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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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225 answers

Ovarian Stimulation & OHSS

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Egg Health & Ovarian Reserve Oct 31, 2023

Immature Egg Rate

Good afternoon, For my 1st, and most recent cycle, I retrieved 14 eggs and only 6 were mature. 6 were GV and 2 were M1. I am 32, my AFC was 17, my AMH is 2.4, my CD3 FS &… — Margaret C.

Dr. Geoffrey Sher answered

In my opinion, this is likely due to the protocol used for ovarian stimulation (see below EGG/ EMBRYO QUALITY IN IVF & HOW SELECTION OF THE IDEAL PROTOCOL FOR OVARIAN STIMULATION INFLUENCES EGG/EMBRYO QUALITY AND OUTCOME. Geoffrey Sher MD The journey of in vitro fertilization can be a…
Ovarian Stimulation & OHSS Oct 20, 2023

If I miss a day of my Buserelin injection

Hi, am currently going through an IVF process and I have been taking my injection since the 8th and it'll continue till next month but I realized this morning that I forgot to do my injection yesterday and also forgot… — Blessing A.

Dr. Geoffrey Sher answered

Without knowing your case and your diagnosis, I cannot respond authoritatively. You will need to talk to your treating doctor.. 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…
Immunology & Implantation Oct 20, 2023

Pregnancy and Reproductive Immunology Protocol

Hello! I'm so grateful to come across this generous offering to answer questions :) I am 36 years old and currently 5W, 2D (gestational sac measures 5W, 5D). Natural pregnancy, B-HCG numbers strongly doubling. I have an RE in Chicago… — Tara S.

Dr. Geoffrey Sher answered

Ideally treatment for NKa+ should commence >10days prior to embryo transfer and be combined with a steroid (prednisone or dexamethasone). Starting this late might not work! I was the first to recommend IVIG for NKa+ and it works well but it is a blood product, it is very…
Fertility Preservation Oct 16, 2023

Egg freezing at 48

I have been prepping for an IVF cycle for the past few months after undergoing an ovarian rejuvenation procedure. After my blood work last week. My doctor said I had ovulated and ready to start birth control pills. My concern… — Lucie A.

Dr. Geoffrey Sher answered

Our cut-off for IVF using own eggs is 47Y. Sorry! 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…
Egg Health & Ovarian Reserve Oct 16, 2023

Empty follicles

Hi Dr, thanks for your article on empty follicles. I have DOR, and had two retrievals in 2021 and 2023 which yielded zero eggs (out of 3-4 follicle ). My protocol were different each time but both at least included… — Halima I.

Dr. Geoffrey Sher answered

It is too complex to respond to here. I suggest you call my assistant Patti at 702-533-2691 and set up an online consultation with me to discuss. Geoff Sher
Egg Health & Ovarian Reserve Oct 13, 2023

DOR

dear Dr.Sher , please help me with your advice. i admire you and i am so sad that here in Serbia we don’t have more fertility options. 39yo ,DOR , fsh 30 , Amh 0,375 4 IVF 1st and 4.… — Ana T.

Dr. Geoffrey Sher answered

Thank you for your kind words Understanding the impact of age and ovarian reserve on the success of in vitro fertilization (IVF) is crucial when it comes to reproductive health. This article aims to simplify and clarify these concepts, emphasizing their significance in the selection of ovarian stimulation…
Egg Health & Ovarian Reserve Oct 9, 2023

Poor Fertilization and Embryo Quality

Hello. I had an egg retrieval last week - 75 eggs collected, 1/2 normal insemination and 1/2 ICSI. 0 eggs fertilized with normal insemination. In the ICSI group (38 eggs) - 25 mature, 12 fertilized, 1 graded 3BB blast at… — Nkoli A.

