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, I need some advice. I had my first egg retrieval on June 1st. I had my first period on June 13th. I should have had my second period 4 days ago( I’m waiting patiently because we are trying to have another egg retrieval this month). So now I’m waiting for my period to start. I cannot naturally conceive, I did take a pregnancy test that was negative to be sure.How long should I wait?? Is this common? When should I contact my doctor?
In my opinion, it isa advisable to have at least 1 full resting cycle between IVF attempts!
Good luck!
Geoff Sher
Hi Dr. had a 3 day embryo transfer on 5 July. Been on Estropause twice daily and cyclogest 200mg three times daily. Did a beta test on 14 july (10 days past transfer) …negative. Slight brown spotting. My dr advised to continue meds and re-test in 4 days time. Is it possible to get a positive beta after initially getting a negative? Im worried because I also dont have any symptoms of pregnancy
Forget to add.. I’ve had a persistent cough since day of embryo transfer. Would this have negatively affected implantation?
It is possible but not very likely…I am afraid.
Geoff Sher
Hello Dr Sher, I am 25 year old with AMH value of 0.06 and I had two failed Ivf cycles using icsi. In my first cycle I had hcg injections of 600mg for two days and 450 mg for the rest. They retrieved 3 eggs (two on one side and one on other) , only one fertilised and had embryo transfer. In my second cycle I had 600 mg hcg injections daily and there are no follicles developed. So they preferred donor egg , doctors then Harvested 4 eggs from donor with two eggs fertilised, I had the embryo transfer and again it failed to attach. Before the ivf procedure our doctor performed hysteryoscopy and found no polyps and endometrium lining is thick enough for embryo transfer. Please suggest me the possible course of action in my case !
Thanks
Women who (regardless of age) have diminished ovarian reserve (DOR) have a reduced potential for IVF success. Much of this is due to the fact that such women tend to have increased production of LH biological activity which can result in excessive LH-induced ovarian male hormone (predominantly testosterone) production which in turn can have a deleterious effect on egg/embryo “competency”.
While it is presently not possible by any means, to reverse the effect of DOR, certain ovarian stimulation regimes, by promoting excessive LH production (e.g. short agonist/Lupron- “flare” protocols, clomiphene and Letrozole), can in my opinion, make matters worse. Similarly, the amount/dosage of certain fertility drugs that contain LH/hCG (e.g. Menopur) can have a negative effect on the development of the eggs of older women and those who have DOR and should be limited.
I try to avoid using such protocols/regimes (especially) in women with DOR, favoring instead the use of the agonist/antagonist conversion protocol (A/ACP), a modified, long pituitary down-regulation regime, augmented by adding supplementary human growth hormone (HGH). I further recommend that such women be offered access to embryo banking of PGS (next generation gene sequencing/NGS)-selected normal blastocysts, the subsequent selective transfer of which by allowing them to capitalize on whatever residual ovarian reserve and egg quality might still exist and thereby “make hay while the sun still shines” could significantly enhance the opportunity to achieve a viable pregnancy
Please visit my new Blog on this very site, http://www.DrGeoffreySherIVF.com, find the “search bar” and 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
•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
•Ovarian Stimulation for IVF using GnRH Antagonists: Comparing the Agonist/Antagonist Conversion Protocol.(A/ACP) With the “Conventional” Antagonist Approach
•Anti Mullerian Hormone (AMH) Measurement to Assess Ovarian Reserve and Design the Optimal Protocol for Controlled Ovarian Stimulation (COS) in IVF.
•The “Biological Clock” and how it should Influence the Selection and Design of Ovarian Stimulation Protocols for IVF.
• A Rational Basis for selecting Controlled Ovarian Stimulation (COS) protocols in women with Diminished Ovarian Reserve (DOR)
•Diagnosing and Treating Infertility due to Diminished Ovarian Reserve (DOR)
•Controlled Ovarian Stimulation (COS) in Older women and Women who have Diminished Ovarian Reserve (DOR): A Rational Basis for Selecting a Stimulation Protocol
•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
•Frozen Embryo Transfer (FET) versus “Fresh” ET: How to Make the Decision
•Frozen Embryo Transfer (FET): A Rational Approach to Hormonal Preparation and How new Methodology is Impacting IVF.
•Staggered IVF: An Excellent Option When. Advancing Age and Diminished Ovarian Reserve (DOR) Reduces IVF Success Rate
•Embryo Banking/Stockpiling: Slows the “Biological Clock” and offers a Selective Alternative to IVF-Egg Donation.
•Preimplantation Genetic Testing (PGS) in IVF: It Should be Used Selectively and NOT be Routine.
•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:
•Traveling for IVF from Out of State/Country–
•A personalized, stepwise approach to IVF
•How Many Embryos should be transferred: A Critical Decision in IVF.
•The Role of Nutritional Supplements in Preparing for IVF
•Premature Luteinization (“the premature LH surge): Why it happens and how it can be prevented.
•IVF Egg Donation: A Comprehensive Overview
I invite you to arrange to have a Skype or an in-person consultation with me to discuss your case in detail. If you are interested, please contact Julie Dahan, at:
Email: Julied@sherivf.com
OR
Phone: 702-533-2691
800-780-7437
I also suggest that you access the 4th edition of my book ,”In Vitro Fertilization, the ART of Making Babies”. It is available as a down-load through http://www.Amazon.com or from most bookstores and public libraries.
Hello, I need some advice. I had my first egg retrieval on June 1st. I had my period on June 13th. I should have had my second period 4 days ago( I’m waiting patiently because we are trying to have another egg retrieval this month). So now I’m waiting for my period to start. How long should I wait?? Is this common? When should I contact my doctor?
In my opinion it is advisable to rest v1 full cycle between egg retrievals.
Geoff Sher
Hi Doctor. I have 3 failed ivf. Have taken almkal every type of treatment including intralipid heparin injection progesterone steroids everything. Even my lining is all good hotmonho level is good but still failing in implantation. Really don’t understand where we are missing or what is going wrong. Only thing is that we both are opposite blood hrp I m A nevanega and my husband is A positive. Can you suggest what can go wrong. Thyroid is also under control