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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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Embryos & Genetic Testing Oct 18, 2023

SET vs. DET

I read through your website in your opinion of how many embryos to transfer. Would your recommendation change in the case of multiple failed euploid transfers in someone under 35? I have done all of the recommended testing and have… — Tasha T.

Dr. Geoffrey Sher answered

If multiple euploid embryo transfers have failed, you likely have an implantation dysfunction and it wont matter whether you transfer 1 or 2 embryos...outcome would be the same. What is needed is ti identify and address the cause of the implantation failure (see below). IVF FAILURE WITH “NORMAL”…
Uterine & Endometrial Health Oct 16, 2023

progesterone in the days prior to FET

atiI took an extra progestrone shot (1 ml) in the morning 4 days prior to my scheduled FET. I'm supposed to take in the evening (yesterday was my first day on progesterone injections and the clinic had me take one… — Mary M.

Dr. Geoffrey Sher answered

I wish I could help but you need to discuss this directly with your treating doctor! Sorry! Geoff Sher
Hormones & Ovulation Oct 9, 2023

Do Intralipids in IVF cause weight gain

I am 37, have low egg count and poor egg quality in the last 3 egg retreivals. There is mild adenomyosis and possible endometrioma on my scans. I don’t have any known autoimmune conditions. My fertility specialist feels I might… — Michaela T.

Dr. Geoffrey Sher answered

It should not cause weight gain. Geoff Sher Herewith are online links to 2 E-books recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your reading pleasure: From In Vitro Fertilization to Family: A Journey with Sher Fertility Solutions (SFS) ; http://sherfertilitysolutions.com/sher-fertility-solutions-ebook.pdf Recurrent Pregnancy Loss and…
Ovarian Stimulation & OHSS Sep 25, 2023

Why is Lupron decreased

Hi there, I was wondering why you decrease the dosage of Lupron once the Estrogen begins? I struggle with a thin endometrium lining and was reading your protocol for FET. I was wondering if the reason why my lining may… — Tracy W.

Dr. Geoffrey Sher answered

Frankly , little to no Lupron is needed once the estrogen therapy begins. A thin uterine lining can have numerous causes. Back in 1989, I conducted a study that examined how the thickness of a woman's uterine lining, known as the endometrium, affected the successful implantation of embryos…
Uterine & Endometrial Health Sep 25, 2023

Lining 1 week prior to transfer

Hello I’m concerned because my ultrasound yesterday 9-22 had my lining at 6.2. My doctor gave me the green light to continue but I’m worried my lining isn’t good enough to go through the transfer and I can’t afford to… — Rachel R.

Dr. Geoffrey Sher answered

Respectfully, I would not do an ET with a lining
Uterine & Endometrial Health Sep 17, 2023

Wrong Progesterone Dosage!!

Hello Dr.S I am in full on panic mode. I am 5 weeks 3 days pregnant. I am supposed to be taking 400 mgs of prog (suppositories) 200 mgs x 2 daily. I just realized that the clinic accidently gave… — Hannah H.

Dr. Geoffrey Sher answered

I can understand your concern/confusion...but respectfully, I think 100-200mg daily is quite adequate. Sincerely, Geoff Sher
Early Pregnancy & hCG Sep 15, 2023

hcg and progesterone halved value in 2 days

On 12 dpt, hcg level was in 300 and Progesterone was in 90s.. 2 days later, HCG level halved and so did progesterone... I know I have to wait for next lab.. I'm scared... would I be losing this? — N B.

Dr. Geoffrey Sher answered

Sadly, this does not look good! Sorry Geoff Sher
Early Pregnancy & hCG Sep 10, 2023

Progesterone dropped at 6-7 weeks while on pessaries

Hi Dr Sher, Im currently 7 weeks pregnant and beta hcg was last measured at 6+5 weeks and was 35000. However, my progesterone has dropped from a high of 73nmol (about 22ng) to 50nmol (around 16ng). This drop has come… — Dani C.

