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.
Hi Dr Sher I have been taking ubiquinol and royal jelly for a year now.
Does this help the quality of eggs?
Thanks
There is no data to that effect but it possibly could have a benefit…in my opinion.
Geoff Sher
I had my tubrs cut tied and burned after my 4th child they were tied for 13 years i had a reversal in march 2012 6 months later i was pregnant in was an ectopic in my left fube so at 8 weeks along they removed my tube so a couple months later i had an hsg done and it showed my right tube blocked at the top i had a vaginal ultra sound yesterday due to alot of pain they said i have a fibroid tumor on my uterus and they said there is a gestational sac in my uterus but they ran a hcg blood test and it was negitive so im at a loss what does this mean and if my tube is blocked how does a sac even get into my uterus and does it mean its empty or that im not pregnant because the blood test is negitive
If the hCG is negative you are not pregnant. The fibroid and the tubal condiytion must be assessed separately.
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.
•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
•The Role of IVF in Cases of Tubal Damage
•Case Study: Treating Hydrosalpinx by Surgical Removal (Salpingectomy) as a Prelude to IVF
•Ectopic (Tubal) Pregnancy and IVF
•Fibroid uterus
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
Hi Dr Sher,
I am starting an IVF shortly but am unclear on the impact my LH day 2 should have on the protocol.
My most recent day 2 blood details below: (husbands sperm is excellent).
Amh: 2.8
Afc: 16
FSH: 7.5
LH: 12.1
Estradiol: 31
Progesterone: <1
My proposed protocol is 225 Gonal-f and 75 Menopur; cetrotide (assuming this will start being administered on around day 6) and a 10,000 iu HCG trigger. I am trying to understand some of the literature on higher than normal LH at start of cycle but not making head or tail of it.
Should I get a second opinion on this protocol ie should I be requesting a down regulation first and then not be using menopur and only sticking with the recombinant FSH (Gonal-f)?
Thank you!
Jessica
I do not believe the LH on day 2 is relevant. What I do not understand is why your stimulation is only starting on day 6. late…
Here is the protocol I advise for women, <40Y who have adequate ovarian reserve.
My advice is to use a long pituitary down regulation protocol starting on a BCP, and overlapping it with Lupron 10U daily for three (3) days and then stopping the BCP but continuing on Lupron 10u daily (in my opinion 20U daily is too much) and await a period (which should ensue within 5-7 days of stopping the BCP). At that point an US examination is done along with a baseline measurement of blood estradiol to exclude a functional ovarian cyst and simultaneously, the Lupron dosage is reduced to 5U daily to be continued until the hCG (10,000u) trigger. An FSH-dominant gonadotropin such as Follistim, Puregon or Gonal-f daily is started with the period for 2 days and then the gonadotropin dosage is reduced and a small amount of menotropin (Menopur---no more than 75U daily) is added. This is continued until US and blood estradiol levels indicate that the hCG trigger be given, whereupon an ER is done 36h later. I personally would advise against using Lupron in “flare protocol” arrangement (where the Lupron commences with the onset of gonadotropin administration.
I strongly recommend that you visit https://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.
• 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
• “Triggering” Egg Maturation in IVF: Comparing urine-derived hCG, Recombinant DNA-hCG and GnRH-agonist:
If you are interested in seeking my advice or 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 .
*FYI
The 4th edition of my newest 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
I’d be interested to hear your opinion on my recent IVF experience, I’m 41 and egg reserves are low Ive tried IUI in the past but this was my first IVF attempt, All was going as good as could be expected for my age, 5 possibilities of eggs, at the trigger injection it started to go a bit wrong the liquid leaked as I mixed it and then the same as I injected it leaked from the join between the needle head and the sering losing some down my tummy, tricky to know how much, I took it off and tried to get it as tight as I can but it still leaked, surely it should do that? 4 eggs were harvested then the purchased donor sperm when thawed was not great only 3% swimming the clinic offered ICSI to help fertilisation, only 2 eggs matured to have ICSI, one was abnormal and the second shows no signs of fertilisation, I just wondered in your profession opinion if the two events totally out of my control had a big impact on the outcome? Many Thanks
Hi Dr
Its my 9th day of missed period. Note that my pms cycle is very regular. I did home pregnancy test that came out to be positive with one dark line and one light pink line. Now ive experienced bright red spotting thrice a day. My doctor suggested dupahstan 10 mg twice a day and adfolic 300mg once a day. Is this spotting normal? Im worried so please reply
Vaginal bleeding occurs in about 25% of all pregnancies. When it happens, it almost invariably raises the concern of pregnancy loss (miscarriage). Bleeding can also be a sign of a tubal (ectopic) pregnancy, and in cases where the distended Fallopian tube ruptures it can precipitate a life-threatening crises. However, a small amount of painless vaginal bleeding can also be the result of normal embryo implantation (i.e. implantation bleeding) or it can result a local erosion of the vagina or cervix and/or trauma during intercourse.
Notwithstanding, in virtually all cases the occurrence of early pregnancy vaginal bleeding congers concerns or even alarm regarding the possibility of miscarriage. And when this happens to women who conceived following infertility treatment, the alarm often turns into panic. However, the truth is that in most such cases the bleeding soon stops and the pregnancy proceeds unabated to the birth of a healthy baby. However, because some do progress and end in miscarriage, and in most cases, only time will tell how things will ultimately turn out, we use the term “threatened miscarriage” to describe such early bleeding. The term “inevitable miscarriage” is used once symptoms and signs confirm a miscarriage is in progress. The term “complete miscarriage” is used if all products of conception are passed, leaving the uterus “empty”. An “incomplete miscarriage” refers to cases where some products
Good luck!
Geoff Sher