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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.

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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226 answers

Embryos & Genetic Testing

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Egg Health & Ovarian Reserve Aug 11, 2023

PGTA/Endometriosis

Hi, quick background info- 37 years old, husband is 48 years old. I have stage 4 endometriosis with bilateral endometriomas about 4-5 cm on both ovaries. AMH of 3.8, FSH 5.5, Estradiol 45. Sperm analysis is above normal. I just… — Marie F.

Dr. Geoffrey Sher answered

When women with infertility due to endometriosis seek treatment, they are all too often advised to first try ovarian stimulation (ovulation Induction) with intrauterine insemination (IUI) ………as if to say that this would be just as likely to result in a baby as would in vitro fertilization (IVF).…
Embryos & Genetic Testing Aug 8, 2023

Balanced translocation & IVF Chemical Pregnancy

Hello Dr. Sher, After having two miscarriages (1 natural and 1 IUI), I found out that I have a robertsonian balanced translocation (13:14). My RE said that my best bet would be to do IVF with PGT-SR testing. I did… — Caitlin D.

Dr. Geoffrey Sher answered

The fact that the embryo transferred was euploid does not guarantee that it is was normal. There are genetic and metabolic factors that also can play a role. As for the low yield of "competent embryos, that likely has to do with the protocol used for ovarian stimulation.…
Embryos & Genetic Testing Aug 7, 2023

Embryo sizing is 6week (.27cm) while GS is 8weeks.

Could this be a early sing of miscarriage? HGC levels have growth 35% form 3 days ago. — Daniela M.

Dr. Geoffrey Sher answered

I am afraid that bhis does not look promising. I hope I am proven wrong but I think you are likely t5o lose this pregnancy. 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…
Embryos & Genetic Testing Aug 7, 2023

Cyst at baseline

Hello Dr, At my baseline scan there was a cyst measured 11mm, i.e. borderline acceptable. Nurses took my blood to check oestradiol level in case Doctor wanted to check it - but the Doctor reported back and said blood test… — Cassidy O.

Dr. Geoffrey Sher answered

Especially since you are doing an FET and there has been no impact on your cycle thus far, I would tend to agree with your RE that the 10mm follicle/cyst is probably irrelevant! Good Luck! Geoff Sher ADDITIONAL INFORMATION: I am attaching online links to two E-books which…
Embryos & Genetic Testing Aug 5, 2023

RIF

Hello, I am a healthy, active 34 year old who has been trying to conceive for 5 years. I’ve had 5 PGT tested embryos transferred with 4 implantation failures and one a very low chemical. One healthy embryo and one… — Devan K.

Dr. Geoffrey Sher answered

Indeed, I often deal with cases such as yours. Implantation dysfunction is unfortunately often overlooked as an important cause of IVF failure. In the pursuit of optimizing outcome with IVF, the clinician has a profound responsibility to meticulously assess and address this important issue if IVF success is…
Embryos & Genetic Testing Aug 5, 2023

Repeated Implantation/Loss

Hi There, I had 12 'healthy' embryos from 2 retrevials . NO natural cycles all with. Progesterone, Esradiol, Prednisone, Baby Aspirin Did 3 transfers for these . 1st failed. - did ERA came back normal. 2nd. B.O. - needed two… — Katrina S.

Dr. Geoffrey Sher answered

Implantation dysfunction is unfortunately often overlooked as an important cause of IVF failure. In the pursuit of optimizing outcome with IVF, the clinician has a profound responsibility to meticulously assess and address this important issue if IVF success is to be optimized. This is especially relevant in cases…
Embryos & Genetic Testing Aug 5, 2023

Do You Offer Reproductive Immunology As A Separate Specialty/Service?

Hello Dr. Sher, I am a patient working with an IVF Clinic that holds 2 more of my PGT-A Euploid Embryos (using Donor Eggs and my husband's sperm), but we have unfortunately arrived at a crossroads where my smaller clinic… — Deanna T.

Dr. Geoffrey Sher answered

Of course we offer the service independent of whether the patient undergoes egg retrieval with us. Geoff Sher In the world of assisted reproduction, when IVF fails repeatedly or without explanation, it's often assumed that poor embryo quality is the main culprit. However, this view oversimplifies the situation.…
Embryos & Genetic Testing Aug 5, 2023

Attrition

We had 20 eggs at Day 3, 10 of which were grade 1 or 2, the rest were grade 3 or 4. By Day 5 we only had 1 blastocyst of 4BB quality. What would cause such a high loss… — Cheryl M.

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; such…
Egg Health & Ovarian Reserve Aug 1, 2023

IVF own eggs after failed attempt

Hello, I am considering treatment at a new clinic after a disappointing first attempt at IVF. I am 46 years old and tried using my own eggs. From my last blood test some two months ago I had an AMH… — Yasmin V.

Dr. Geoffrey Sher answered

You certainly could try again, but please know that age is a major factor affecting IVF outcome. Women over 44y of age are advised to do egg donation. Age should never be a barrier to hope and fulfillment when it comes to IVF. Many women in their early…
Clinic & Practice Aug 1, 2023

Frozen Transfer

Hello! I am wondering what the process would be to book in for a frozen transfer this coming fall/winter. I currently have embryos stored in New York, Would it be possible to book a call with either Dr. Sher or… — Brittany M.

Dr. Geoffrey Sher answered

It would be our privilege to be of service: See Below! GS 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…
Embryos & Genetic Testing Aug 1, 2023

Embryo Transfer

If two untested embryos are transferred & one is a normal embryo, the other is abnormal - does the abnormal embryo ‘kill off’ or damage the normal embryo? Thanks ;) — Rosie S.

Dr. Geoffrey Sher answered

In my opinion.the concomitant transfer of the abnormal embryo should not prejudice the normal one. 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…
Egg Health & Ovarian Reserve Aug 1, 2023

No blastocysts from 2 ivf cycles.

My husband and I are both 29 years, we’ve been trying to conceive since two years and we’ve started visiting a fertility clinic since 11/2022. We’re both healthy, have no other health issues. Later in March-2023, my AMH fell to… — Kamala K.

Dr. Geoffrey Sher answered

If you've undergone in vitro fertilization (IVF) and didn't achieve a successful pregnancy, you may be wondering why. It's important to know that IVF outcomes can be unpredictable, but there are factors that can affect your chances. Let's explore some common reasons for IVF failure in simpler terms.…
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…
Embryos & Genetic Testing Jul 22, 2023

Implantation dysfunction

I saw your interview on THE EGG WISPERER podcast and really appreciated your information and inspiration. We have been trying to conceive for about 6 years now (age 37) with no children, have low AMH (last tested about 18 months… — Ponda C.

Dr. Geoffrey Sher answered

Implantation dysfunction is often overlooked as a significant reason for IVF failure. This is especially true when IVF failure is unexplained, or when there are recurring pregnancy losses or underlying issues with the uterus, such as endo-uterine surface lesions, thin uterine lining (endometrium), or immunological factors. IVF success…

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.

226 answers

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