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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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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
Uterine & Endometrial Health Aug 21, 2023

FET lining 17

Hi, I read a lot online about the lining being too thick for a successful FET. Mine is measuring 17 and still a week to go. Should I be concerned or are they right were good to move forward with… — Jennifer M.

Dr. Geoffrey Sher answered

Provided t here is no endometrial pathology, a thick lining does not adversely affect IVF outcome. 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…
Uterine & Endometrial Health Aug 21, 2023

Sub fertility

Can the catheter drain pus in the blocked fallopian tube — Awulatu A.

Dr. Geoffrey Sher answered

I am afraid 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…
Uterine & Endometrial Health Aug 17, 2023

Follicle and lining

Hi Dr.sher, As a follow up to my last question. Could you still do an FET if the lining thickens to a good size although the follicle is slow to develop/lack of ovulation. My lining is close to 7 mm… — Kristin C.

Dr. Geoffrey Sher answered

In my opinion, the lining needs to be >8mm (at least) prior to ovulation and/or progesterone supplementation. 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…
Embryos & Genetic Testing Aug 12, 2023

Second hand infertility

Hi, I came across your podcast about implantation issues. I went thru infertility issues for 4 years (Ivf wasn’t covered) 19iuis- I had a miscarriage in the 2nd trimester- 3 chemical pregnancies and 2 miscarriages ending before 9 weeks we… — Lauren B.

Dr. Geoffrey Sher answered

Clearly you have recurrent pregnancy loss...likely due to an implantation dysfunction (anatomical or immunologic.However, I would need much more information to be able to comment authoritatively. When it comes to reproduction, humans face challenges compared to other mammals. A significant number of fertilized eggs in humans do not…
Egg Health & Ovarian Reserve Aug 11, 2023

PGTA/Endometriosis

Hi, quick background info- 37 years old, husband is 48 years old. I have stage 4 endometriosis with bilateral endometriomas about 4-5 cm on both ovaries. AMH of 3.8, FSH 5.5, Estradiol 45. Sperm analysis is above normal. I just… — Marie F.

Dr. Geoffrey Sher answered

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 likely to result in a baby as would in vitro fertilization (IVF).…
Immunology & Implantation Aug 7, 2023

Do you think my problem is immunological?

Dear Dr Sher, I have a history of 5 natural pregnancies complicated by pre-eclampsia, 2 previous csection births. After my last birth via csection, i have had 3 first trimester miscarriages. I'm now undergoing ivf with donor eggs due to… — Lisa W.

Dr. Geoffrey Sher answered

It is indeed possible that you have acquired an immunologic implantation dysfunction. 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…
Embryos & Genetic Testing Aug 7, 2023

Cyst at baseline

Hello Dr, At my baseline scan there was a cyst measured 11mm, i.e. borderline acceptable. Nurses took my blood to check oestradiol level in case Doctor wanted to check it - but the Doctor reported back and said blood test… — Cassidy O.

Dr. Geoffrey Sher answered

Especially since you are doing an FET and there has been no impact on your cycle thus far, I would tend to agree with your RE that the 10mm follicle/cyst is probably irrelevant! Good Luck! Geoff Sher ADDITIONAL INFORMATION: I am attaching online links to two E-books which…
Infertility Basics Aug 7, 2023

Fertility options

My wife was diagnoses last year with Adenomyosis after having a miscarriage, and had a DNC. We've been having trouble getting pregnant ever since, and would like to know all options. We saw this on a show, and wondering if… — Adam L.

Dr. Geoffrey Sher answered

Adenomyosis is a condition where endometrial glands develop outside the uterine lining (endometrium), within the muscular wall of the uterus (myometrium). Definitive diagnosis of adenomyosis is difficult to make. The condition should be suspected when a premenopausal woman (usually>25 years of age) presents with pelvic pain, heavy painful…
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…
Embryos & Genetic Testing Aug 5, 2023

Repeated Implantation/Loss

Hi There, I had 12 'healthy' embryos from 2 retrevials . NO natural cycles all with. Progesterone, Esradiol, Prednisone, Baby Aspirin Did 3 transfers for these . 1st failed. - did ERA came back normal. 2nd. B.O. - needed two… — Katrina S.

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…
Embryos & Genetic Testing Aug 5, 2023

Do You Offer Reproductive Immunology As A Separate Specialty/Service?

Hello Dr. Sher, I am a patient working with an IVF Clinic that holds 2 more of my PGT-A Euploid Embryos (using Donor Eggs and my husband's sperm), but we have unfortunately arrived at a crossroads where my smaller clinic… — Deanna T.

Dr. Geoffrey Sher answered

Of course we offer the service independent of whether the patient undergoes egg retrieval with us. Geoff Sher 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.…

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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