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 had a fet about nine days ago. HPTs are coming up positive. My del estrogen dose is .2ml every three days.
There was a miscommunication and my husband injected me with .3ml.
The question is, do you perceive any issue with that if it was just the one time?
Getting daily IM of PinO as well.
Thank you for any insight you can provide
No problem. It probably will make no difference!
Looking good!
Geoff Sher
We just finished our first round of IVF. 12 eggs were retrieved, 6 were mature, 5 were fertilized (ICSI), 4 were viable at day 5. One embryo was transferred on day 5. The remaining three disintegrated by day 6. The transfer was unsuccessful.
During our follow-up meeting, our RE said all 12 eggs were granular and contained uneven blastomeres. He was unsure why half of my eggs were immature at the time of retrieval, and he said there were no stimulation protocol changes that would improve the maturity or the quality of the eggs. He recommended egg donor as our next step.
Based on your previous blog posts, I’m under the impression a change to the trigger can improve maturation. Are there potential changes that could improve granularity and/or the blastomere issue?
Thank you for your help!
The entire protocol needs to be reviewed and revised. But to provide authoritative input I would need much more information.
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.
•Optimizing Response to Ovarian Stimulation in Women with Compromised Ovarian Response to Ovarian Stimulation: A Personal Approach.
•Egg Maturation in IVF: How Egg “Immaturity”, “Post-maturity” and “Dysmaturity” Influence IVF Outcome:
•Commonly Asked Question in IVF: “Why Did so Few of my Eggs Fertilize and, so Many Fail to Reach Blastocyst?”
•Human Growth Hormone Administration in IVF: Does it Enhances Egg/Embryo Quality and Outcome?
•The BCP: Does Launching a Cycle of Controlled Ovarian Stimulation (COS). Coming off the BCP Compromise Response?
•Blastocyst Embryo Transfers Should be the Standard of Care in IVF
•Why did my IVF Fail
•Hereditary Clotting Defects (Thrombophilia)
•Blastocyst Embryo Transfers done 5-6 Days Following Fertilization are Fast Replacing Earlier day 2-3 Transfers of Cleaved Embryos.
•Embryo Transfer: The “Holy Grail in IVF.
•IVF: Approach to Selecting the Best Embryos for Transfer to the Uterus.
•Frozen Embryo Transfer (FET): A Rational Approach to Hormonal Preparation and How new Methodology is Impacting IVF.
•Staggered IVF
•Staggered IVF with PGS- Selection of “Competent” Embryos Greatly Enhances the Utility & Efficiency of IVF.
•Preimplantation Genetic Testing (PGS) in IVF: It should be Used Selectively and NOT be Routine.
•IVF: Selecting the Best Quality Embryos to Transfer
•Preimplantation Genetic Sampling (PGS) Using: Next Generation Gene Sequencing (NGS): Method of Choice.
•PGS in IVF: Are Some Chromosomally abnormal Embryos Capable of Resulting in Normal Babies and Being Wrongly Discarded?
•PGS and Assessment of Egg/Embryo “competency”: How Method, Timing and Methodology Could Affect Reliability
•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.
•Avoiding High Order Multiple Pregnancies (Triplets or Greater) with IVF
•The Role of Nutritional Supplements in Preparing for IVF
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
Just wondering if you would considering transferring a mosaic trisomy 16 embryo (30%)? Thanks for your great expertise and help.
Yes i would!
Geoff Sher
Hi Dr. Sher, I am 38 years old and have infertility on the basis of severe male factor requiring microTESE and diminished ovarian reserve. I had my son at age 36 after 2 attemps at IVF in 2015 – the first attempt was negative, the second attempt was negative but I had a frozen blastocyst from that cycle which was transferred in a subsequent natural cycle FET which resulted in the birth of my son. We have been trying for a second baby for the past year. I had 2 negative cycles at age 37. The third cycle resulted in a blastocyst which was transferred in a subsequent natural cycle FET which resulted in an early miscarriage at 5.5 weeks. I then decided to do back to back cycles to bank embryos. I now have 4 six day blastocysts – Grade 3BB, Grade 3BC, Grade 1BB, and Grade 2BB and am planning for a natural cycle FET at the end of July/early August. Do you think I have a chance of success and would you recommend transferring one or two blastocyst? None of the blastocysts were PGS tested. I really do not want twins due to the high risk nature and I already have a 2 year old son but also want to maximize my chances of pregnancy. Thank you!!
Hi Tina!
Indeed you do have a chance. Pity you did not have PGS done, but my advice would be NOT to do 2ndary PGS. This will in my opinion traumatize the embryos. Rather transfer them without testing and if no pregnancy, get in touch with me and let us re-discuss. I also am not partial to NC FET’s. The results are far better when FET is done in hormone-treated cycles.
Good luck!
Geoff Sher
Hi dr Sher
Is it possible to send the blood to be tested for NK cells activation and cytokenes to lab from China to the USA? If so, How to send it?
Regards,
Lawry
Yes!,
Contact Tina at 702-281-7437 and she will advise.
Geoff Sher