Ask Our Doctors – Archive
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.
Good day Dr Sher,
I am 29 years old, diagnosed with SLE (Lupus) back in 2001. In November 2017 we went to the infertility specialist in an attempt to get pregnant. I left all my medication for the SLE and is only on prednisone 5mg, Ecotrine, Intralipid infusion, Glucophage and vitamins. The dr gave me an injection to ovulate and then progesterone pills and cream to take 2 days after conception. The treatment was unsuccessful. I just want to know if this treatment will work for someone with my condition and what else can be done? Thank you
Hi Anja,
This alone might not be enough to resolve your infertility issues.
Successful management of “Unexplained Infertility” requires that a very individualized approach be taken. Wherever possible the underlying cause should first be identified. Problems that involve ovulation dysfunction (hormonal imbalance) require ovulation induction with oral or injectible fertility drugs. Cervical mucous hostility due to infection with ureaplasma (which is transferred back and forth sexually to both partners) requires specific and concurrent antibiotic therapy. In other cases involving younger women (under 39 years) where there is a problem with sperm migration via the cervix and uterus to the fallopian tube(s) intrauterine insemination (IUI) with or without ovulation induction, is indicated. When these treatments fail, in cases, women over the age of 39 years, in women with IID, in men or women who harbor antisperm antibodies in significant concentrations and in cases associated with tubal abnormalities, in vitro fertilization (IVF) is needed. All cases of intractable, moderate or severe male infertility call for injecting sperm directly into the egg to achieve forced fertilization (intracytoplasmic sperm injection-ICSI).
If you are interested in my advice or medical services, I urge you to contact my concierge, Julie Dahan ASAP to set up a Skype or an in-person consultation with me. You can also contact Julie by phone or via email at 702-533-2691/ Julied@sherivf.com. You can also apply online at http://www.SherIVF.com.
Also, my book, “In Vitro Fertilization, the ART of Making Babies” is available as a down-load through http://www.Amazon.com or from most bookstores and public libraries.
Geoffrey Sher MD
It is an indisputable fact that most causes of infertility can be diagnosed and it is a great pity that the diagnosis of “unexplained infertility” is often used as an excuse for not having performed a full and detailed evaluation of the problem. Couples should not simply accept a diagnosis of “unexplained infertility” at face value since treatment is most likely to be successful when the specific cause of the problem can be fully identified
Hello, I have endometriosis we just did a IVF cycle that only resulted in 2 4AB embryos. I only had 11 follicles during the IVF cycle, about 6 months before on no meds I had over 20 follicles. All tests have come back where they should, I am 31 years old, my last lap was 4 years ago, I have had 2 miscarries. Should I do another lap than IVF or IUI or just do another IVF cycle one I feel ready?
Endometriosis is a significant feature of your history and could be central to your IVF failure as well as miscarriages.Please access the relevant articles on my blog that are listed below.
I strongly recommend that you visit http://www.DrGeoffreySherIVF.com. Then go to my Blog and access the “search bar”. Type in the titles of any/all of the articles listed below, one by one. “Click” and you will immediately be taken to those you select. Please also take the time to post any questions or comments with the full expectation that I will (as always) respond promptly.
•The IVF Journey: The importance of “Planning the Trip” Before Taking the Ride”
•Controlled Ovarian Stimulation (COS) for IVF: Selecting the ideal protocol
•IVF: Factors Affecting Egg/Embryo “competency” during Controlled Ovarian Stimulation(COS)
•The Fundamental Requirements For Achieving Optimal IVF Success
•Use of GnRH Antagonists (Ganirelix/Cetrotide/Orgalutron) in IVF-Ovarian Stimulation Protocols.
