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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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Hormones & Ovulation Aug 15, 2022

Hoshimoto’s question

Dear Dr. Sher, I've been following your comments for years. Thanks for the info. on 2 shots of Ovidrel. I'm interested in what you say here about Hoshimoto's and what you call "Immunologic Implantation Dysfunction." You mention that 50% of… — Katharine C.

Dr. Geoffrey Sher answered

I published on this 25y ago. Sher G, Maassarani G, Zouves C, Feinman M, Sohn S, Matzner W, Chong P, Ching W. "The use of Combined Heparin/Aspirin and Immunoglobulin G. Therapy in the Treatment of IVF Patients with Antithyroid Antibodies" Am J Repr Immunol, 1998; 39:223-5.
IVF Failure & Pregnancy Loss Aug 12, 2022

Ivf failure and suspect endometriosis

Hi Dr Sher I have been trying to conceive for 3 years now with no success. I've recently had 1 failed ivf cycle where I began bleeding 7 days post embryo transfer. Which I believe is implantation failure. I have… — Isma B.

Dr. Geoffrey Sher answered

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). Nothing could be further from reality It is time to set the record…
Hormones & Ovulation Aug 11, 2022

Hormone-producing simple cyst found at baseline scan

Dear Dr Sher, I recently had a baseline scan and oestrogen and progesterone blood tests for an upcoming FET cycle. The scan and blood tests identified a 2.5cm hormone-producing simple cyst on my left ovary. I have been prescribed 21… — Charlotte D.

Dr. Geoffrey Sher answered

Yes! It is likely to cause the functional cyst to absorb by the next period! An ovarian cyst is any collection of fluid, surrounded by a very thin wall, within an ovary. An ovarian follicle that is larger than 22mm is termed a functional follicular cyst. They are…
Embryos & Genetic Testing Aug 10, 2022

Embryo donation

We have an extra embryo to donate to another couple or science. What are our options? — Patrick R.

Dr. Geoffrey Sher answered

Please call 646-792--7476 and ask for Bushra Sudal RN. She will be glad to assist you.
Hormones & Ovulation Aug 10, 2022

Estradiol maximum levels before FET

Good day Dr. Geoffrey, I salute you from Mexico City. I'm in the mieddle of the preparatios for the FET, and I want to know what should the maximium estradiol levels be at the day before my FET. Today I'm… — Jimena A.

Dr. Geoffrey Sher answered

I prescribe twice weekly injections of estradiol valerate (Delestrogen). Using this approach, I aim for peak E2 values ranging between 500 and 1000pg/ml! Good luck!
Cost & Insurance Aug 9, 2022

Family Balancing

[et_pb_section fb_built="1" admin_label="section" _builder_version="4.16" global_colors_info="{}"][et_pb_row admin_label="row" _builder_version="4.16" background_size="initial" background_position="top_left" background_repeat="repeat" global_colors_info="{}"][et_pb_column type="4_4" _builder_version="4.16" custom_padding="|||" global_colors_info="{}" custom_padding__hover="|||"][et_pb_text admin_label="Text" _builder_version="4.16" background_size="initial" background_position="top_left" background_repeat="repeat" global_colors_info="{}"]Hello. I am writing today to inquire about your services. I am 36 years old. I have 2 healthy… — Jacqueline S.
Egg Health & Ovarian Reserve Aug 8, 2022

No normal embroys

Hi Dr. Sher, I am asking this question after first egg retrieval. I am 40 years old, first time doing this IVF. I saw about 23 follicles during ultrasound and was on 21 days lupron protocol ended with 20 eggs,… — Esther L.

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…
Hormones & Ovulation Aug 4, 2022

Follicle Size – Immature at LH Surge?

Hi Dr. Sher, Just following up from my last question regarding my 14mm follicle on day 15 when I had a LH surge... isn't this too small of a follicle for a surge to happen meaning an immature/eggless follicle? I… — Elona K.

