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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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138 answers

Immunology & Implantation

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Embryos & Genetic Testing Jun 5, 2023

Ivf

Unexplained infertility I underwent failed frozen transfer 5 times with 7 blastocyst. However conceived in the 1st fet with day 3 embryo. Did hysteroscopic.No issues found in uterus. Husband sperm also good However,i did test my auto immune(ANA) out of… — Jes J.

Dr. Geoffrey Sher answered

_ In the world of assisted reproduction, when IVF fails repeatedly or without explanation, it's often assumed that poor embryo quality is the main culprit. However, this view oversimplifies the situation. The process of embryo implantation, which begins about six or seven days after fertilization, involves a complex…
Immunology & Implantation Jun 5, 2023

Prednisone

When is the standard timeline to wean off of prednisone? — K M.

Dr. Geoffrey Sher answered

10 weeks! Geoff Sher ADDITIONAL INFORMATION: I am attaching online links to two E-books which I recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your reading pleasure: 1.From In Vitro Fertilization to Family: A Journey with Sher Fertility Solutions (SFS) “ http://sherfertilitysolutions.com/sher-fertility-solutions-ebook.pdf “Recurrent Pregnancy Loss…
Immunology & Implantation May 30, 2023

Hashimoto’s & Repeat Implantation Failure

Hi Dr. Sher, I am on the verge of giving up. I have just gone through 4 failed egg donor transfers. I have Hashimotos, so for the last 2 transfers my doctor put me on Prednisone, low dose aspirin, Neupogen,… — Shannon B.

Dr. Geoffrey Sher answered

_ Between 2% and 5% of women of the childbearing age have reduced thyroid hormone activity (hypothyroidism). Women with hypothyroidism often manifest with reproductive failure i.e. infertility, unexplained (often repeated) IVF failure, or recurrent pregnancy loss (RPL). The condition is 5-10 times more common in women than in…
Immunology & Implantation May 30, 2023

3rd miscarriage – subchorionic hematoma

Hi Dr Sher, Thanks for all the wonderful work that you do! I've just had my third miscarriage, I have no living children. This was my first IVF pregnancy. Our embryo was genetically tested and I was on an immune… — Beth Y.

Dr. Geoffrey Sher answered

Please be aware that in my opinion for IL/steroids to be of benifit , timing and dosage administration is crucial. The IL must be administered starting 10-14 days prior to embryo transfer. Administration starting just prior to transfer is not helpful. UNDERSTANDING RECURRENT PREGNANCY LOSS ( RPL): CAUSES…
Embryos & Genetic Testing May 8, 2023

Implantation failure

Hi doctor , I have pgt a tested embryos which failed in 3 FET. My frozen embryos are over now and I’m diagnosed with ssa ro positive and all other tests negative. I was given intralipids last two times and… — Rakshitha R.

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 May 4, 2023

Hashimotos

Is it true that some women with hashimotos will have no issues getting and staying pregnant? While others will suffer from recurrent loss? What causes this discrepancy? — M J.

Dr. Geoffrey Sher answered

Between 2% and 5% of women of the childbearing age have reduced thyroid hormone activity (hypothyroidism). Women with hypothyroidism often manifest with reproductive failure i.e. infertility, unexplained (often repeated) IVF failure, or recurrent pregnancy loss (RPL). The condition is 5-10 times more common in women than in men.…
Immunology & Implantation Apr 24, 2023

kir-hla

Dear Dr Sher. I have had 5 euploid embryo transfers, with no baby yet. We finally did the Kir-hla exam at the Rosalind Franklin university. I am kirbx and hla C1-c1 and my husband is hla C1-c1 too. It seems… — Stephanie R.

Dr. Geoffrey Sher answered

Currently, with few exceptions, practitioners of assisted reproduction tend to attribute “unexplained and/or repeated” IVF failure(s), almost exclusively to poor embryo quality, advocating adjusted protocols for ovarian stimulation and/or gamete and embryo preparation as a potential remedy. The idea, having failed IVF, that all it takes to ultimately…
Immunology & Implantation Apr 10, 2023

immunologic implantation dysfunction

I have had several miscarriages the last 2 after IVF but I've never been tested for autoimmune implantation dysfunction even though I have Lupus, Celiac disease, and Rheumatoid arthritis. I have 2 frozen embryos and am 47. My current husband… — Sabrina P.

