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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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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…
Egg Health & Ovarian Reserve Aug 24, 2023

Fertilizing well, but with really high attrition rates

Age: 39.5 AMH 3.6 FSH 6.1 LH 4.6 I just completed my second fairly disappointing cycle. I've been told my AMH is high for my age, although, I have not been formally diagnosed with PCOS and my RE told me… — Taylor M.

Dr. Geoffrey Sher answered

In my provisional opinion, this is likely attributable to the protocols used for ovarian stimulation. I do not agree with testosterone supplementation or concomitant clomiphene included in the cycle. I think we should talk and I urge you to contact Patti Converse (my assistant) at 702-533-2691 (see below).…
Egg Health & Ovarian Reserve Aug 23, 2023

13 cycles of immature eggs

Dear Dr Sher, I'm 37.5 years old and have a long history of unsuccessful IVF rounds albeit with one successful cycle four years ago. My case has been classed as quite challenging. I've undergone 13 IVF cycles under the care… — O W.

Dr. Geoffrey Sher answered

_ If you've undergone in vitro fertilization (IVF) and didn't achieve a successful pregnancy, you may be wondering why. It's important to know that IVF outcomes can be unpredictable, but there are factors that can affect your chances. Let's explore some common reasons for IVF failure in simpler…
Ovarian Stimulation & OHSS Aug 23, 2023

Cabergoline before oocyte collection

Could taking Cabergoline after trigger but before oocyte collection have a negative impact on oocyte quality? — Cristina Y.

Dr. Geoffrey Sher answered

No! It should not! 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 (Drew Tortoriello MD)....... for your reading pleasure: From In Vitro Fertilization to Family: A Journey with Sher Fertility…
Immunology & Implantation Aug 21, 2023

Endo and Lupron

Hello, I scored 1.8 on the Receptiva test, and had a laparoscopy two weeks ago that revealed pelvic and bowel adhesions, and a blocked tube (all likely caused by a past silent infection - not from endo?). They also found… — Mel P.

Dr. Geoffrey Sher answered

I personally do not advocate long acting Lupron for treating endometriosis-related infertility. When women with infertility due to endometriosis seek treatment, they are all too often advised to first try ovarian stimulation (ovulation Induction) with intrauterine insemination (IUI) ………as if to say that this would be just as…
Ovarian Stimulation & OHSS Aug 16, 2023

Slow Growth on Letrozole

Hi Dr.Sher, I am almost 40 and just did an egg retrieval on may. I have 5 euploids and 1 LLM. I also have pcos. I was hoping to do a modified natural cycle this month using 5mgs of letrozole.… — Kristin C.

Dr. Geoffrey Sher answered

I am afraid it does not look good for this cycle. Respectfully, I am not a fan of Letrozole used in "older" women. The journey of in vitro fertilization can be a rollercoaster of emotions for many patients. Often times they have to face the harsh reality that…
Embryos & Genetic Testing Aug 15, 2023

Optimal trigger

Hi Dr Sher, apologies to bother you again, your insights are so helpful and I'm worried this IVF round isn't going to work! It's a Euploid embryo being transferred that I don't want to wast. We're doing a modified natural… — Cassidy O.

Dr. Geoffrey Sher answered

No! It sounds as if the timing will still be OK! Good luck! Geoff Sher
Embryos & Genetic Testing Aug 15, 2023

Is there an optimal timing of the trigger/embryo transfer on a modified natural cycle

I went in for a scan today in anticipation of doing a modified natural cycle, it's day 10 - LH levels are rising -I've not reached ovulation yet, LH normally surges on day 14 for me. The lining was trilaminar… — Cassidy O.

Dr. Geoffrey Sher answered

Candidly, I am not a fan of modified natural cycle FET's. However, the time to trigger is just before the onset of the natural LH surge.; This is determined by the size (20+mm) of the dominaqnt follicle and bloopd E2. (150pg/ml+ or 300+ if there are >2 dominant…
Ovarian Stimulation & OHSS Aug 15, 2023

Ovidrel only trigger

I am 42, 2.15 AMH, did the first cycle with Decapeptyl only and got all empty follicles. Then did three more cycles with dual trigger and got no euploids. Should I try an Ovidrel only trigger? 500 or 250? (I… — Anne C.

Dr. Geoffrey Sher answered

Empty Follicle Syndrome" is a misleading term because follicles always contain eggs. However, some eggs may have difficulties detaching and being retrieved. This is more likely to happen when multiple attempts are needed to retrieve an egg from a follicle, indicating the egg may have chromosomal abnormalities. The…
Egg Health & Ovarian Reserve Aug 11, 2023

Failing to achieve an euploid

Dear Dr. Sher, 42 year old here desperately wanting to be mother for the first time! 6 year unknown infertility, 99 lbs, 5'6'', eat healthy, taking COQ10 and prenatal, very healthy and no disease illnesses in the past. My AMH… — Anne C.

Dr. Geoffrey Sher answered

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 protocols for IVF. By providing you…
Ovarian Stimulation & OHSS Aug 11, 2023

Cyst

I had follicle measuring 15mm with estrogen 155 and 5 days later estrogen dropped to 106. This is from natural cycle using no stimulation. The clinic wanted to aspirate and fertilize then decided not to due drop in estrogen and… — Jumna P.

Dr. Geoffrey Sher answered

Your RE made the right decision. That follicle would not have propagated a good egg! 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…
Ovarian Stimulation & OHSS Aug 7, 2023

Trigger

Do you recommend to trigger with 10,000 IU of Pregnyl ( containing HCG and LH) or Novarel ( containing only HCG ) for females over 40 with high LH? — Mia P.

Dr. Geoffrey Sher answered

T%hey are in fact identical and interchangeable. Either would be fine! Good luck! 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…
Ovarian Stimulation & OHSS Aug 5, 2023

IVF FET PREP

I am doing my first FET prep cycle - I am on oral estrogen (2mg) and estrogen patches (0.1mg/day) I started at 2 patches and 1 pill per day and then gradually bumped up to 3 pills and 3 patches… — Mikie D.

Dr. Geoffrey Sher answered

There are different approaches to hormonal preparation of the uterine lining for FET. In my practice, the following is the approach I take.. I think using this might prevent the kind of response you experienced last time. Until less than 3 decades ago, most women undergoing IVF would…
Egg Health & Ovarian Reserve Aug 5, 2023

HGH if PCOS suspected?

Hello I read your blog and love the content. I am 36yrs old woman (AMH 29 pmol/L, AFC 14-20), obesity (BMI from 31-34 in the last year, used to be much more). My DHEA, testosterone, PRL were normal/low-normal/mid-range... FSH 7… — Petra V.

Dr. Geoffrey Sher answered

HGH will not do harm. I personally do not advocate routine use of DHEA. The journey of in vitro fertilization can be a rollercoaster of emotions for many patients. Often times they have to face the harsh reality that the number and quality of eggs retrieved has fallen…
Early Pregnancy & hCG Aug 1, 2023

Ivf

Is it normal to have bleeding during IVF stimulation — Akanksha M.

Dr. Geoffrey Sher answered

In the very early stage of stimulation, it could simply be a result of the period that launched the cycle. However, if it occurs several days into stimulation...that is NOT normal. Geoff Sher ADDITIONAL INFORMATION: I am attaching online links to two E-books which I recently co-authored with…

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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