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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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230 answers

Ovarian Stimulation & OHSS

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Ovarian Stimulation & OHSS Aug 11, 2023

Cyst

I had follicle measuring 15mm with estrogen 155 and 5 days later estrogen dropped to 106. This is from natural cycle using no stimulation. The clinic wanted to aspirate and fertilize then decided not to due drop in estrogen and… — Jumna P.

Dr. Geoffrey Sher answered

Your RE made the right decision. That follicle would not have propagated a good egg! Geoff Sher Herewith are online links to 2 E-books recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your reading pleasure: From In Vitro Fertilization to Family: A Journey with Sher…
Ovarian Stimulation & OHSS Aug 7, 2023

Trigger

Do you recommend to trigger with 10,000 IU of Pregnyl ( containing HCG and LH) or Novarel ( containing only HCG ) for females over 40 with high LH? — Mia P.

Dr. Geoffrey Sher answered

T%hey are in fact identical and interchangeable. Either would be fine! 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 pleasure: 1.From In Vitro Fertilization to Family: A…
Ovarian Stimulation & OHSS Aug 5, 2023

IVF FET PREP

I am doing my first FET prep cycle - I am on oral estrogen (2mg) and estrogen patches (0.1mg/day) I started at 2 patches and 1 pill per day and then gradually bumped up to 3 pills and 3 patches… — Mikie D.

Dr. Geoffrey Sher answered

There are different approaches to hormonal preparation of the uterine lining for FET. In my practice, the following is the approach I take.. I think using this might prevent the kind of response you experienced last time. Until less than 3 decades ago, most women undergoing IVF would…
Egg Health & Ovarian Reserve Aug 5, 2023

HGH if PCOS suspected?

Hello I read your blog and love the content. I am 36yrs old woman (AMH 29 pmol/L, AFC 14-20), obesity (BMI from 31-34 in the last year, used to be much more). My DHEA, testosterone, PRL were normal/low-normal/mid-range... FSH 7… — Petra V.

Dr. Geoffrey Sher answered

HGH will not do harm. I personally do not advocate routine use of DHEA. 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…
Early Pregnancy & hCG Aug 1, 2023

Ivf

Is it normal to have bleeding during IVF stimulation — Akanksha M.

Dr. Geoffrey Sher answered

In the very early stage of stimulation, it could simply be a result of the period that launched the cycle. However, if it occurs several days into stimulation...that is NOT normal. Geoff Sher ADDITIONAL INFORMATION: I am attaching online links to two E-books which I recently co-authored with…
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…

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.

230 answers

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