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.
I am 36yrs old, is it possible to increase the egg quality and endometrium thickness, if I take medicine, will it work?
Yes it is possible in most cases.
Call 800-780–7437 and set up a Skype consultation with me to discuss.
Geoff Sher
Hi dr. Sher, i an 36 yr, i did 2 ivf cycle on 2016 first one on march and there was 3 eggs but hcg after 2 weeks was 25 then dropped down to 2 and then misscarriage, then on August 2016 did second ivf with 2 eggs but failed and hcg was 0.1. On December 2017 did 3rd cycle again hcg was 0.2, for these 3 cycles all my hormones including prolactine, LH,FSH, Estradiole, Proges and were normal before egg pickup, then in January my physician suggest to do another trial but without ovarian stimulation and there was one follicle during pick up , but without egg, unfortunately. My question is that does i have chance to concieve or i have blighted follicle and there is no hope? Thanks
My Embryo transfer was done on 16/01/2018 and blood test was on 31/01/2018 but hcg level is 2.26mlu, I took the same test on 02/02/2018 and hcg level is .25mlu, so doctor told me that embryo’s were not implanted and I will get periods by 14/02/2018, she told me to visit her on that day..but I am feeling heavy stomach and pain/crams in stomach(@vigina) as well. I am not understanding anything about pregnancy. Can you please help me to understand this situation( urine test is also negative)
Regretfully, it does not sound as if you are pregnant. I agree with your doctor tyat a period is likely iminent.
Geoff Sher
Hi Dr Sher, you asked me to keep you informed on my progress with the partially compacting morula on day 5.
My HCG on 14dpo was 5, p4 was 35 but I did have a period that lasted 4 days.
On 16dpo it was 15.7, p4 was 11 (I stopped progesterone pressaries on 14dpo but resumed again on 16dpo).
On 18dpo it was 19 and progesterone was 28. At this point my RE told me it was not viable and to stop progesterone.
On 22dpo my HCG was 62 and progesterone was 1.82.
My RE doesn’t think this is a viable pregnancy on the basis that my progesterone has plummeted and if it was a viable pregnancy HCG would be causing my body to produce progesterone.
I’ve typed these figures into a beta calculator and its doubling within 58 hours. Google says so long as its within 72 hours that’s ok?
What do you think? Do you agree think this is not viable? Was my RE right to get me to stop progesterone on 18dpo wheh HCG was 19??
This does not look very promising , I am afraid. However repeat the hCG in about 4 days time and then if it is still rising, do an US in about 2 weeks.
Good luck!
Geoff Sher
Just completed first IVF with no success. Age 40.
Here are the details: 16 eggs retrieved, 15 fertilized, 6 made it to blast. All 6 PGS tested abnormal.
Protocol: Spontaneous Antagonist Lupron Trigger
For my second IVF cycle in March, they will either do Antagonist Lupron Trigger with BCP or Spontaneous Antagonist Lupron Trigger protocol.
Any thoughts on how I could improve egg quality? Thank you!
Hi Mindy,
Age plays a critical role in determining egg/embryo competency. That aside, it is the protocol used for ovarian stimulation that nust be carefully constructed and individualized.
Here is the protocol I advise for women with 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