Dr. Geoffrey Sher answered

My response was based upon he suspicion that this 14mm follicle was actually 18mm + a day or so before and the reduction in size was due to partial ovulation.
Hormones & Ovulation Aug 4, 2022

Surge on day 15 with 14mm follicle

Hi Dr.Sher, I am doing an investigative cycle through my fertility clinic this month. Yesterday was my day 15 and on ultrasound I had a dominant follicle measuring 14mm. It was growing at a rate of 1mm per day since… — Elona K.

Dr. Geoffrey Sher answered

The most likely explanation is that when (on day 15 the 14mm follicle was seen, ovulation had already commenced!
Embryos & Genetic Testing Aug 4, 2022

Gender selection

Im looking to have a girl for my third pregnancy after having 2 boys. I have had no fertility issue and for both my kids I got pregnant in my first try. Do you have any gender selection service? Like… — Maryam F.

Dr. Geoffrey Sher answered

Couples have for centuries sought to influence the gender of their offspring. More than seven centuries ago the ancient Chinese developed a birth calendar said to be able to predict gender on the basis of when conception occurred. Later, the ancient Greeks suggested that by lying on her…
Early Pregnancy & hCG Aug 4, 2022

High risk pregnancy

Hello Dr. Sher, I can only imagine how busy you are so I will try to make this question as brief and concise as possible. I just turned 39. Currently 5wks pregnant (naturally conceived--was told it was an impossibility by… — Kristine S.

Dr. Geoffrey Sher answered

I am so happy for you. The fact that you have had 2 children with this underlying autoimmune condition, suggests that you are of the50% of women who have thyroid antibodies but do not have activated uterine natural killer cells. If so, this pregnancy could be safe. Besides,…
Embryos & Genetic Testing Jul 28, 2022

Do you recommend Sildenafil 4x 25mg/day during the follicular phase

Dear Dr. Sher, Do you recommend Sildenafil 4x 25mg/day during the follicular phase or only when the embryo transfer is scheduled? Do you recommend Sildenafil although there are no previous evidences of lack of thickening of the endometrial walls? Thank… — Ola

Dr. Geoffrey Sher answered

Yes…only in the follicular phase but not in the absence of an endometrial thickness issue! Geoff Sher
Embryos & Genetic Testing Jul 27, 2022

I need your advice. I have had two failed embryo transfers

I need your advice. I have had two failed embryo transfers. I had my embryos PGT tested and they were normal and very high-quality embryos. I am 37 years old with no underlining health conditions. But maternal history of endometriosis.… — Vanessa A.

Dr. Geoffrey Sher answered

antibodies (APA) that can compromise development of the embryo’s root system (trophoblast). In addition and far more serious, is the fact that in about one third of cases endometriosis, regardless of its severity is associated with NKa and cytotoxic uterine lymphocytes (CTL) which can seriously jeopardize implantation. This…
Egg Health & Ovarian Reserve Jul 26, 2022

I would like to ask you about DUO stim protocol for women with DOR

Dear Dr. Sher, I would like to ask you about DUO stim protocol for women with DOR. Is it OK to have double stim within the same menstruation cycle? I have DOR, endometriosis stage 1, MTHFR, 35 yrs old and… — Ola

Dr. Geoffrey Sher answered

Respectfully, I am not a protagonist of Duo-stimulations. In my opinion it can compromise follicle development as well a jeopardize egg/embryo “competency”. Geoff Sher
Egg Health & Ovarian Reserve Jul 25, 2022

I have very low ovarian reserve Amh=0.4

Dear Doctor, I saw your video on internet and I noticed that you master very well my case. I have very low ovarian reserve Amh=0.4 So I live in France and I want to came and have an ivf protocol… — Elies E.

Dr. Geoffrey Sher answered

Thank you! If you wish to consult with me online, please contact my assistant, Patti Converse at 702-533-2691. When it comes to reproductive performance, humans are the least efficient of all mammals. Even in young women under 35y, at best only 1 out of 2 eggs are chromosomally…

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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