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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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Dr. Geoffrey Sher

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Ovarian Stimulation & OHSS Nov 20, 2022

IVF protocol meds

Hi, I have already had three cycles of IVF with my last one being the most successful. My protocol was 7 units omnitrope and testosterone gel with norethindrone for a few weeks before stopping norethindrone to start my cycle. I… — Vivian K.

Dr. Geoffrey Sher answered

I just don't know how the replacement of Menopur with low-dosage hCG would stack up as I personally have never used hCG in this way during stimulation. On the face of it it probably would work OK but it would be preferable if you could access other HMG…
Immunology & Implantation Nov 20, 2022

NK cells profile and Th1/Th2 cytokine ratios

Hi Dr Sher, I have recently had some basic immune blood tests, including NK cell profile, NK cell cytotoxicity assay and Th1/Th2 cytokine ratio assay. The results show that my NK percentage was 11.56% and I have significantly raised Th1/Th2… — Anne-Marie D.

Dr. Geoffrey Sher answered

This information alone in isolation, does not provide a basis for implementing selective immunotherapy. I would need to know more. Specifically: 1. Which Reproductive immunology laboratory did the testing? 2. Was the cytokine analysis done on blood or on endometrial biopsy tissue? 3. What was the NK cell…
Egg Health & Ovarian Reserve Nov 19, 2022

Infertility

I am 32, have PCO. I have experienced EFS in all egg collections, medicated and unmedicated. Recently, I found out I have ZP1 homozygous mutation (autosomal recessive) which means maturation oocyte defect. Is there a way to find eggs or… — Andria E.

Dr. Geoffrey Sher answered

There is certainly room for differing opinions her, But I would not go straight to egg donation. There are so many factors that impact egg quality in women with PCOS, but most of them are amenable to treatment using an individualized protocol for ovarian stimulation. Polycystic ovary syndrome…
Hormones & Ovulation Nov 19, 2022

IVF

Dr. Sher, My husband and I are 25 years old and have been trying for 2 years to conceive. I have stage 4 endometriosis, and had our first transfer 10/10 which failed. The protocol I was placed on was just… — Ashleigh G.

Dr. Geoffrey Sher answered

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 likely to result in a baby as would in vitro fertilization (IVF).…
Uterine & Endometrial Health Nov 19, 2022

Cycle cancelled due to thin lining and fluid in endometrium

Thanks for taking the time to provide all this info and answer questions on this blog. It's so very much appreciated. We just had a frozen embryo transfer cancelled due to a thin lining and excess fluid in the endometrial… — Mike M.

Dr. Geoffrey Sher answered

A lining
Immunology & Implantation Nov 17, 2022

Reproductive immunology related

I am 4+1 week pregnant. Had miscarriages before. I have hashimotos. What test should I do to confirm the autoimmune issue this time. Any suggestions for that? — Farhana A.

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 men.…
Early Pregnancy & hCG Nov 16, 2022

hcg

5.8 hcg is it pregnant? how many weeks — Feabe G.

Dr. Geoffrey Sher answered

That is a low level. You need to Repeat the hCG test in 48h of the last one, to see if it at least doubles as it should do! Good luck! Geoff Sher
Early Pregnancy & hCG Nov 16, 2022

Enquiry

17790mIU/mL in HCG blood test means pregnancy positive or negative — Devika N.

Dr. Geoffrey Sher answered

POSITIVE!!
Early Pregnancy & hCG Nov 15, 2022

Bhcg

656 IU/L is good at 4 week 2 days?? — Janbat U.

Dr. Geoffrey Sher answered

Very good. Repeat it in 2 days to see if it (at least) doubles...as it should!
Ovarian Stimulation & OHSS Nov 15, 2022

Stim Protocol

Dear Dr. Sher, My spouse and I are both 36 years old with unexplained infertility. We've had 6 failed IUIs (4 with letrozole, 1 with letrozole and Menopur, and 1 with Gonal-F). My spouse's AMH is 1.27 ng/mL and AFC… — Gautam J.

Dr. Geoffrey Sher answered

. Obviously there are differences of opinion. What I have espoused is based upon 38Y in the field and >17000babies. The importance of the IVF stimulation protocol on egg/embryo quality cannot be overstated. This factor seems often to be overlooked or discounted by t IVF practitioners who use…
Age & Fertility Nov 14, 2022

factor 5

Hello Hello, I am not sure my last email went through. we were successful with Elin Fifer being born on 8/28/2013. I am from Colorado and saw you 3 times. Elin is extremely smart and tested a high IQ. she… — Elizabeth A.

Dr. Geoffrey Sher answered

I personally do not see this as an absolute contraindication. The dosage would be the same! I do however suggest you discuss this with a Hematologist. Geoff Sher
Cost & Insurance Nov 14, 2022

LIT

Dear Dr. Sher, In 2 days, due to partial DQA match with my husband and weak positive LAD Im going to have LIT in Greece. There are 2 clinics with big differences in price. One does the transfer to my… — Ola K.

Dr. Geoffrey Sher answered

The subcutaneous injection of the male partner’s lymphocytes to the mother is thought to enhance the ability for the mother’s decidua (uterus) to recognize the DQ alpha matching embryo as “self” or “friend” and thereby avert its rejection. LIT has been shown to up-regulate Treg cells and thus…
Age & Fertility Nov 14, 2022

Stimulation with LH in older women

Dear Dr. Sher, thank you very much for all the things you do for our community of fertility warriors. I have heard that gonadotrophins stimulation in older women with low ovarian reserve should only be done with FSH and no… — Shira M.

Dr. Geoffrey Sher answered

It is primarily the egg (rather than the sperm) that determines the chromosomal integrity (karyotype) of the embryo, the most important determinant of egg/embryo competency”. A “competent” egg is therefore one that has a normal karyotype and has the best potential to propagate a “competent” embryo. In turn,…
Embryos & Genetic Testing Nov 14, 2022

steroids for raised TH1/TH2 assay

I had my first child with no difficulty. followed by 3 losses due to chromosomal issues then went to IVF and had 1 successful birth! We have been trying for the last 4 years and it has resulted in 2… — Tasnem A.

Dr. Geoffrey Sher answered

Your raised TH1: TH2 suggests activated uterine natural killer cells. In your case, having had a child already, this suggests that it is alloimmune rather than autoimmune, immunologic implantation dysfunction (IID). This would require a different approach to treatment. First, however you need to establish a diagnosis. We…
Embryos & Genetic Testing Nov 7, 2022

Thin Endometrium

Hello Dr., I am currently 36 with unexplained infertility. We sought help in 2019 and ended up with a successful IVF cycle, 7 PGS -tested normal embryos (1 day 5 and 6 day 6). We transferred our day 5 embryo… — Natasha B.

Dr. Geoffrey Sher answered

Obviously I cannot with certainty define the cause of your thin lining. I can tell you 2 things: 1. A lining of

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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