Dr. Geoffrey Sher answered

I really do not believe this will be an issue. A P4 of 16ng/ml at this stage is still adequate. Good luck! Geoff Sher PLEASE SHARE THIS WITH OTHERS AND HELP SPREAD THE WORD!! Herewith are online links to 2 E-books recently co-authored with my partner at SFS-NY…
Uterine & Endometrial Health Sep 9, 2023

Lubion injections of progesterone

Hello Dr Sher, I hope you’re well. I am pleased to say that I got my first pregnancy confirmed on Monday, beta levels/ rises are healthy so far. I’m using Lubion instead of PIO for progesterone support and I’m concerned… — Cassidy O.

Dr. Geoffrey Sher answered

Congratulations Cassidy, The needle size (although unnecessarily large) will in no way adversely effect delivery of the medication or outcome. Good luck! Geoff Sher
Uterine & Endometrial Health Sep 4, 2023

Progesterone Timing and Receptivity

Hi Doctor. I am worried about my uterine receptivity and progesterone exposure. I'm in the TWW after a modified natural cycle. On a Monday my follicle was 17mm. and my doctor told me to trigger the next day not expecting… — Albena T.

Dr. Geoffrey Sher answered

I do not think the surge or the "trigger" with Ovidrel will change the timing of the FET. But to be quite honest, I personally prevent FET's in hormone replacement cycles to better pinpoint the ideal window of implantation. Prior to 2 decades ago, most women undergoing IVF…
Infertility Basics Sep 1, 2023

Unexplained infertility

Hi Dr Sher, Having heard some of your talks online, I felt reinvigorated and am now determined to find out the cause of my infertility. I am 25 years old and my husband is 29. We had been trying for… — Layla A.

Dr. Geoffrey Sher answered

Given your age and history, I would not be at all surprised if this were an implantation dysfunction (possibly immunologic). See the urticles below . In my opinion, you should delay doing another FET until there is a diagnosis. Infertility affects y 10%-15% of couples who are unable…
Ovarian Stimulation & OHSS Aug 30, 2023

Endo?

At the last scan before my retrieval, one of my ovaries was found to be adhered to the back of my uterus. I have no history of infection or STIs. Is this indicative of endometriosis? — Grace D.

Dr. Geoffrey Sher answered

Very possibly Yes! Endometriosis is a condition where the lining of the uterus grows in other places besides its usual spot inside the uterus. It can affect the Fallopian tubes, ovaries, and bowel and on rare occasions can even disseminate beyond the pelvis and abdominal cavity. While it…
Embryos & Genetic Testing Aug 30, 2023

international patient

Hello Dr. Tortoriello, My name is Jeffrey Dorr and I am a US physician (neuroradiologist) living overseas in Japan. My wife is 41 yo, and has undergone fertility treatment here in Japan for the last 16 months, including 6 rounds… — Jeffrey D.

Dr. Geoffrey Sher answered

Dear Dr Dorr, We do not manage patients during pregnancy.We only address reproductive dysfunction. Might I I suggest that you reach out to an obstetrician to look after your wife while you are in NY. If you need help in finding one., please let me know and I…
Embryos & Genetic Testing Aug 30, 2023

TSH prior to FET

Hello, I was wondering what the recommended parameters are for TSH/T4 level prior to FET. I have no issues with thyroid and my most recent TSH level was 3.6 and T4 1.3, just wondering if these are good numbers for… — Julie M.

Dr. Geoffrey Sher answered

Your TSH is modestly elevated. In my opinion this is an indication to evaluate for antithyroid antibodies, which if present, could suggest an underlying autoimmune, immunologic implantation dysfunction linked to activation of uterine natural killer cells (NKa). This should be addressed in advance of undergoing FET in my…
Uterine & Endometrial Health Aug 29, 2023

FET Today – I may have messed it up

Hi Dr.Sher, I just had my FET today. I went for acupuncture and drank a TON of liquid before but didn't feel the urge to pee. I fell asleep at acupuncture and when I woke up an hour later, I… — Rivka R.

Dr. Geoffrey Sher answered

I sincerely do not believe that this would impact embryo implantation one way or another. 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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