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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 Jul 26, 2023

Receptiva Test

Hi Dr. Sher, I have a question. I am 30 years old. No known medical issues, with unexplained infertility. I did a recent retrieval, and got 5 chromosomally normal embryos. I have transferred 2 now, both failed. The first was… — Rosina H.

Dr. Geoffrey Sher answered

Understanding the Power of Receptiva Test The Receptiva Test is often inconclusive but would do no harm. However, 30% of endometriosis is associated with an immunologic implantation dysfunction (IID). If present and there is evidence of increased natural killer cell activity (NKa) and/or antiphospholipid antibodies, this could cause…
Embryos & Genetic Testing Jul 26, 2023

Endometriosis

Hello Dr Im 35yo. Been trying to conceive since 2020. Did 3 IUI in 2022-did not work. Normal hormone levels. Miraculously got pregnant for the first time in Jan 2023 but miscarriage at around 7 weeks reports say likely due… — Pareet A.

Dr. Geoffrey Sher answered

You are correct, the Receptiva test is often inconclusive, but would do no harm. And, unless ultrasound shows endometriotic cysts I would not do a laparoscopy or take Lupron. Rather, I would undergo blood testing for an immunologic implantation dysfunction (IID) specifically looking for antiphospholipid antibodies (APA) and…
Egg Health & Ovarian Reserve Jul 22, 2023

Cut off Age for using own egg

Do you have a cut off age for using own egg. I am 46 and have never been pregnant, my last amh was about 0.4. Main reason of my infertility is currently blocked tubes which i experienced after fibroid surgery… — Jane M.

Dr. Geoffrey Sher answered

Our cut off for egg retrievals is 47Y. Frozen embryo transfers....no definitive cut off. See below: Age should never be a barrier to hope and fulfillment when it comes to IVF. Many women in their early to mid-40s are successfully having IVF babies using their own eggs, especially…
Ovarian Stimulation & OHSS Jul 22, 2023

IVF protocol

2 abortion- 32 y. (was because of personal reason), second 37 y. (no development). Now 42 years old. AMH 0,05, FSH 39 (after first stimulation in march), LH last measurement 03.2023 -22(FSH 22). First Protocol Gonal 300. Failed. Second PRP… — Desislava Y.

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…
Age & Fertility Jul 19, 2023

Questions

Hi Dr Sher, I’m 43 yrs old & had a baby with IVF at 41 using the mini stim protocol (fresh) & hoping to try again for a 2nd. We’ve had 3 failed cycles since (using way higher doses). The… — Rosie S.

Dr. Geoffrey Sher answered

Frozen transfer of PGS-normal blastocyst is preferable in my opinion. With regard toi stimulation, consider the following: 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…
Egg Health & Ovarian Reserve Jul 18, 2023

LOW AMH AND PREGNANCY

Hi I am struglling from last 6 years to conceive but there is no luck yet.Had 4 round of IVF with short and long protocole 2 rounds of IUI and dozen of cycles of ovulation induction with Letrozole and Clomofin,nothing… — Sobia H.

Dr. Geoffrey Sher answered

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 short of their expectations. Then, should fertilization of these eggs not propagate chromosomally normal…
Ovarian Stimulation & OHSS Jul 9, 2023

Slow follicular growth

Hi, can an estrogen priming ( 5 days before my period )or taking hGh 8 weeks prior to stimulation and during stimulation cause slower growth of follicles? My forth stimulation protocol is the same as the previos three ( third… — Polona B.

Dr. Geoffrey Sher answered

In my opinion, estrogen priming, by suppressing FSH, can suppress antral follicle formation and son delay follicle growth and development. 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:…
Egg Health & Ovarian Reserve Jul 9, 2023

Functional cyst

Hello! I was told I have a 40mm cyst in my right ovary at my baseline Ivf ultrasound today. They called this afternoon and said my baseline bloodwork is normal (estrogen level is normal) and I can proceed with stim… — Molly S.

