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.
Hello Dr. Sher,
First of all I want to thank you again for all the advises and for being there – I am sure that it is thanks to this that I am now 23 weeks pregnant 🙂
I hoped that everything would go smooth now and I wouldn’t bother you. But I would love to hear your opinion regarding baby’s heart echo before 24 weeks – is there really increased heart risk with IVF (this is what I am told)?
So everything looked good on ultrasounds at 12 and 20 weeks. But despite that I am told to do echo of the baby’s little heart… as it is “a routine recommendation for patients after IVF”.
They told me this echo/ultrasound is safe for the baby. But I read contradicting info online… I am concerned since its a wave and some sort of energy (maybe generating increased temperature) I am afraid this extended exposure could have some consequences. They said this echo is very detailed examination that would take about 2 hours.
We already had a lot of ultrasounds since week 5 because I was spotting/bleeding until ~ week 10.
Maybe I am paranoid and overly protective of this little miracle after all those long years of fighting for it. But if there was any heart issue, shouldn’t they see it at 20 week ultrasound, when they checked everything…
Would you recommend to do echo only because of IVF?
Thank you!
Zuza
While I do not see an indication for a routine echocardiogram, it wont do harm!
Good Luck!
Geoff Sher
Before my POI and then POF diagnosis, I went in for a standard fertility assessment at age 35 and my e2 was 600?! Normal fsh and normal prolactin. Then a few months later my fsh was 89 and estrogen was quite low. My RE believes I probably had cystic ovaries when e2 was 600. My question is why this sequence/crash? Could my fsh have been only temporarily high as it corrected from high estrogen? My LH is never high and my progesterone has always been low. I always thought I had PCOS as a teen but tested normal. Could I have burned out my ovaries by ovulating too much? I now have only 3 follicles showing!
I think this is an indication of POF. The hormonal levels can fluctuate.
Geoff Sher
Hi Dr. Sher,
We tried a first natural non-medicated IVF cycle after multiple failed one (with great response-18-20 eggs and no or low fertilization). We trigger with one 18 in follicle but there was no egg retrieved. How common is this? What could this empty follicle be due to? Could this be a trigger issue?
Thank you!
Osnat
It is not unusual to have premature luteinization especially when non-medicated cycles are used older women and/or women with diminished ovarian reserve.
Geoff Sher
Dr Sher, do you see any problem with transferring one 5-day blast and one 6-day blast together? Or does that mess up progeterone timing? (i.e- would the 6-day nee an extra day of PIO prior to transfer?)
Also do you recommend AM or PM PIO injections?
No problem katie!
Geoff Sher
Dr Sher,
I have E2 level 1000 on oral and vaginal estrace; total of 10mg daily. Is this too high or what are your thoughts? My RE is confident this is good news. What will you recommend as a decent dose of IM progesterone? My level right now is 0.4.
Thank you for your time.
Luteal support with P4 commences with 50 mg IM on the day prior to the egg provider undergoing ER (i.e., P4-Day 1). On day P4-Day 2, the progesterone dosage is increased to 100mg IM daily (given as a single injection or 50 mg twice daily) and this is continued until the 10th week of pregnancy or until a blood pregnancy test/negative ultrasound discounts a viable pregnancy. Commencing on the day following the ET, the patient inserts one vaginal P4 suppository (100 mg) + 2 mg E2V vaginal suppository is administered daily continuing until the 10th week of pregnancy or until pregnancy is discounted by blood testing or an ultrasound examination after the 6th gestational week. With the obvious exception of the fact that embryo recipients do not receive an hCG injection, luteal phase and early pregnancy hormonal support and immuno-suppression is otherwise the same for conventional IVF patients. Blood pregnancy tests are performed 12 days and 14 days after the first P4 injection was given.
Good luck!
Geoff Sher