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.
Dear Dr Sher,
I have 20mm and 18mm follicles. Others are too small.
Ganirelix has kept my LH below 2.
1- Is it ok to trigger with LH of 2? Or must Ganirelix be stopped to let LH gradually increase a little more to trigger? I am scared that reducing Ganirelix may cause ovulation as when I briefly stop Ganirelix the LH starts climbing fairly fast.
2- Would eggs be too immature if suppressed by Ganirelix and triggered with LH under 3?
3- does increasing FSH make eggs mature?
4- does increasing LH make eggs mature?
5- what can be done to make follicles grow and eggs mature?
Yola!
As you currently are in cycle with another RE, I am not comfortable commenting mid-stream. It does not feel right to do so!
Sorry,
Geoff Sher
Dear Dr. Sher,
I have 3 follicles. 20mm, 15.5mm, 2mm. E2 is 400 and LH is 2.5 with Ganirelix suppression that was started from the beginning of the cycle and has been fluctuation between 1 and 6. I am thinking a day more may give me 2 eggs instead of one but I am afraid that the 20mm may get too mature and the 15.5mm may be too immature if triggered a day later. When there is a lead follicle of 20mm and another not too far behind but may put the larger one at risk, what is the general practice? Is it to go for the 20mm dominant follicle taking that it maybe the best one or take a risk and wait for two?
This is a call that must be made by the treating RE. It is a clinical on-sight call to be made.
Sorry!
Geoff Sher
Hello Dr. Sher:
For the past 8 months, at the age of 40, almost 41 (this summer), I underwent 3 IVF cycles. I responded very well. From the 3 cycles, 28 embryos made it to blast stage day 5/6, all were PGD tested, only 1 normal embryo. AMH is over 4.o. My question to you is should I go for another round of IVF, or move to DE. I spoke with my RE already (highly reputable in the field) and would like your take on my case.
Thank you in advance for your time on this request.
I think this requires in depth discussion and one-on-one deliberation.
Please call or email Julie Dahan, my patient concierge. She will guide you on how to set up an in-person or Skype consultation with me. You can reach Julie at on her cell phone or via email at any time:
Julie Dahan
•Email: Julied@sherivf.com
•Phone: 702-533-2691
Geoff Sher
Hi Dr. Sher,
I have stage 3 endometriosis and have had one failed fresh IVF cycle and one failed FET. I am doing another egg retrieval right away and doing a freeze all. I would like to go on Lupron to suppress my period. Do you recommend 3 or 6 months of suppression? Surgery is not an option due to the extent of the tissue growth. So my doctor and I agreed try suppression followed by the lovenox, dexamethasone & intrilipids protocol. Any advice would be appreciated. Thanks
Unless you have ovarian endometriotic cysts (endometriomas) that require surgical intervention, waiting 3 months on Lupron-suppression will in my opinion not be helpful.
Also, before taking IL therapy, there needs to be a definitive immunologic diagnosis for justification and implementing.
Please call or email Julie Dahan, my patient concierge. She will guide you on how to set up an in-person or Skype consultation with me. You can reach Julie at on her cell phone or via email at any time:
Julie Dahan
•Email: Julied@sherivf.com
•Phone: 702-533-2691
Geoff Sher
Dear Dr,
My wife, 31, has PCOD. I am 33. We are planning to go for IVF. However, I have developed a skin abscess for which I am taking antibiotics, and it looks like these may continue til the day of egg retrieval and embryo formation. Is it okay to go for IVF or we should wait until the skin infection is completely gone.
Also, in IVF, is there any risk with ICSI and embryo freezing or is it okay to get these things done?
Thanks
Rahul
In my opinion, you can go ahaead since the sperm you currently have, were formed 3 months ago.
ICSI done in the absence of male factor infertility, in my opinion is not associated with a significant increased risk.
Geoff Sher