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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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Dr. Geoffrey Sher

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Ovarian Stimulation & OHSS Oct 19, 2022

Back to back FETs

Hi Dr Sher, I've just had a failed medicated FET. I have now stopped all medication and am waiting for my period to start. I want to do my next transfer as quickly as possible and I'm keen to try… — Anne-Marie D.

Dr. Geoffrey Sher answered

The answer to both questions is yes! However, I am not a proponent of natural cycle FET. See below: Until less than a decade ago, most women undergoing IVF would have embryos transferred to the uterus in the same cycle that the egg retrieval was performed (“Fresh” Embryo…
Egg Health & Ovarian Reserve Oct 17, 2022

DOR Protocol Suggestions

I am 41.5 with DOR. I'm desperately looking for advice on what would be the right protocol. I don't believe BC helps me. I had 2 months cancelled when on it for cysts. 1 estrogen producing and the other was… — Kodi F.

Dr. Geoffrey Sher answered

I cannot provide you with a specific protocol via this venue. I can only do so for an active patient of mine. You would need to contact my assistant, Patti Converse at 702-533-26912 and set up an online consultation with me for this. However, below please find the…
Age & Fertility Oct 15, 2022

IVF

Hi, I'm 40 years old, 3 failed IUI during the last year and consulting for IVF. I'm looking for a clinic that allows me 2 embryo transfer at once for a chance of twins. is this possible at your clinic? — Nagibe C.

Dr. Geoffrey Sher answered

I would absolutely consider this favorably! I suggest you call my assistant, Patti Converse at 702-533-2591 and set up an online consultation with me to discuss. Geoff Sher
Egg Health & Ovarian Reserve Oct 15, 2022

High AFC with PCOS and pregnancy

Hi Dr. I am 39 and have PCOS. I went for my day 3 AFC and I was informed by the nurse that I have 20 follicles on my left ovary and another 20 on my right. The strange thing… — Kristin C.

Dr. Geoffrey Sher answered

Quite frankly, at 39y ,with PCOS, I would favor IVF over ovarian stimulation with or without IUI. 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…
Uterine & Endometrial Health Oct 15, 2022

ERA in adenomyosis

Dear Doctor, I would like to ask for your opinion of ERA specifically in women with adenomyosis. I had an ERA which showed that I would need one extra day of progesterone (so transfer after 6 days). However, a new… — Shira M.

Dr. Geoffrey Sher answered

Herewith my response on both issues; A: ADENOMYOSIS: Adenomyosis is a condition where endometrial glands develop outside the uterine lining (endometrium), within the muscular wall of the uterus (myometrium). Definitive diagnosis of adenomyosis is difficult to make. The condition should be suspected when a premenopausal woman (usually>25 years…
Uterine & Endometrial Health Oct 13, 2022

Infertility

Hello Doctor Sher, I have a question about my last analyses. I got the resulting biopsy. CD3 (Polyclonal Rabbit, Dako) - an average of 20 positive cells per 1 v.p.z. X40; CD4 (Clone4B12, Thermo scientific) - an average of 28… — Svitlana M.

Dr. Geoffrey Sher answered

In my opinion, these tests cannot provide reasonable insight into whether or not there is an underlying immunologic implantation dysfunction.(IID). Might I recommend that you contact my assistant, Patti Converse at 702-533-2691 and set up an online consultation with me to discuss~! Implantation dysfunction is unfortunately often overlooked…
Immunology & Implantation Oct 11, 2022

Recurrent miscarriage

Hi Dr Sher, I wish you had never left South Africa, as that is where I am from. I am 33 years old, we went to do ivf as my fiance is paralysed. He was placed on meds to improve… — Yvonne W.

Dr. Geoffrey Sher answered

I really sympathize with your predicament but there is no substitute for an appropriate and comprehensive medical evaluation of your problem....especially when it comes to an evaluation of immunologic implantation dysfunction. I urge you to download a free copy of my E-book , “Recurrent Pregnancy Loss and Unexplained…
Embryos & Genetic Testing Oct 11, 2022

Reproductive potential of euploid in women >40

Hi Dr Sher, I hope this message finds you very well! I'm turning 44 soon and have finished the embryo banking process (2 euploid embryos + 7 LLM embryos). Clearly I'm unlikely to retrieve any more euploid embryos at my… — Cassidy O.

Dr. Geoffrey Sher answered

Thank you for your communication. Although age primarily affects IVF outcome through impacting the risk of aneuploidy, it also presumably has an effect via other factors (metabolomic and epigenewtic) although these are far less relevant. In my opinion, you would be well served to evaluation for embryo implantation…
Embryos & Genetic Testing Oct 10, 2022

How long to taper off progesterone support

Dear Dr Sher, I am currently 8+2 pregnant following our final FET with our last euploid embryo. It was a natural FET. My 8 week scan showed everything to be on track with no obvious concerns. My IVF clinic say… — Vicky A.

Dr. Geoffrey Sher answered

I agree eith your RE! Geoff Sher
Immunology & Implantation Sep 29, 2022

IVIG

Hi Dr Sher, How many days before FET should IVIG be administered? Is it ok to do it 3 days before? Is it ok to take antibiotics/Nitrofurantoin when doing IVIG? Many thanks, Sheena — Sheena S.

Dr. Geoffrey Sher answered

3 days before is much too late in my opinion. Ideally t needs to be 10-14 days before. Geoff Sher
Embryos & Genetic Testing Sep 26, 2022

Chromosomal Abnormalities

High doses of drugs used to stimulate the ovaries of older women undergoing fertility treatment may be causing chromosomal abnormalities in their eggs? — Tina M.

Dr. Geoffrey Sher answered

I strongly doubt it! Geoff Sher
Clinic & Practice Sep 26, 2022

Second opinion for pregnancy

Hello, On 9/15, I tested positive on an at home test. On 9/21, I went to see an ob for an transvaginal us where a sack could not be detected. The same day, I got my blood drawn for hcg… — Michelle A.

Dr. Geoffrey Sher answered

That is not encouraging as the hCG should have at least doubled in 2 days! Sounds like this could be a "chemical pregnancy" Sorry!! Geoff Sher
Early Pregnancy & hCG Sep 26, 2022

Hcg levels

Is it normal for you hcg levels to go from 780 to 5,900 in 5 days? I go to my first ob appointment the 4th... im just curious about it because this will be my first kid... — Larissa B.

Dr. Geoffrey Sher answered

It is actually quite encouraging! Good Luck! Geoff Sher
Clinic & Practice Sep 26, 2022

Pregnant and need help

Good morning. We just found out we are pregnant this morning. As previous clients, we are reaching out to see what we need to do. We had the implantation issues and were on blood thinners during treatment. Do we need… — Obioma O.

Dr. Geoffrey Sher answered

If you are already pregnant, there is not much that can be done to impact improved implantation. Treatment needs to be implemented before pregnancy occurs to have real benefit! I suggest you wait and see what transpires and reach out to me in the event things do not…
Embryos & Genetic Testing Sep 26, 2022

repeated implantation failed

Dear Dr, Embryo Solution recommended me to contact you to get your point of view on my fertility problem. With my husband we have a severe male infertility problem and in 2017 we did a fertility treatment when we lived… — Sofia G.

Dr. Geoffrey Sher answered

The commonest cause of your type of issue relates to egg/embryo "competency". AND here, the protocol used for ovarian stimulation is pivotal. 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…

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.

980 answers

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