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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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Page 61 of 68

Embryos & Genetic Testing Dec 14, 2022

Fever after FET

I had my FET 3 days ago of two embryos and 36 hours later experienced cold/flu symptoms (sore throat, cough, headache) which was accompanied by a rising temperature, which went up to 100.6. Can this negatively impact implantation? I am… — Victoria R.

Dr. Geoffrey Sher answered

Let me assure you that this is not due to your body reacting to the embryo(s). It is likely unrelated to the FET. I suggest you see your doctor and be evaluated to make sure it is not Covid. In the interim, try to keep your temperature down…
Ovarian Stimulation & OHSS Dec 13, 2022

Provera IVF Protocol

Dr Sher, I was supposed to start IVF in December. My Provera IVF protocol is birth control, followed by stims and antagonist, and trigger with HCG (10,000). However, I did not get my period (Cycle Day 40 today) and my… — Sophie J.

Dr. Geoffrey Sher answered

No real concern at all. However, make certain that you are not pregnant before taking Provera. Do a urine pregnancy test! ADDITIONAL INFORMATION: I am attaching online links to two E-books that I recently co-authored with my partner at SFS-NY (Drew Tortoriello MD) for your reading pleasure: From…
Egg Health & Ovarian Reserve Dec 12, 2022

Egg Maturity

What approach is best for optimising egg maturity? Would HGH be useful for this? I already use a double ovidrel trigger, but only get 1-3 mature eggs, despite retrieving about 8 eggs. I also stimulate rather quickly, with my follicles… — Cristina Y.

Dr. Geoffrey Sher answered

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 a “one-size-fits-all” approach to ovarian stimulation. My experience is that the use of individualized/customized COS protocols can greatly improve IVF…
Egg Health & Ovarian Reserve Dec 12, 2022

DHEA & Testosterone Levels

Hello, I am wondering what you thoughts were on my situation. I just turned 39 and I have “lean” pcos. I have one living child conceived 6 years ago through medicated timed intercourse. Since then I have had a few… — Stephanie W.

Dr. Geoffrey Sher answered

Here is an article I wrote on PCOS an IVF: Polycystic ovary syndrome (PCOS) is a common hormonal system disorder among women affecting between 5% and 10% of women of reproductive age worldwide. Women with PCOS may have enlarged ovaries that contain small collections of fluid — called…
Egg Health & Ovarian Reserve Dec 5, 2022

Poor response to oestrogen

Hello, My first IVF cycle with embryo adoption has been cancelled due to a thin endometrium as I have not responded well to the oestrogen medication (it was increased to 8mg of Progynova a day in combination with an estraderm… — Alyson B.

Dr. Geoffrey Sher answered

It is possible that the treatment of your endometrial cancer might have negatively impacted endometrial thickening in response to estrogen. This having been said, I would need much more information in order to provide an authoritative response! ADDITIONAL INFORMATION: I am attaching online links to two E-books which…
Immunology & Implantation Dec 5, 2022

Miscarriage

I had a term baby at 38years. I was treated with immune protocol - Intralipid, clexane, dexamethasone,aspirin and so on for repeated implantation failure( after 6 failed implantation) Hla DQ and NK cells normal At 40 I did ivf again… — Ananthy A.

Dr. Geoffrey Sher answered

I am afraid , I would need a great deal more information to be able to comment authoritatively!. We should talk! 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…
Embryos & Genetic Testing Dec 3, 2022

3 failed pgs donor fet transfers

Hi Dr. Sher, I have a child conceived naturally at 39 and then two early miscarriages also natural conception (first loss at 6 weeks and second loss at 7 weeks prior to heartbeat being detected) at age 42 and age… — Eliana B.

Dr. Geoffrey Sher answered

This is highly likely to at least in part, be due to a secondary implantation dysfunction (see below). While not definitive, I suspect an immunologic implantation dysfunction (IID). The fact that you have had a child already means that it if an IID exists, it is possibly alloimmune…
Hormones & Ovulation Dec 2, 2022

Infertility/Recurrent loss

Hello Dr. Sher, Thank you for taking the time to answer my questions. I have 1 daughter (age 16) then loss my son at 23 weeks gestation 2 years later, had 3 ectopic pregnancies and 4 chemical pregnancies. I've had… — Janeé B.

