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’m a 35 year old female with an amh level of 2.5, FSH of 7.7, and an afc of 22. I’ve tried an antagonist protocol and a delayed start antagonist protocol and was cancelled both times for the development of dominant follicles that seem to grow very quickly on 225 of Gonal f and 75 of menopur. I was on two weeks of estrogen prior to the first round of stims and one week of estrogen then one week of Cetrotide before the second round of stims. I haven’t spoken with my RE about this second cancelled cycle yet, but per her nurse she’s recommending a luteal lupron protocol next. Do you have any thoughts on this approach for managing dominant follicles? Do you have any suggestions for questions to ask or points to discuss when I do speak with her? I’m confused as to why I seem to have plenty of eggs left but we are not able to get more of them to respond. I appreciate your time!
Dear Dr. Sher,
I am so sorry if this is a too basic question: How do you determine the actual size of a follicle on ultrasound? Meaning, do you always go by the biggest measure or is it an average of the three measurements? For example, during my last ultrasound before trigger, my biggest follicle was 24x15x20. If i would go by the longest measurement, it would be overdeveloped at 24mm. However, an average of the three measurements would yield 19.7mm, which would be just fine before trigger.
How do you proceed?
Thank you so much !
I do 2 measurements and divide by 2.
Geoff Sher
Dear dr. Sher,
I have an endometrioma. I underwent ivf and produced 11 top grade embryos. My fresh transfer failed. Do you think it is because of the endometrioma? I was told the only reason to remove a cyst is before stimulation to get better quality eggs, however, it seems I did not have that issue. Should I get it removed though? Maybe it killed the embryos
I would have removed it in advance.
Geoff Sher
Hi Dr.
If someone, 30 yr old, produced 9 embryos all top quality grade wise, is it safe to assume that most will be normal?
About 50% will be normal.
Geoff sher
Dr. Sher,
I had 2 HSGs done last year. The first HSG showed both tubes blocked. Performed without any medication. Got pregnant a few months later which resulted in a blighted ovum. The second HSG showed one open one blocked. Performed with a pill to help open my cervix taken the night before. I had another HSG performed recently showing both tubes blocked. No spillage and no hydrosalpinx. I am wondering if my tubes are open somewhere since I got pregnant recently and had a miscarriage a few months ago at 6 weeks. Are my tubes contributing to my miscarriages? Are the miscarriages being caused by egg quality because of my age? I am 40. Is there anything I can take or do to prevent the miscarriage and aid in carrying my pregnancies to term? Thanks for your help I hope to hear from you soon.
Almost certainly at least one tube is open for you to have been able to conceive. There is a relatively common explanation for temporary blockage and that is “tubal spasm”.
Good luck!
Geoff Sher