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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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214 answers

Uterine & Endometrial Health

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Infertility Basics Dec 13, 2023

ERA and EMMA and ALICE tests

Hi there, I am a 41-year-old trying to decide whether to do an ERA and EMMA and ALICE tests ahead of my next donor egg transfer. I had two high-quality embryos transferred last time from a 20-year-old egg donor, but… — Lorna T.

Dr. Geoffrey Sher answered

• 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 recurring pregnancy losses or underlying issues with the uterus, such…
Uterine & Endometrial Health Dec 12, 2023

ERA question

Dear Dr. Sher, Do you believe in the ERA? We did a modified natural mock cycle. Biopsy was performed at 158.5 hours after a took my trigger shot. I came back at 98 hours receptive. This is so confusing as… — Rachael K.

Dr. Geoffrey Sher answered

The blastocyst and the endometrium are in a constant state of cross-talk. In order for successful implantation to take place, the blastocyst must be at the appropriate stage of development and needs to signal a well synchronized endometrium to ‘accept it”. This dialogue between embryo and endometrium involves…
IVF Failure & Pregnancy Loss Dec 10, 2023

Chemical Pregnancy

TTC 3+ years. One Tube removed from ectopic 17 years ago previous partner. AFC 11. 37years old. Elevated NK cells. 1 failed round of IVF. 3 IUI, 2 of which were recent and I had chemical pregnancy in both. One… — Anneka K.

Dr. Geoffrey Sher answered

Subject to confirmation through further consultation and testing, I believe your history to be highlyb suggestive of an implantation dysfunction (probably) partly or completely due to an immunologic cause. Implantation dysfunction is often overlooked as a significant reason for IVF failure. This is especially true when IVF failure…
Uterine & Endometrial Health Dec 8, 2023

Invitro

Se puede hacer un invitro si tube clamidia y mi utero está inflamado — Karina C.

Dr. Geoffrey Sher answered

Please post your comment/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: 1. From In Vitro Fertilization to Family: A Journey…
Egg Health & Ovarian Reserve Dec 8, 2023

Suspected endometriosis and low AMH.

I have suspected endometriosis and very low ovarian reserve. Should I do a laparoscopy for endometriosis, then PRP therapy to increase my ovarian reserve before I retry IVF? Will this help? My last two attempts at IVF have only ever… — Aqsa G.

Dr. Geoffrey Sher answered

Unless you need surgery because of intractable symptoms or you require surgical treatment of ovarian endometriomas, I would not advocate laparoscopy at all. Your miscarriages could well be due to endometriosis-induced , immunologic implantation dysfunction. When women with endometriosis-related infertility seek treatment, they are often advised to try…
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
Uterine & Endometrial Health Dec 5, 2023

Viagra

For thin lining I am considering trying viagra suppositories. Is there a difference between just using the regular tablet vs. Having it compounded? As info, with just estradiol, my lining seems to max out at about 7.2, hoping based on… — Tasha T.

Dr. Geoffrey Sher answered

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 the uterine lining measured less than 8mm in thickness by the day of…
Uterine & Endometrial Health Nov 30, 2023

Fluid in endometrium before FET

Hello, I am currently on day 14 of taking estrogen in preparation for a FET, but since Day 12, a small mount of fluid has been seen in the lining. The estrogen is working to build the lining an Friday… — Rebecca S.

Dr. Geoffrey Sher answered

In many cases, the fluid will absorb after a few days of progesterone. If it fails to absorb, the FET should be canceled and a hysteroscopy performed to look for a surface lesion in the uterine cavity. Please also note that if the endometrium was
Embryos & Genetic Testing Nov 27, 2023

Miscarriage and Adenomyosis

Hi there I am 39 and since 33 have had recurrent miscarriages. I had two at 6.5 weeks and then a live baby and then 1 at 6.5 weeks that had two trisomies when tested. During that third miscarriage I… — Sophie T.

Dr. Geoffrey Sher answered

Adenomyosis can compromise implantation, but in my opinion this only occurs when the endometrial lining at the time of ovulation, hCG "trigger" or when progesterone treatment begins in cases of FET/embryo adoption etc. In fact in most cases adenomyosis is found in women who have had several babies,…
Uterine & Endometrial Health Nov 22, 2023

Endometrioma treatment

Hi Dr. Sher, I was diagnosed with endometriosis and 2 ovarian endometriomas 2yrs ago after I started having aching in my left pelvis. I’ve been reading PubMed and NIH articles and I’m searching for a doctor who can do the… — Jennifer P.

Dr. Geoffrey Sher answered

I suggest you contact Dr. Aykut Bayrak at LA-IVF Cinic, Century City, CA Sclerotherapy of Ovarian Endometriomas Geoffrey Sher MD The precise mechanism by which ovarian endometrioma causes infertility is unknown. In women with ovarian endometriomas, infertility is potentially associated with a decreased oocyte retrieval rate, reduced oocyte…
Uterine & Endometrial Health Nov 17, 2023

endometrioma

Hello, I am trying to conceive and have been told the issue is I have a 5cm endometrioma. I am hoping to have this aspirated before starting any treatments. I do not want surgery to remove it as they want… — Danille M.

Dr. Geoffrey Sher answered

Advanced endometriosis is often associated with ovarian endometriotic cysts, known as endometriomas. In my opinion, such cysts, if numerous or sizable (>1cm) can and often do activate the surrounding ovarian connective tissue to locally produce excessive amounts of male hormones such as testosterone. This effect can often not…
Uterine & Endometrial Health Nov 17, 2023

Endometrial Hyperplasia

Hi Dr Sher I’m 43 year old woman with PCOS and Type 2 Diabetes and have endometrial hyperplasia atypia. My doctor initially recommend a hysterectomy but I would like to have a family. I realise I will likely require IVF… — Lou M.

Dr. Geoffrey Sher answered

The commonest form of EH in women with PCOS is cystic glandular hyperplasia and this is not commonly associated with atypia and is not premalignant. It can be suppressed with progestational therapy and alone does not preclude pregnancy. Another form of hyperplasia that sometimes occurs with PCOSi s…
Uterine & Endometrial Health Nov 10, 2023

First Dose of Progesterone in Oil

Hello. I am 45 and I am days away from medicated FET. I did a mock FET first, and then I was cancelled during my last FET round (right at the end) because I ovulated. So I waited, scheduled a… — Michelle R.

Dr. Geoffrey Sher answered

In my opinion, your errors were minor and in any case, you apparently corrected for them in a timely manner. I do not think you have compromised your chances at all! Good luck! Geoff Sher
Uterine & Endometrial Health Nov 7, 2023

Viagra

When is best time to start and stop Viagra through vigaina. — Okeoma N.

Dr. Geoffrey Sher answered

THE IMPACT OF A THIN UTERINE LINING ON EMBRYO IMPLANTATION: THE BENEFITS OF VIAGRA THERAPY Geoffrey Sher MD 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.…
Immunology & Implantation Oct 31, 2023

NK cell activation – endometriosis

My NK results from Fertilysis Greece came back within range but I read on this blog that sometimes women with endometriosis can have NK results that appear normal when they are in fact very elevated. I’m not sure if the… — Lucy T.

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 interaction…

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.

214 answers

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