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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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165 answers

Egg Health & Ovarian Reserve

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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?.…
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…

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.

165 answers

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