•Anti Mullerian Hormone (AMH) Measurement to Assess Ovarian Reserve and Design the Optimal Protocol for Controlled Ovarian Stimulation (COS) in IVF:
•The Role of Immunologic Implantation Dysfunction (IID) & Infertility (IID):PART 1-Background
•Immunologic Implantation Dysfunction (IID) & Infertility (IID):PART 2- Making a Diagnosis
•Immunologic Dysfunction (IID) & Infertility (IID):PART 3-Treatment
•Thyroid autoantibodies and Immunologic Implantation Dysfunction (IID)
•Immunologic Implantation Dysfunction: Importance of Meticulous Evaluation and Strategic Management:(Case Report
•Intralipid and IVIG therapy: Understanding the Basis for its use in the Treatment of Immunologic Implantation Dysfunction (IID)
•Intralipid (IL) Administration in IVF: It’s Composition; How it Works; Administration; Side-effects; Reactions and Precautions
•Natural Killer Cell Activation (NKa) and Immunologic Implantation Dysfunction in IVF: The Controversy!
•Treating Out-of-State and Out-of-Country Patients at Sher-IVF in Las Vegas
•Should IVF Treatment Cycles be provided uninterrupted or be Conducted in 7-12 Pre-scheduled “Batches” per Year
•A personalized, stepwise approach to IVF
•How Many Embryos should be transferred: A Critical Decision in IVF.
•Endometriosis and Immunologic Implantation Dysfunction (IID) and IVF
•Endometriosis and Infertility: Why IVF Rather than IUI or Surgery Should be the Treatment of Choice.
•Endometriosis and Infertility: The Influence of Age and Severity on Treatment Options
•Early -Endometriosis-related Infertility: Ovulation Induction (with or without Intrauterine Insemination) and Reproductive Surgery Versus IVF
•Treating Ovarian Endometriomas with Sclerotherapy.
•Effect of Advanced Endometriosis with Endometriotic cysts (Endometriomas) on IVF Outcome & Treatment Options.
•Deciding Between Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF).
•Intrauterine Insemination (IUI): Who Needs it & who Does Not: Pro’s &
•Induction of Ovulation With Clomiphene Citrate: Mode of Action, Indications, Benefits, Limitations and Contraindications for its ue
•Clomiphene Induction of Ovulation: Its Use and Misuse!
If you are interested in my advice or medical services, I urge you to contact my concierge, Julie Dahan ASAP to set up a Skype or an in-person consultation with me. You can also contact Julie by phone or via email at 702-533-2691/ Julied@sherivf.com. You can also apply online at http://www.SherIVF.com.
Also, my book, “In Vitro Fertilization, the ART of Making Babies” is available as a down-load through http://www.Amazon.com or from most bookstores and public libraries.
Geoffrey Sher MD
Dear Dr. Sher,
After years of IVF attempts, we have decided to adopt an embryo.
We are offered tested and euploid hatching blastocyst of the highest grade but from day 6.
Intuitively I would wait until blastocyst from day 5 is available. Am I right? – Does in your opinion blastocyst from day 5 give a better chance for success? … or it doesn’t matter day 6 or day 5 as long as it is tested?
I have one more question: does the age of donor (28yrs old) matter if embryo was tested normal?
We went thru a lot and this time just I want to make everything and anything I can to help the success even if it means to wait another cycle.
Thank you so much!
A day 6 embryo that tested PGS-normal from embryos derived from eggs of a 28y old is good!
Good luck!
Geoff Sher
Hey Dr. Sher, do you grade frozen embryos again after they are thawed? (Before transferring?). If so, how much merit should you give to those grades? I’ve noticed in our last two FETs, our embryo ratings went down significantly upon thaw. (BBB to CCC). Is that normal/expected after initial thaw or is it a sign that the embryo is not viable?
Not really. We tend to thaw on the morning of the FET so that the blastocysts often have not had sufficient time to re-expand…making grading very difficult!
Geoff Sher
Hi Dr Sher, what should baseline hormone levels be (FSH, LH and E2) after 21 days on BCP with 3 day lupron overlap and further 6 days of lupron before starting stimulation medication? Is there such a thing as too low? On last cycle after 21 days on BCP and 3 days of lupron overlap and a further 6 days of lupron 10u my baseline hormone levels were LH: 2.4 and oestrogen is 10 pg/ml. Is that oestrogen level on third day of menses a bit too low? I started FSH that evening.
I do not think that it can be too low!
Geoff Sher