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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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Immunology & Implantation Sep 19, 2022

HLA/DQ Alpha

I have implantation dysfunction. 6 transfers of 7 embryos have failed (our last being a PGS normal). I do have low LADs but never got HLA/DQ Alpha testing. We have moved on to surrogacy with my husbands sister. Transferred a… — Karly W.

Dr. Geoffrey Sher answered

Implantation dysfunction is unfortunately often overlooked as an important cause of IVF failure. This is especially relevant in cases of unexplained IVF failure, recurrent pregnancy loss (RPL), and in women with underlying endo-uterine surface lesions, thickness of the uterine lining (endometrium) and /or immunologic factors. IVF success rates…
Immunology & Implantation Sep 18, 2022

DQa partial match

Hello Dr, My question is, it possible to just keep trying naturally in the hope that there will at some stage not be a match and a pregnancy will proceed normally without any intervention? I have had 4 miscarriages so… — Emma P.

Dr. Geoffrey Sher answered

DQ alpha matching is in my opinion only a problem if it is associated with NK cell activation (see below). When it comes to reproduction, humans are the poorest performers of all mammals. In fact we are so inefficient that up to 75% of fertilized eggs do not…
Embryos & Genetic Testing Sep 18, 2022

IVF

I have done an I VF and I am right now in the two week wait anxiety . I have tried 4 times previously and have a failure . The doctor this time did surgical scratching for the uterus ,… — Monica E.

Dr. Geoffrey Sher answered

I suggest you await the outcome and if you do not conceive, that you contact my assistant Patti Converse (702-533-2691) and set up a consultation online, with me. Good luck! Geoff Sher
Age & Fertility Sep 18, 2022

DGP

Hola, soy Juan Francisco Martínez , tengo 39 años, recientemente he sido diagnosticado de de una mutación en el gen que codifica la proteína Desmina, con leve repercusión cardiomiopática en el momento actual aunque hay antecedentes de muerte súbita en… — Martinez J.

Dr. Geoffrey Sher answered

Please post your question in English!
Embryos & Genetic Testing Sep 13, 2022

Day 6 and Day 7 euploid embryos

I'm 36 and doing IVF with PGT-A and PGT-M to avoid passing on a genetic condition I'm a carrier for. I don't have any identified fertility issues and have had a viable natural pregnancy before at age 34. I've had… — Charlotte D.

Dr. Geoffrey Sher answered

Frankly, you and I should have an in depth discussion to address these issues. I do not believe there is merit in transferring day 7 blastocysts whether or not they are euploid. The chance of pregnancy is dismal. There could be embryo issues relating to a possible deficiency…
Embryos & Genetic Testing Sep 13, 2022

Implantation failure

Hi Dr Sher. I am from New Zealand and almost 2 years on in my fertility journey. I’m 42 now and have 3 children of my own. My husband has 1. We are both fit and healthy. I’ve always had… — Barbara C.

Dr. Geoffrey Sher answered

Whenever a patient fails to achieve a viable pregnancy following embryo transfer (ET), the first question asked is why! Was it simply due to, bad luck?, How likely is the failure to recur in future attempts and what can be done differently, to avoid it happening next time?.…
Embryos & Genetic Testing Sep 12, 2022

Where to go after 3 rounds of egg retrieval

Hello Dr. I have had 3 MCs ( chromosome issues) 3 rounds of er, in total 34 eggs, 23 fertilized, 5 blasts no euploid, 1 failed fresh 3-day transfer. I am 40 started all this when I was 38. My… — Desiree B.

Dr. Geoffrey Sher answered

There is really a great deal to talk about here. I strongly urge you to call my assistant Patti at 702-533-2691 and set up an online consultation with me. Given your history of 3 losses I think that aside from an egg/embryo quality issue you could, in addition,…
Male Infertility Sep 12, 2022

Morphology

Hello Dr. Sher, My husband's semen analysis came back as 250 million motile sperm but only 4% morphology. Is such low morphology an issue in your professional experience? Does this mean that its basically 10 million sperm that are ok… — Lisa M.

Dr. Geoffrey Sher answered

This quite acceptable. I do not see it as a significant issue at all.when it comes to IVF/ICSI, Geoff Sher
Immunology & Implantation Sep 8, 2022

Infertility for 14 years

Hi, we have been facing recurring losses, dq alpha complete match, nk cells causing allergic reactions at the time of implantation. Is there anything you can suggest for us to be pregnant. I'm 40 and my husband 39, we don't… — Shama S.

Dr. Geoffrey Sher answered

When it comes to reproduction, humans are the poorest performers of all mammals. In fact we are so inefficient that up to 75% of fertilized eggs do not produce live births, and up to 30% of pregnancies end up being lost within 10 weeks of conception (in the…
Early Pregnancy & hCG Sep 8, 2022

Test

What test would you consider if someone had 4 miscarriages before 6 weeks I have done all the basic test Immune conditions Chromosome Ovarian reserve My husband sperm Protein Std Everything is normal No polyps I do have fibroids not… — Medjine E.

Dr. Geoffrey Sher answered

When it comes to reproduction, humans are the poorest performers of all mammals. In fact we are so inefficient that up to 75% of fertilized eggs do not produce live births, and up to 30% of pregnancies end up being lost within 10 weeks of conception (in the…
Hormones & Ovulation Sep 8, 2022

Estrogen levels

Hello doctor Sher, Thanks for taking the time to answer our questions!! Is it true that vaginal estrogen route result in higher serum estradiol unlike transdermal and intramuscular? Does the estradiol level a day to pio matter ? Can it… — Indo I.

Dr. Geoffrey Sher answered

My preference is subcutaneous estradiol twice weekly injections.. My second preference is trans dermal. Vaginal estradiol is not evenly absorbed and oral estradiol is in my opinion the poorest choice because absorption through the GIT passes via the liver to the systemic circulation and this can alter the…
Male Infertility Sep 6, 2022

Sperm retrieval

Hi, My partner and I have had a friend that was successful at your clinic (Michelle and Steve Christie) and we are exploring a child together but do not have the funds to have it not be successful going back… — Kristen S.

Dr. Geoffrey Sher answered

Here is some information on : Previous vasectomy and IVF; Gender selection and Endometriosis and infertility. We should talk,. call Patti Converse (702-533-2691) and set up an online consultation with me. 1. GENDER SELECTION Couples have for centuries sought to influence the gender of their offspring. More than…
Uterine & Endometrial Health Sep 6, 2022

Ovarian sclerotherapy

Hi, I came across your page because I have been dealing with a 5 cm endometrioma and have been looking at different options. I found your article about ovarian sclerotherapy and was wondering if you know where this procedure can… — Sophia G.

Dr. Geoffrey Sher answered

I really do not know who offers this or where you could find out! You will have to inquire around. Geoff Sher
Early Pregnancy & hCG Sep 6, 2022

422,000 mIU/ml at 6weeks pregnancy

My wife had a test two weeks a go at 4th week, the result read 33,896 miu/mi. Fast forward 2weeks and it is standing at 423,909 miu/mi. SIhould we be worried? — Ejiofor B.

Dr. Geoffrey Sher answered

Not in my opinion! Geoff Sher
Early Pregnancy & hCG Sep 4, 2022

422,000 mIU/ml at 6weeks pregnancy

My wife had a test two weeks a go at 4th week, the result read 33,896 miu/mi. Fast forward 2weeks and it is standing at 423,909 miu/mi. Should we be worried? — Ejiofor I.

Dr. Geoffrey Sher answered

I think it is OK. However, she should have a confrontational US. Good look! 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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