Dr. Geoffrey Sher answered

Your underlying PCOS does not explain the losses (chemical or ectopic). You likely have an underlying secondary implantation dysfunction which could be an autoimmune and/or alloimmune, immunologic implantation dysfunction (IID). The presentation suggests that it possibly is more likely the latter. Endometriosis is associated with an IID in…
Embryos & Genetic Testing Nov 30, 2022

FET Protocol Opinion

Hi, I just wanted a second opinion on what my FET protocol looks like given my personal situation. I was diagnosed with endometriosis via laparoscopy in 2018. I did a total of 6 IUIs in 2021-2022 with my 4th one… — Taylor A.

Dr. Geoffrey Sher answered

This is an inordinate drop off from egg to "competent" embryo. In my opinion, , in spite of your borderline AMH (1.48ng/ml) which would suggest otherwise, you are a high responder to fertility drugs. The most likely explanation for your poor egg to "competent" embryo conversion has to…
IVF Failure & Pregnancy Loss Nov 30, 2022

Recurrent Chemical Pregnancy

Hi Dr. Sher, I love listening to you and first discovered you on the Dr. Aimee show! Thank you for all you have done and do in this field! I am 37 years old with 2 LB's, AMH is 6.37mg/dl… — Crystal M.

Dr. Geoffrey Sher answered

Q1. How likely could the negative impacts of potential endometriosis, such as poorer egg quality have on RPL in my case? I don't have any endometriomas, good reserve, clear tubes etc. It seems that more studies link endometriosis to infertility vs. RPL, specifically chemical pregnancy? I'm concerned if…
Embryos & Genetic Testing Nov 29, 2022

What causes embryos to arrest during development?

I recently completed my 2nd egg retrieval at age 36 and had very different results. I have PCOS (high AMH =15 and many follicles, regular periods, thin/normal BMI ) and respond well to meds. We used 75 Menopur, 100 Gonal… — Maya S.

Dr. Geoffrey Sher answered

It could be an inherent underlying egg defect. However, more commonly it has to do with the selection of an optimal protocol for ovarian stimulation, the type of "trigger used" and the implementation of said protocol. The importance of the IVF stimulation protocol on egg/embryo quality cannot be…
Egg Health & Ovarian Reserve Nov 29, 2022

POI and egg quality

Hello, a few weeks ago I was diagnosed with POI by my OB - I had one blood test that showed my FSH at 100, AMH at .003, and Estriadol at 17. I do not know my AFC yet, I… — Caitlin D.

Dr. Geoffrey Sher answered

I doubt it has anything to do with your long term use of BCP. What I can say is that with your FSH of 100 and very low AMH, I am doubtful you will respond to stimulation for IVF. However, if you do, your age would be in…
Egg Health & Ovarian Reserve Nov 29, 2022

Getting FSH to rise following BCP

Hi Dr Sher, You've written that for women launching COS coming off a BCP something needs to be done to cause a rise in FSH for 5-7 days to facilitate PAF to AF conversion. You suggest that this be done… — Gautam J.

Dr. Geoffrey Sher answered

Theoretically this might be achievable through administration of gonadotropins for several days longer while still on BCP but in my pinion would hold no advantage.
Ovarian Stimulation & OHSS Nov 28, 2022

Use of the Birth Control Pill (BCP) to launch IVF-COS

Dear Dr Sher, You have written that pre-antral follicles require exposure to FSH for 5 - 7 days to be able to develop into Antral Follicles. However, taking Birth Control Pills (BCPs) prior to COS suppresses FSH, and therefore does… — Gautam J.

Dr. Geoffrey Sher answered

Thank you for your very thought provoking comments and questions. Frankly, I cannot disagree that administration of FSH-in small amounts over the last few days of the BCP might not have a similar effect to overlapping with Lupron. It might however add an additional unnecessary variable and expense.…
Clinic & Practice Nov 27, 2022

Video consultation please for an old patient please

Hi Dr Tortoriello, I met you years ago in nyc at your practice. I already had a daughter and wanted in vitro for a son. As my husband and I moved around this time to London we went ahead and… — Elizabeth G.

Dr. Geoffrey Sher answered

Thank you kindly! It would be a pleasure to talk with you. Please call my assistant, Patti Converse (702-533-2691 tomorrow and set up an online consultation with me. Thank you! Geoff Sher

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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