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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 Nov 23, 2022

RIF and DE cycles

I have had 5 DE failed cycles. I’m Kir-Aa, I have Hashimotos, and I’ve been on Lovenox, Prednisone and Aspirin for the last 3 rounds and still failed despite high quality embryos. The donor was HLA. Now we can start… — Sophie W.

Dr. Geoffrey Sher answered

WE really should talk! To me it seams that there is an underlying implantation dysfunction that is likely immunologic in origin. If I am correct then respectfully, in my opinion, the treatment to address the immunologic implantation dysfunction (IID) was not optimal/adequate.I invite you to contact my assistant,…
Immunology & Implantation Nov 23, 2022

Hla DQ aplha

Hello, I saw your podcast with Dr Aimee. I wanted to ask what treatments is given in case of HLA DQ alpha in both partners? We both have it unfortunately and are experiencing recurrent ivf failure ( had two chemicals… — Liza S.

Dr. Geoffrey Sher answered

I really think I can help you. I invite you to contact my assistant, Patti Converse at 702-533-2691 and set up an online consultation with me. Currently, with few exceptions, practitioners of assisted reproduction tend to attribute “unexplained and/or repeated” IVF failure(s), almost exclusively to poor embryo quality,…
Immunology & Implantation Nov 23, 2022

Free immunology e-book link

Good afternoon, I recently heard your interview with Dr. Aimee (the Egg whisperer) about reoccurring implantation failure. My husband and I are seeing a fertility specialist in the Chicagoland area and we have gone through the gambit of miscarriage from… — Rachel P.

Dr. Geoffrey Sher answered

I really suspect an underlying implantation dysfunction...probably an immunologic implantation dysfunction. If I am correct, you were not (in my opinion) adequately treated. WE should talk!! Might I suggest that you contact my assistant, Patti Converse at 702-533-2691 and set up an online consultation with me. I believe…
Immunology & Implantation Nov 20, 2022

NK cells profile and Th1/Th2 cytokine ratios

Hi Dr Sher, I have recently had some basic immune blood tests, including NK cell profile, NK cell cytotoxicity assay and Th1/Th2 cytokine ratio assay. The results show that my NK percentage was 11.56% and I have significantly raised Th1/Th2… — Anne-Marie D.

Dr. Geoffrey Sher answered

This information alone in isolation, does not provide a basis for implementing selective immunotherapy. I would need to know more. Specifically: 1. Which Reproductive immunology laboratory did the testing? 2. Was the cytokine analysis done on blood or on endometrial biopsy tissue? 3. What was the NK cell…
Immunology & Implantation Nov 17, 2022

Reproductive immunology related

I am 4+1 week pregnant. Had miscarriages before. I have hashimotos. What test should I do to confirm the autoimmune issue this time. Any suggestions for that? — Farhana A.

Dr. Geoffrey Sher answered

Between 2% and 5% of women of the childbearing age have reduced thyroid hormone activity (hypothyroidism). Women with hypothyroidism often manifest with reproductive failure i.e. infertility, unexplained (often repeated) IVF failure, or recurrent pregnancy loss (RPL). The condition is 5-10 times more common in women than in men.…
Cost & Insurance Nov 14, 2022

LIT

Dear Dr. Sher, In 2 days, due to partial DQA match with my husband and weak positive LAD Im going to have LIT in Greece. There are 2 clinics with big differences in price. One does the transfer to my… — Ola K.

Dr. Geoffrey Sher answered

The subcutaneous injection of the male partner’s lymphocytes to the mother is thought to enhance the ability for the mother’s decidua (uterus) to recognize the DQ alpha matching embryo as “self” or “friend” and thereby avert its rejection. LIT has been shown to up-regulate Treg cells and thus…
Embryos & Genetic Testing Nov 14, 2022

steroids for raised TH1/TH2 assay

I had my first child with no difficulty. followed by 3 losses due to chromosomal issues then went to IVF and had 1 successful birth! We have been trying for the last 4 years and it has resulted in 2… — Tasnem A.

Dr. Geoffrey Sher answered

Your raised TH1: TH2 suggests activated uterine natural killer cells. In your case, having had a child already, this suggests that it is alloimmune rather than autoimmune, immunologic implantation dysfunction (IID). This would require a different approach to treatment. First, however you need to establish a diagnosis. We…
Early Pregnancy & hCG Nov 7, 2022

Recurrent early pregnancy loss

Dear Dr Sher, My husband and I (both 35) have a severe male factor as well as lean PCOS. Despite this we had great fertilization and blastocysts rates in our IVF-ICSI with beautiful AA and BB embryos. Meanwhile we had… — Katrina S.