Dr. Geoffrey Sher answered

Respectfully, I would not proceed with stimulation with a 40mm cyst present. An ovarian cyst is any collection of fluid, surrounded by a very thin wall, within an ovary. An ovarian follicle that is larger than 22mm is termed a functional follicular cyst. They are non-malignant (benign) and…
Egg Health & Ovarian Reserve Jul 3, 2023

Synarel and DHEA

Hi, I have been a responding best to the long protocol where I start with Synarel on day 21. Because of low testosterone I’ve been taking DHEA for the last weeks. I read that DHEA can cause an increase in… — Linda B.

Dr. Geoffrey Sher answered

Synarel is a GnRH agonist. It is administered nasally. As such, absorption sometimes erratic. I prefer Lupron or decapeptyl which are administered intramuscularly. Dehydroepiandrosterone (DHEA), is steroid hormone produced by the adrenal glands and ovary. It is involved in producing the male hormones, androstenedione testosterone and also estrogen.…
Egg Health & Ovarian Reserve Jun 29, 2023

Please Help!

Dear Dr. Sehr, I’m almost 37 years old AMH 1,08 (measured under the pill, last measurement 09/21 was 3,5) Husband has OAT3, used zymot last Icsi. Had 4 ICSIs, 7 transfers, one MMC 9weeks, one MC six weeks. Last four… — Jana S.

Dr. Geoffrey Sher answered

I very respectfully disagree with your RE who informed you that only the best morphologic embryos should be biopsied. I also disagree with the use of "flare" (short)-DR protocols for women with diminished ovarian reserve (DOR). The journey of in vitro fertilization can be a rollercoaster of emotions…
Hormones & Ovulation Jun 28, 2023

Estrogen Priming in IVF

Hi Dr. I'm 39 with amh of 0.3 and going through my 3rd ivf cycle. Because of lab availability for PGS they are looking at delaying my priming and injections, starting my priming on CD19 (my cycle is 24 days)… — Yasmin G.

Dr. Geoffrey Sher answered

There are different philosophies regarding ovarian stimulation protocols. Of one thing I personally have no doubt about and that is that the protocol used needs to be tailored to the individual. I wish I could advise you directly but to do so I would need much more information.…
Egg Health & Ovarian Reserve Jun 27, 2023

Improving Maturity Rates and Blastocyst Development Rate

Hi Dr. Sher, I've been through 8 IVF cycles with two separate clinics. Overall, despite changes to protocols, I've encountered the same issues. The first issue is that, though my ovaries produce a good number of oocytes, not enough of… — J C.

Dr. Geoffrey Sher answered

I think we should talk. Please call my assistant, Patti Converse at 702-533-2691 and set up an online consultation with me. In the interim, please read the articles that I have written...below. A: EGG/ EMBRYO QUALITY IN IVF & HOW SELECTION OF THE IDEAL PROTOCOL FOR OVARIAN STIMULATION…
Ovarian Stimulation & OHSS Jun 26, 2023

IVF Antihistamine Protocol – FET for Endo

Hi Dr. Sher, I am a 34F, underwent IVF for UI/suspected endo (I have painful periods and hyperechoic cysts, which are 1-2 occasionally, that come and go on my ovaries). I did a Gonal F protocol with Luveris, Ovidril Trigger,… — Crystal B.

Dr. Geoffrey Sher answered

I am not in favor of natural cycle FET's. In my opinion, it is better to pinpoint the ideal window for implantation with hormonal preparation. Here is the protocol I use: IVF FET Protocol Until less than a decade ago, most women undergoing IVF would have embryos transferred…
Egg Health & Ovarian Reserve Jun 22, 2023

GV eggs

Hello I’m Asala from Saudi Arabia I’m 28 years old with stage 3 endometriosis my husband has normal semen analysis My fsh 9.9 amh 1.3ng/ml I have done 5 eggs retrievals with no success My first cycle one year ago… — Asala S.

Dr. Geoffrey Sher answered

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 short of their expectations. Then, should fertilization of these eggs not propagate chromosomally normal…
Egg Health & Ovarian Reserve Jun 17, 2023

Differences between medication

I had many ivf cycles most of them failed due to empty follicles, I got 0 eggs after collection. I used gonal it shows goid response but no eggs collected. MENUPOR the ovaries didnt response at all. PUREGONI got 6… — Talia D.

Dr. Geoffrey Sher answered

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 short of their expectations. Then, should fertilization of these eggs not propagate chromosomally normal…

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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