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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 Apr 12, 2023

low immature oocytes

Hello, I had a failed IVF cycle. I am 34, healthy (No smoking, healthy diet, yoga 3 times a week), BMI 22 and doing IVF due to male infertility reasons. My Dr gave me the short protocol, my body responded… — Rana N.

Dr. Geoffrey Sher answered

I do not believe that this is likely to be due to an intrinsic egg issue. It is likely due to the type of protocol used and/or the type and typing/dosage/timing of the "trigger". We really need to talk. I suggest you call my assistant, Patti Converse at…
Egg Health & Ovarian Reserve Apr 12, 2023

Low amh clomid protocol advice

n online consultation with me to discuss.Hello, I'm almost 39yo with an amh of 0.3 and 6 follicles at baseline. Trying for a second child. Started a max dose ivf antagonist protocol and responded really fast, 7 days of stim… — Yasmin G.

Dr. Geoffrey Sher answered

Respectfully, In my opinion neither mini-IVF nor clomiphene is good in women with diminished ovarian reserve. 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…
Egg Health & Ovarian Reserve Apr 11, 2023

Poor egg quality

Hello Dr Sher. I am a 34 yo F with spouse 43 yo M. G0P0, dx with unexplained infertility. BMI 22, no PMH and no male factors based on SA. Placed on levothyroxine during initial work up to bring TSH… — Aradhna S.

Dr. Geoffrey Sher answered

I think we should talk! Please consider calling my assistant, Patti Converse at 702-533-2691 and setting up an online consultation with me to discuss your case in detail.: One of the commonest questions asked by patients undergoing IVF relates to the likelihood of their eggs fertilizing and the…
Egg Health & Ovarian Reserve Apr 3, 2023

Immature egg

Hello! Thanks for this chance! I am 22 years old, I made ivf (gonal f, cetrotide, menopur, trigger) I have received 11 eggs. 6-GV, 2-M1, 3-M2. None embryos because only 1 egg was fertilized but could not divided. Second ivf… — Mary J.

Dr. Geoffrey Sher answered

_ One of the commonest questions asked by patients undergoing IVF relates to the likelihood of their eggs fertilizing and the likely “quality of their embryos. This is also one of the most difficult questions to answer. On the one hand many factors that profoundly influence egg quality;…
Egg Health & Ovarian Reserve Apr 2, 2023

AMH and AFC

Good Morning. I am 31 and have a hormonal IUD. I had fertility testing done and my AMH came back as 0.18 however my AFC was 16. Estrogen 88 and FSH 2.35. I don’t know where I was in my… — Ashley H.

Dr. Geoffrey Sher answered

Your AFC, your age and your basal FSH all suggest to me that the AMH value might not br accurate. I would definitely repeat it!~ 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…
Egg Health & Ovarian Reserve Mar 31, 2023

Success at 43

Hello! I have recently turned 43 and wondering whether to keep trying IVF. Have done 5 cycles in the past 12 months. AMH is 30 and AFC ~35. But, only get around 7-12 eggs at a time and poor fertilisation… — Kristy D.

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 Mar 29, 2023

Genuine Empty Follicle Syndrome

Hello Dr Sher, thank you for your very thorough response. I forgot to mention with my AMH being 15 which is satisfactory for my age do you think I will ever be able to have a child naturally ? Thank… — Laura K.

Dr. Geoffrey Sher answered

Possibly...but I would need much more information to provide an authoritative opinion. Geoff Sher
Egg Health & Ovarian Reserve Mar 29, 2023

Genuine Empty Follicle Syndrome

Hello Dr Sher, thank you for your very thorough response. I forgot to mention with my AMH being 15 which is satisfactory for my age do you think I will ever be able to have a child naturally ? Thank… — Laura K.

Dr. Geoffrey Sher answered

Possibly...but I would need much more information to provide an authoritative opinion. Geoff Sher
Egg Health & Ovarian Reserve Mar 28, 2023

Genuine Empty Follicle Syndrome

Hello Dr Sher I have just completed my 2nd ivf which failed due to my 13 follicles in egg collection being empty. The consultant diagnosed me with genuine empty follicle syndrome. I am 36 years old with a AMH of… — Laura K.

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…
Egg Health & Ovarian Reserve Mar 25, 2023

Am I a lost cause?

Dear doctor Sher, I am 33 years old and my husband is 36. After 5 months of trying to conceive (that was back in November 2022), we decided to visit a fertility specialist in Switzerland where we are currently located.… — Alexandra C.

Dr. Geoffrey Sher answered

Hi Alexandra, Yes indeed, based on your AMH blood level, you have prematurely developed diminished ovarian reserve (DOR) and this means you have very much reduced egg population (which cannot be replenished) and accordingly will propagate very few follicles. In addition, women with DOR often have an adverse…
Age & Fertility Mar 24, 2023

Adenomyosis, AMH and advanced maternal age

Hello Dr, Sher, from one South African to another :) I am living in Portugal now, and am trying to fall pregnant. I have been diagnosed with diffuse adenomyosis (mild) which is at the top of my uterus. Mainly on… — Lisa-Marie E.

Dr. Geoffrey Sher answered

Respectfully, I do not agree. Both age and diminishing ovarian reserve, make this a poor choice. I would move to IVF ASAP . Frankly , unless your adenomyosis is associated with a "thin uterine lining at mid-cycle, I would not be over concerned about this aspect.I am including…
Egg Health & Ovarian Reserve Mar 24, 2023

Egg Immaturity

Hello - I’ve just finished my second egg retrieval, both of which had disappointing results. I am 36 years old with a low AMH (0.69 as checked in November of 2022). Last FSH was 7.7. First egg retrieval was in… — Natalie M.

Dr. Geoffrey Sher answered

WE need to talk! Might I suggest that you contact my assistant, Patti Converse (702-533-2691) and set up an online3 consultation with me. In the meanwhile, please read below. The importance of the IVF stimulation protocol on egg/embryo quality cannot be overstated. This factor seems often to be…
Egg Health & Ovarian Reserve Mar 23, 2023

IVF – Friend of Ivan Sher

Hello, I am 41 years old. I am a friend of Ivan Sher's for many years and he mentioned I could get some help from Dr. Sher on here. My AMH levels are 2.87. We started IVF when I was… — Mash P.

Dr. Geoffrey Sher answered

I am flattered that Ivan referred you to me and will do my best to advise. The response will be lengthy but please read it carefully: There are several issues that apply here 1, AGE: It is primarily the egg (rather than the sperm) that determines the chromosomal…
Egg Health & Ovarian Reserve Mar 21, 2023

IVF

Hello, Im 41 . I had to have a myomectomy in 2021 which made me wait 6 months from consult to surgery then 7 months recovery. Long story short Dr did not tell me I had low ovarian reserve till… — Iris G.

Dr. Geoffrey Sher answered

Perhaps we should talk. I suggest you contact my assistant, Patti at 702-533-2691 and set up an online consultation with me to discuss. 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…
Egg Health & Ovarian Reserve Mar 19, 2023

Hormone levels during IVF

I am 36 years old and only freezing eggs. My AMH was just over 1 ng about a year ago, AFC usually 6-8. I have a long history of stage 4 endometriosis. 1. Could a disproportionately high estrogen to follicle… — Lilly G.

Dr. Geoffrey Sher answered

I do not believe tyhat an E2 of 3000pg/ml at peak, is potentially harmful. This having been said, the protocol used for ovarian stimulation is important, but without much more information in this regard, I cannot comment authoritatively. Av separate issue is the effect of endometriosis on IVF…

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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