Dr. Geoffrey Sher answered

I suspect it has to do with the ovarian stimulation protocol rather than an inherent egg quality deficit. Geoff Sher Empowering Choices: Embryo Banking vs. Egg Banking for Fertility Preservation" Geoffrey Sher MD It's crucial for women to make informed decisions about preserving their fertility. Delaying trying to…
Ovarian Stimulation & OHSS Sep 27, 2023

BCP initiated IVF

Hi Dr. Sher, At what stage of the menstrual cycle do you recommend starting the birth control pill, prior to initiating ivf stimulation protocol? Thank you for your help. Regards, RACHEL — Rachel L.

Dr. Geoffrey Sher answered

Within the 1st week of the period starting. One often hears the expressed opinion that the BCP suppresses response to ovarian stimulation. This is not the case, provided that the BCP is overlapped with administration of an agonist (e.g. Lupron, Buserelin, Superfact) for several days leading up to…
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…
Embryos & Genetic Testing Sep 25, 2023

IVF protocol

My name is Polona, I'm 50 and I've done four IVF cycles, all in North Cyprus, two of them when I was 48 and two of them at 50, for the last one I changed clinics. I’m planning to do… — Polona B.

Dr. Geoffrey Sher answered

Dear Polona, I cannot in good faith support a decision to do IVF with own eggs at 50y of age. The chance of success is virtually zero, regardless of ovarian reserve. You should exclusively be focused on egg donation. Understanding the impact of age and ovarian reserve on…
Hormones & Ovulation Sep 23, 2023

BMI for egg retrieval

Hi there, I am wondering what your opinion is on why so many reproductive endocrinologists tell women with high BMIs that they cannot do IVF (or sometimes even IUI?) I have a BMI of about 55 but have had a… — Cailey S.

Dr. Geoffrey Sher answered

I am not tat concerned about the ER. I am more concerned about technical problems in performing ET and the effect of a high BMI on pregnancy! Geoff Sher Herewith are online links to 2 E-books recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your…
Ovarian Stimulation & OHSS Sep 22, 2023

Protocol question

Hi Dr. T, Thank you so much for your quick response to my other question. I’m trying to make a decision as to whether to begin my second cycle with my current doctor or not and was wondering if I… — Bree M.

Dr. Geoffrey Sher answered

ADDRESSING ADVANCING AGE AND DIMINISHING OVARIAN RESERVE (DOR) IN IVF Understanding the impact of age and ovarian reserve on the success of in vitro fertilization (IVF) is crucial when it comes to reproductive health. This article aims to simplify and clarify these concepts, emphasizing their significance in the…
Ovarian Stimulation & OHSS Sep 22, 2023

Benefit to back to back cycles

Hi Dr. Sher, Is there a big benefit to doing back to back cycles of egg retrieval? I’m questioning whether I want to stay with my current clinic or switch to a new one. But switching means that I will… — Bree M.

Dr. Geoffrey Sher answered

There are different views. However in my opinion, there are with very few exceptions no advantage in doing back-to back stimulation cycles. I always recommend taking at least 1 resting cycle between attempts to rest the ovaries. Good Luck! Geoff Sher PLEASE SHARE THIS WITH OTHERS AND HELP…
Egg Health & Ovarian Reserve Sep 20, 2023

Flare Protocol for Low Ovarian Reserve

Hi Dr. Sher, I have gone through 2 ivf cycles and one FET done so far - i had 5 eggs retrieved in first cycle , 4 fert, resulting in 1 euploid embryo . Second cycle - 8 follicles, 6… — Sujana G.

Dr. Geoffrey Sher answered

Women with DOR , often have excessive LH-induced ovarian testosterone production which in my opinion can be hazardous to egg development. Lupron induces a rapid increase in LH release and in the setting of DOR further prejudices egg development. When Lupron is given at the very start of…
Ovarian Stimulation & OHSS Aug 31, 2023

Eggs disintegrate

is it possible 10 hours after egg retrieval your eggs can disintegrate and if so, how is that possible? — Mckeeya B.

Dr. Geoffrey Sher answered

It is most unusual but it can happen due to an egg issue or due to a laboratory dysfunction. In my opinion the most important remedy is to use an individualized protocol for ovarian stimulation to try and protect egg development during stimulation. The journey of in vitro…

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.

225 answers

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