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
I am worried. I did frozen embryo transfer of 5 days embryos at 27/9 then first beta at 5/10 was 157
second beta at 7/10 was 473 so doubling time around 32 hr but third beta at 10/10 was 976 so doubling time increase to 69 hr I am afraid help me.
I am not despondent at this stage. In fact this looks quite promising.
Good luck!
Geoff Sher
Hello Dr Sher! Thank you for this wonderful blog. I have high estrogen levels( 190) and no follicle in sight. Just one hemorrhagic cyst at 14mm. It is day 8 of my cycle. I am so confused. Can I please ask:
a) Can a hemorrhagic cyst create estrogen or does it have to be a corpus luteum hemorrhagic cyst? ie can a follicle bleed into iteself before ovulating and thus create an estrogen producing hemorrhagic cyst? b) Can I take Ovidrel to get rid of this 14mm hemorrhagic structure assuming that this is a follicle that bled into itself? Will taking Ovidrel hurt? Thank you.
Yes! Any functional cyst can produce estrogen. Ovidrel will not help here at all!
Good luck!
Geoff Sher
Hello Dr Geoffrey, I’m 40years old, and have both Fallopian tubes blocked. My husband and I decided to go through IVF. I started the injections and was also being monitored through sonogram to check the follicles. It happens that only one follicle got bigger at about 21m . It was retrieved and then the next day I got a disappointing call saying the egg couldn’t hold up. I don’t know where to go from here, and I’m so lost now.
You clearly likely have diminished ovarian reserve (DOR).Women who (regardless of age) have DOR have a reduced potential for IVF success. Much of this is due to the fact that such women tend to have increased 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, www. SherIVF.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
If you are interested in my advice or medical services, I urge you to contact my patient concierge, ASAP to set up a Skype or an in-person consultation with me. You can also set this up by emailing concierge@sherivf.com or by calling 702-533-2691 and/or 800-780-743. You can also enroll for a consultation with me, 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 .
Geoffrey Sher MD
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.
My embryo s we’re grade 1 blastocyst and uterus lining thickness was greater than 8 mm and Doppler technique measured blood flow in uterus was good in systolic and diastolic cycles when the transfer was done.
Hello doctor, I went through Frozen embryo transfer on 28 the of Sep 2018. My day 3 embryo s we’re thawed and cultured till they become blastocyst and then inserted inside me. No hcg injection was administered. I was taking estrogen tablets, progesterone and Clexane injections daily. After 13 days, I have a hcg level of 4.36. I also unfortunately had a brawl with my husband on 1st and 2nd October 2018. Is my hcg level ok? Did my brawl with my husband when I was screaming because of his disrespectful behavior affected my ivf procedure and success? I took leave from office but was actively doing cooking at home and some light activities.
I am sure b the associated stress did not help. However it is unlikely that the physical encounter wold have compromised implantation. In the end, only time will tell. Do another hCG test in 2-4 days.should double every 48h.
Good luck!
Geoff Sher