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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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159 answers

Egg Health & Ovarian Reserve

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Egg Health & Ovarian Reserve Jun 5, 2023

Maturing and young eggs

Does a young egg refer to the egg before or after maturation? — Adya P.

Dr. Geoffrey Sher answered

Before, 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 and…
Egg Health & Ovarian Reserve May 31, 2023

Diminished ovarian reserve

I have been diagnosed with diminished ovarian reserve and my husband has some morphology issues on semen analysis. We have completed 6 egg retrievals, 1 fresh transfer of 2 day 3 embryos, 1 FET of 2 day 3 embryos, 1… — Sahar T.

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…
Egg Health & Ovarian Reserve May 30, 2023

IVF with low ovarian reserve

Hello, I am 40 yr old female with low ovarian reserve. I responded poorly to my first protocol OCP/antagonist. That cycle was cancelled and I was restarted on estrogen priming antagonist protocol with clomid and omnitrope adjuncts. I cleared my… — Amanda M.

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…
Egg Health & Ovarian Reserve May 30, 2023

To IVF again or not…

Aloha Dr. Sher! I just finished a second IVF cycle that was a total failure. I just turned 41, AMH .6, FSH 15, AFC 5. I had three follicles that were 17-20 at trigger but only retrieved one egg that… — Katie W.

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…
Egg Health & Ovarian Reserve May 30, 2023

Infertility

I had stimulation done and during it it had antral follicles growing and got to 21,19 15,13 on day 11 ,with a high dose of 4501u ,on day 11 it was stepped down to 225iu as I complained of feeling… — Abigail R.

Dr. Geoffrey Sher answered

__ The importance of the IVF stimulation protocol on egg/embryo quality cannot be overstated. This factor seems often to be overlooked or discounted by t IVF practitioners who use a “one-size-fits-all” approach to ovarian stimulation. My experience is that the use of individualized/customized COS protocols can greatly improve…
Egg Health & Ovarian Reserve May 30, 2023

Low maturity rate related to retrieval timing?

Hello - I have gone through 5 rounds of freezing embryos with limited success, primarily due to very low maturity rates of my eggs (~25%). For example, I recently retrieved 27 eggs, similar in size, dr. pushed the size greater… — Rebecca P.

Dr. Geoffrey Sher answered

The problem is far more likely to be related to the protocol used for ovarian stimulation. The importance of the IVF stimulation protocol on egg/embryo quality cannot be overstated. This factor seems often to be overlooked or discounted by t IVF practitioners who use a “one-size-fits-all” approach to…
Egg Health & Ovarian Reserve May 22, 2023

Egg quality

I have gone through ovrian drilling for pcos before three months.. m not able to get pregnant and i have quality issue with my eggs how can i improve the quality pls suggest any diet plan — Kitty K.

Dr. Geoffrey Sher answered

There is like more to this than dietary control. I would need to know much more to be authoritative, but women with PCOS need a very individualized approach to ovarian stimulation. We should talk. Call my assistant, Patti (702-533-02691 and set up an online consultation with me to…
Egg Health & Ovarian Reserve May 18, 2023

Question-LH -short protocol-Metformin

Dear doctor, I am 35 years old, have gone through 8 ivf cycles, no pregnancy. At beginning e2 92, fsh 7,1, lh 9.5, amh 1.39. No PCOS. Early regrutation, I suppose DOR. From the start poor response on short protocol,… — Tamara I.

Dr. Geoffrey Sher answered

WE should talk! Feel free to call my assistant Patti Converse to set up an onloine consultation. Whenever a patient fails to achieve a viable pregnancy following embryo transfer (ET), the first question asked is why! Was it simply due to, bad luck?, How likely is the failure…
Egg Health & Ovarian Reserve May 11, 2023

CMP

Hi there, I've had 1 MMC and 2 Complete Molar Pregnancies in 2022. I recently had an egg retrieval where they got 22 eggs, 20 eggs were mature and only 7 fertilized via ICSI. I am now waiting to see… — Suman B.

