– Geoffrey Sher, MD
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Embryos & Genetic Testing
Just wondering if you see any pitfalls in doing a simple oestrogen/progesterone protocol. I asked about adding in prednisolone, as a precaution. But the clinic is not keen using steroid medications- such as prednisolone, in patients who do not necessarily… — Cassidy C.
Dr. Geoffrey Sher answered
Perhaps we should talk! 702-533-2691
Embryos & Genetic Testing
Good afternoon dear doctor! I am 42 years old, after 8 hormonal stimulations, I have a single mosaic embryo. Blastocyst 7 days. I need to decide an important question whether to transfer it or not. Embryo seq(3)x1~2,(6)x1~2. Mosaic monosomy of… — Olga M.
Dr. Geoffrey Sher answered
I would not advise using this embryo! Human embryo development occurs through a process that encompasses reprogramming, sequential cleavage divisions and mitotic chromosome segregation and embryonic genome activation. Chromosomal abnormalities may arise during germ cell and/or preimplantation embryo development and represents a major cause of early pregnancy loss.…
Infertility Basics
Hello Dr Sher! I've taken this drug to treat thrush, 150mg. I'm getting my period is 8 days and am planning to start FET protocol - but I've since read that it's not a safe drug to take when trying… — Cassidy C.
Dr. Geoffrey Sher answered
THERE WOULD IN MY OPINION BE NO PROBLEM!
IVF Failure & Pregnancy Loss
i'm 40 years old,my AHM is 0.89. i was undergoing an ivf which failed. they got 6 eggs,5 mature,i embryo was slowly groing ending up not sticking after transfering. later the doctir told me they examined my eggs and came… — Tammy S.
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,…
Hormones & Ovulation
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
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
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
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
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
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Egg Health & Ovarian Reserve
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
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
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
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
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,…