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…
Immunology & Implantation Apr 10, 2023

2 failures with Donor Eggs

Hi Dr. Sher, I’m writing you at a complete loss and low point in my treatment. I am 34. My husband is 41. We started to try to conceive when I was age 31 and within 3 months, I became… — Alyssa J.

Dr. Geoffrey Sher answered

There is very likely to be an implantation dysfunction. We should talk. I suggest you call my assistant, Patti Converse (702-533-02691 and set up an online consultation with me. Implantation dysfunction is unfortunately often overlooked as an important cause of IVF failure. In the pursuit of optimizing outcome…
Embryos & Genetic Testing Apr 7, 2023

immunological incompatibility

Dear Dr. Sher, Thank you very much for your prompt response. Maybe I should have told you a bit of my story. I am 37 years old and last year I had 3 abortions (week 7+5, week 5 and week… — Lis A.

Dr. Geoffrey Sher answered

Please contact my assistant Patti (702-533-2691) after the Easter weekend and set up an online consultation with me to discuss in detail. Geoff Sher
Immunology & Implantation Apr 7, 2023

immunological incompatibility

I would like you, please to help me to understand our results from KIR HLA-C test: My KIR: KIR2DL1: positive KIR2DL2: negative KIR2DL3: positive KIR2DL4: positive KIR2DL5: positive KIR2DS1: positive KIR2DS2: negative KIR2DS3: negative KIR2DS4: positive KIR2DS5 : positive KIR3DL1:… — Lis A.

Dr. Geoffrey Sher answered

I am sorry...these are not the tests I would advise/order to look for an alloimmune , immunologic implantation dysfunction. Alone, the results would be of negligible help to me. Geoff Sher In the United States, effective treatment of NK/CTL activation associated with either alloimmune or autoimmune implantation dysfunction…
Immunology & Implantation Apr 4, 2023

Intralipids with Hashimotos

Hello, I am wondering whether I should have intralipids with my next IVF cycle (donor egg). I have Hashimotos and have heard that the soy in intralipids can aggravate Hashimotos. In my last cycle my TSH rose from 1.6 to… — Gemma B.

Dr. Geoffrey Sher answered

__ Between 2% and 5% of women of the childbearing age have reduced thyroid hormone activity (hypothyroidism). Women with hypothyroidism often manifest with reproductive failure i.e. infertility, unexplained (often repeated) IVF failure, or recurrent pregnancy loss (RPL). The condition is 5-10 times more common in women than in…
Early Pregnancy & hCG Apr 4, 2023

Scared to Try Again

Hi Dr. Sher, Thank you for taking my question. I am 28 years old who conceived naturally and unfortunately experienced a miscarriage three weeks ago. I was 14 weeks and this was my first pregnancy. Everything I have read online… — Kay M.

Dr. Geoffrey Sher answered

WE should talk! The commonest causes of mid-trimester miscarriage are: 1. Cervical incompetency 2. Uterine congenital anomaly (e.g. a septum 3. Uterine anatomical pathology (e.g. fibroids; adenomyosis; post surgical scarring; endo-uterine synecheae 4. Placental failure due to vascular or immunologicic causes 5. Developmental fetal abnormalities (genetic and multifactorial)…
Hormones & Ovulation Mar 16, 2023

2 Failed FETs

Hi Dr Sher, first of all thank you for taking the time to read my question. I am 35 years old, and I just had my 2nd failed FET. On both occasions we transferred a 5aa hatching embryo non PGT… — Alisa W.

Dr. Geoffrey Sher answered

I think we should talk. P)lease consider calling my assistant, Patti Converse at 702-533-2691 to set up an online consultation with me. Geoff Sher Whenever a patient fails to achieve a viable pregnancy following embryo transfer (ET), the first question asked is why! Was it simply due to,…
Immunology & Implantation Mar 7, 2023

Autoimmune test results

Hi Dr Sher, I've been following your work for some time and I really hope you can help. I'm based in the UK and have just had my second unsuccessful IVF cycle in Prague (first IVF was with the NHS… — Angela E.

Dr. Geoffrey Sher answered

Implantation dysfunction is unfortunately often overlooked as an important cause of IVF failure. In the pursuit of optimizing outcome with IVF, the clinician has a profound responsibility to meticulously assess and address this important issue if IVF success is to be optimized. This is especially relevant in cases…

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.

138 answers

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