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.
In my opinion…very, very improbable.
Geoff Sher
It is possible that progesterone might increase the likelihood of gastric reflux in some women, causing such symptoms.
Geoff Sher
Hello Dr. Sher
We have a day 3 8 cell grade 1 embryo, embryologist said it is perfect! What are the chances it makes it to the blastocyst stage at day 5? We will be doing a day 5 transfer on Monday
There are many factors that affect the ability of a morphologically normal cleaved embryo to progress to blastocyst. The most significant are the age of the woman and her ovarian reserve , as these impact the chromosomal integrity of the embryo. In a woman <35y with normal ovarian reserve, the chance of this embryo making it to blastocyst should be about 40%. After 40y , probably half that.
Geoff Sher
Hi Sher,
I am currently seven weeks pregnant after IVF and taking prometrium tablets (six vaginally per day, and five orally per day). I am suffering from serious stomach pains likely heartburn and indigestion. I read that the pregesterone hormone in a woman’s body causes relaxation of the lower esophageal sphincter leading to heartburn when pregnant. If pregesterone does this, wouldn’t prometrium be playing a role in giving me heartburn by causing my stomach muscles to relax even further? In my last pregnancy I took the same amount of prometrium until twelve weeks of pregnancy and I had the same stomach pain. After delivery I was diagnosed with gastritis and given antibiotics. It healed but then I did ivf with the same protocol and now I’m getting the same symptoms. I couldn’t figure out what gave me gastritis but after reading about progesterone I wonder if it’s the prometrium tablets. What do you think? If so, could I reduce the amount of prometrium without losing the pregnancy? I have no known infertility issues but I am 41.
Thank you very much,
Michelle
Here is the approach I take in women, who have “adequate” ovarian reserve.
My advice is to use a long pituitary down regulation protocol starting on a BCP, and overlapping it with Lupron 10U daily for three (3) days and then stopping the BCP but continuing on Lupron 10u daily (in my opinion 20U daily is too much) and await a period (which should ensue within 5-7 days of stopping the BCP). At that point an US examination is done along with a baseline measurement of blood estradiol to exclude a functional ovarian cyst and simultaneously, the Lupron dosage is reduced to 5U daily to be continued until the hCG (10,000u) trigger. An FSH-dominant gonadotropin such as Follistim, Puregon or Gonal-f daily is started with the period for 2 days and then the gonadotropin dosage is reduced and a small amount of menotropin (Menopur—no more than 75U daily) is added. This is continued until US and blood estradiol levels indicate that the hCG trigger be given, whereupon an ER is done 36h later. I personally would advise against using Lupron in “flare protocol” arrangement (where the Lupron commences with the onset of gonadotropin administration.
I strongly recommend that you visit https://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.
• 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
• “Triggering” Egg Maturation in IVF: Comparing urine-derived hCG, Recombinant DNA-hCG and GnRH-agonist:
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
With women undergoing superfetation, Can they release eggs during the 7th-9th month of pregnancy. I did hear that some women may release eggs while pregnant?