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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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137 answers

Immunology & Implantation

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Immunology & Implantation Feb 26, 2023

Prednisone/Blood thinner

We are adding prednisone and Lovenox to my protocol next transfer. When is the best time to begin each of these- in relation to the transfer? For example, before transfer, day of transfer, after positive test? — K M.

Dr. Geoffrey Sher answered

10-14 days prior to transfer.! 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…
Embryos & Genetic Testing Feb 16, 2023

Failed implantation

Hello, my husband and I have had a total of 6 good/top quality day 5 embryos implanted over the course of 2 years (2021- present). I have endometriosis, which I had surgery for in 2021. Following this surgery we had… — Ashley C.

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…
Embryos & Genetic Testing Feb 14, 2023

Failed cycles

Hi, I learned of your clinic today on the egg whisperer and several questions arose from that video. I’ve had one retrieval with six day 5 embryos. My first fresh transfer failed with no implantation and my second was a… — Mary E.

Dr. Geoffrey Sher answered

There is a possibility that the hydrosalpinges could be playing a role here. However, it is important to also consider the possibility of an anatomical and/or immunologic implantation dysfunction. Please read below and then, if you are interested, contact my assistant Patti Converse (702-533-2691) and set up an…
Embryos & Genetic Testing Feb 9, 2023

Request for book download

Hi Dr. Sher, I am an IVF patient of Dr. Randall Loy (RE) at the Center for Reproductive Medicine in Winter Park, Florida. I am also a patient of Dr. Jubiz Giovanni (RI) in Kissimmee, Florida. After two losses and… — Michelle R.

Dr. Geoffrey Sher answered

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 Unexplained IVF Failure:…
Immunology & Implantation Jan 30, 2023

Partial DQ Alpha & elevated NK cells

Hello Dr Sher, thanks for your reply, I made an error in my last message to you. Please read amended below: I have elevated NK cells and even after completing a full immune protocol (ivig, intrallipids, dex, nupogen) my NK… — Melissa K.

Dr. Geoffrey Sher answered

Unfortunately, this is not a sperm: egg matching issue. It has to do with genotypic matching between the fertilizing sperm and the host....... So using donor egg will likely not help matters. Geoff Sher Geoff Sher
Hormones & Ovulation Jan 28, 2023

Laparoscopic Surgery or IVF?

I’m 31 with secondary infertility and been trying for 4 years with my husband. Three years ago I was diagnosed with hypothyroidism, hashimotos, pcos (before I was diagnosed I did 5 rounds of letrozle, and one IUI) and now endometriosis?… — Rachel B.

Dr. Geoffrey Sher answered

Unless the laparoscopy is intended to alleviate symptoms by ablating lesions, freeing pelvic adhesions or removing an ovarian endometrioma, I would NOT go that route. I would do IVF. When women with infertility due to endometriosis seek treatment, they are all too often advised to first try ovarian…
Immunology & Implantation Jan 28, 2023

High NK Cells & using donor egg

Hello Dr Sher, I have elevated NK cells and even after completing a full immune protocol (ivig, intrallipids) my NK cells went from 15.6 down to 14.9. My husband and I have a full DQ alpha match and no matter… — Melissa K.

Dr. Geoffrey Sher answered

In my opinion...you would face the same issues . It is not recommended! This is about your genotype and that of the sperm that fertilized the egg. It is not about egg and sperm. Read the additional information below! Geoff Sher ADDITIONAL INFORMATION: I am attaching online links…
Embryos & Genetic Testing Jan 17, 2023

Implantation testing

Hi Dr Sher, I hope all is well. I just received my results for implantation tests and I was told that my vaginal microbiome was "low" - good bacteria content was low. The advice to do not do anything, just… — Cassidy O.

Dr. Geoffrey Sher answered

I do not believe in Microbiome testing. 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)…
Immunology & Implantation Jan 9, 2023

Fish oil and clexane

Hi Dr Sher, Thank you so much for all the wonderful work that you do. I'm in Australia, and have Stage 4 endo (excised via laproscopy) and have had two miscarriages (one at 7 weeks and a MMC after seeing… — Bethany Y.

Dr. Geoffrey Sher answered

That would be fine! Good luck Geoff Sher More than half of women who have endometriosis harbor antiphospholipid antibodies (APA) that can compromise development of the embryo’s root system (trophoblast). In addition and far more serious, is the fact that in about one third of cases endometriosis, regardless…
Embryos & Genetic Testing Dec 20, 2022

Dental bone graft before FET

Hi Dr.Sher, Thank you for taking the time to answer my question. A month prior to my FET I had dental bone graft placed. I took a full course of antibiotics and the healing was uneventful. Following month, my FET… — Ramya S.

Dr. Geoffrey Sher answered

The dental surgery and antibiotics would not have affected outcome. 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…
Immunology & Implantation Dec 15, 2022

Reproductive immunology

Hello, I’m wondering if I’ve come to the right place - Valley IFV suggested you might be able to help. I’m looking for an immunology work up as related to recurrent miscarriages (1 natural/successful pregnancy, followed by 3 miscarriages (natural… — Jennifer D.

Dr. Geoffrey Sher answered

You are at the right place. 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,…
Embryos & Genetic Testing Dec 14, 2022

Fever after FET

I had my FET 3 days ago of two embryos and 36 hours later experienced cold/flu symptoms (sore throat, cough, headache) which was accompanied by a rising temperature, which went up to 100.6. Can this negatively impact implantation? I am… — Victoria R.

Dr. Geoffrey Sher answered

Let me assure you that this is not due to your body reacting to the embryo(s). It is likely unrelated to the FET. I suggest you see your doctor and be evaluated to make sure it is not Covid. In the interim, try to keep your temperature down…
Immunology & Implantation Dec 5, 2022

Miscarriage

I had a term baby at 38years. I was treated with immune protocol - Intralipid, clexane, dexamethasone,aspirin and so on for repeated implantation failure( after 6 failed implantation) Hla DQ and NK cells normal At 40 I did ivf again… — Ananthy A.

Dr. Geoffrey Sher answered

I am afraid , I would need a great deal more information to be able to comment authoritatively!. We should talk! 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…
Embryos & Genetic Testing Dec 3, 2022

3 failed pgs donor fet transfers

Hi Dr. Sher, I have a child conceived naturally at 39 and then two early miscarriages also natural conception (first loss at 6 weeks and second loss at 7 weeks prior to heartbeat being detected) at age 42 and age… — Eliana B.

Dr. Geoffrey Sher answered

This is highly likely to at least in part, be due to a secondary implantation dysfunction (see below). While not definitive, I suspect an immunologic implantation dysfunction (IID). The fact that you have had a child already means that it if an IID exists, it is possibly alloimmune…
Embryos & Genetic Testing Nov 29, 2022

What causes embryos to arrest during development?

I recently completed my 2nd egg retrieval at age 36 and had very different results. I have PCOS (high AMH =15 and many follicles, regular periods, thin/normal BMI ) and respond well to meds. We used 75 Menopur, 100 Gonal… — Maya S.

Dr. Geoffrey Sher answered

It could be an inherent underlying egg defect. However, more commonly it has to do with the selection of an optimal protocol for ovarian stimulation, the type of "trigger used" and the implementation of said protocol. The importance of the IVF stimulation protocol on egg/embryo quality cannot be…

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.

137 answers

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