Dr. Geoffrey Sher answered

No! It is not indicative that you cannot conceive with own eggs. A hydatidiform molar pregnancy happens when tissue that normally forms the placenta instead becomes a growth, that triggers symptoms of pregnancy. A hydatidiform mole is a benign tumor of the root system (trophoblast) of the embryo…
Egg Health & Ovarian Reserve May 10, 2023

Empty Follicle

Dear Dr, what could possible be the cause of having empty follicle on egg retrieval day for ivf. I took the trigger 34hrs before the retrieval and I’m 34yra — Faith A.

Dr. Geoffrey Sher answered

Frequently, when following vigorous and often repeated flushing of follicles at egg retrieval they fail to yield eggs, it is ascribed to “Empty Follicle Syndrome.” This is a gross misnomer, because all follicles contain eggs. So why were no eggs retrieved from the follicles? Most likely it was…
Egg Health & Ovarian Reserve Apr 26, 2023

low immature oocytes

Hello, I have recently had a failed IVF cycle, and I think it might be due to the lupron being used as a trigger shot. I am 34, healthy, non smoker, active. We are doing IVF due to mail fertility… — Rana N.

Dr. Geoffrey Sher answered

Very respectfully, I must agree that the protocol used for ovarian stimulation was likely an issue here. I think we need to talk . Please contact my assistant, Patti Converse at 702-533-2691 and set up an online consultation with me. Regards, Geoff Sher The importance of the IVF…
Egg Health & Ovarian Reserve Apr 25, 2023

Anemia and egg quality

Hi Dr. She’s, Due to countless fibroids and endometriosis, I spent two and half years bleeding heavily with no respite. As a result I was severely anemic and had to undergo many iron and blood infusions/transfusions to stabilize my iron.… — Rebecca M.

Dr. Geoffrey Sher answered

As long as the anemia has been cured, there should not be any significant adverse effect on egg/embryo quality. 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…
Egg Health & Ovarian Reserve Apr 17, 2023

31y, normal AMH, no blasts after 3 rounds

Hi Dr. Sher, I started IVF when I was 30y/o and did 1 round with the standard antagonist protocol in March 2022 at CCRM Houston (BCP priming, 225u follistim, 2 vials menopur, ganirelix, combo trigger, dexamethasone qd). Stimmed for 8… — Macy S.

Dr. Geoffrey Sher answered

I believe that your problem can be resolved! We should talk........ I suggest that you call my assistant, Patti Converse (702-533-2691) and set up an online consultation with me to discuss your case in depth. While age and ovarian reserve can and do affect egg quality, these are…
Age & Fertility Apr 16, 2023

Question re: ideal protocol for 40 yo woman with low AMH/

Hello Dr Sher I have diminished ovarian reserve. My AMH 2 yrs ago was 0.36. Its likely even lower now :( I have been a poor responder to high dose IVF with gonal-f (450 units) and menopur 150 units. Prior… — Yvette R.

Dr. Geoffrey Sher answered

It is primarily the egg (rather than the sperm) that determines the chromosomal integrity (karyotype) of the embryo, the most important determinant of egg/embryo competency”. A “competent” egg is therefore one that has a normal karyotype and has the best potential to propagate a “competent” embryo. In turn,…
Egg Health & Ovarian Reserve Apr 15, 2023

What next?

Hi Dr Sher, we are a couple aged 35 and 34. We had 2 natural pregnancies which resulted in first trimester miscarriages. We later found out that my husband has balanced translocation and I have low amh of about 0.8ng/ml… — Sofia C.

Dr. Geoffrey Sher answered

Whenever a patient fails to achieve a viable pregnancy following embryo transfer (ET), the first question asked is why! Was it simply due to, bad luck?, How likely is the failure to recur in future attempts and what can be done differently, to avoid it happening next time?.…

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.

159 answers

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