 29, 2023

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…
Egg Health & Ovarian Reserve Jun 17, 2023

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…
Embryos & Genetic Testing Jun 14, 2023

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…
Embryos & Genetic Testing Jun 5, 2023

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…

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.

137 answers

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