Dr. Geoffrey Sher answered

When it comes to reproduction, humans are the poorest performers of all mammals. In fact we are so inefficient that up to 75% of fertilized eggs do not produce live births, and up to 30% of pregnancies end up being lost within 10 weeks of conception (in the…
Immunology & Implantation Oct 21, 2022

Partial DQ apha and NK cells

Dear Doctor Sher, After many years of trying and 13 chemical pregnancies finally I did some immune tests this month: (Partner) 01.02 02.01 (Me) 01.02 01.02 19 17.9 (H) (2.00 - 12.00) 19 +cells 5+ 11.3 (H) (5.00 - 10.00)… — Ola K.

Dr. Geoffrey Sher answered

WE really do need to talk! Please call Patti Converse (my assistant, at 702-533-2691 and set up an online consultation with me. You have a partial DQ alpha match with your husband. This is only significant if in addition, you have activated NK cells (which needs to be…
Immunology & Implantation Oct 11, 2022

Recurrent miscarriage

Hi Dr Sher, I wish you had never left South Africa, as that is where I am from. I am 33 years old, we went to do ivf as my fiance is paralysed. He was placed on meds to improve… — Yvonne W.

Dr. Geoffrey Sher answered

I really sympathize with your predicament but there is no substitute for an appropriate and comprehensive medical evaluation of your problem....especially when it comes to an evaluation of immunologic implantation dysfunction. I urge you to download a free copy of my E-book , “Recurrent Pregnancy Loss and Unexplained…
Immunology & Implantation Sep 29, 2022

IVIG

Hi Dr Sher, How many days before FET should IVIG be administered? Is it ok to do it 3 days before? Is it ok to take antibiotics/Nitrofurantoin when doing IVIG? Many thanks, Sheena — Sheena S.

Dr. Geoffrey Sher answered

3 days before is much too late in my opinion. Ideally t needs to be 10-14 days before. Geoff Sher
Immunology & Implantation Sep 19, 2022

HLA/DQ Alpha

I have implantation dysfunction. 6 transfers of 7 embryos have failed (our last being a PGS normal). I do have low LADs but never got HLA/DQ Alpha testing. We have moved on to surrogacy with my husbands sister. Transferred a… — Karly W.

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…
Immunology & Implantation Sep 18, 2022

DQa partial match

Hello Dr, My question is, it possible to just keep trying naturally in the hope that there will at some stage not be a match and a pregnancy will proceed normally without any intervention? I have had 4 miscarriages so… — Emma P.

Dr. Geoffrey Sher answered

DQ alpha matching is in my opinion only a problem if it is associated with NK cell activation (see below). When it comes to reproduction, humans are the poorest performers of all mammals. In fact we are so inefficient that up to 75% of fertilized eggs do not…
Immunology & Implantation Sep 8, 2022

Infertility for 14 years

Hi, we have been facing recurring losses, dq alpha complete match, nk cells causing allergic reactions at the time of implantation. Is there anything you can suggest for us to be pregnant. I'm 40 and my husband 39, we don't… — Shama S.

Dr. Geoffrey Sher answered

When it comes to reproduction, humans are the poorest performers of all mammals. In fact we are so inefficient that up to 75% of fertilized eggs do not produce live births, and up to 30% of pregnancies end up being lost within 10 weeks of conception (in the…
Hormones & Ovulation Aug 15, 2022

Hoshimoto’s question

Dear Dr. Sher, I've been following your comments for years. Thanks for the info. on 2 shots of Ovidrel. I'm interested in what you say here about Hoshimoto's and what you call "Immunologic Implantation Dysfunction." You mention that 50% of… — Katharine C.

Dr. Geoffrey Sher answered

I published on this 25y ago. Sher G, Maassarani G, Zouves C, Feinman M, Sohn S, Matzner W, Chong P, Ching W. "The use of Combined Heparin/Aspirin and Immunoglobulin G. Therapy in the Treatment of IVF Patients with Antithyroid Antibodies" Am J Repr Immunol, 1998; 39:223-5.

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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