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.
dr sher
i had abortion 3weeks ago. it didnt stop bleeding.. dr gave me transamine but it didnt work. another doctor gave me cyclo-progynova it decreased my bleeding immediatly. she said my lining 3mm. former doctor said it is because of hormonal changes but i think it is because of deep curretaj. it will recover, right?
today i took third cyclo-progynova pill. is this my cd3? when can i ovulate? is it when white pills finishes? i wanna try to get pregnant spontane this month. how can i calculate my ovulation day
sorry i posted same question again
Hi dr sher
What is your opinion regarding ET at endometrial thickness of 1.8cm.And can tachycardia and anxiety affect my implantation.
In my opinion, as long as the thickened endometrium is not due to a pathological cause such as hyperplasia or neoplasia, this thickness of the endometrium would in my opinion not be an impediment. This needs to be assessed.
I do not believe anxiety is a mitigating factor.
Geoff Sher
i had abortion 3week ago i have been bleeding since then. doctor said it is because of hormonal changes but i think it is bucause of deep curretaj what do you think? he gave transamine but it didnt stop bleeding i went another doctor she gave cyclo-progynova. it almost stop bleeding after 2day. my lining was 3mm bucause of bleeding or curretaj.. will it recover immediatly because i am 43years old and i have to have ivf again as soon as possible.
how can i calculate about my cyle while taking cyclo-progynova. is it my cd3 or what? can i ovulate this month and which cd to try spontan pregnancy..
You would need to continue estrogen therapy for a a week or two in my opinion. Once the endometriumm thickens adequately, a progesterone withdrawal bleed can be induced, whereupon, in my opinion, at 43y of age you absolutely need IVF…perhaps even using an egg donor, given age and its effect on your biological clock!
Geoff Sher
Hello Dr. Sher. I have been reading all of your information regarding elevated LH importance on egg quality. I have consistenly elevated daily LH for months due to low reserve.
My doctor wants to put me on the following protocol: coming off a natural cycle, a week after ovulation start cetrotide, along with estrogen priming. Once menses starts, gonal-f daily and then cetrotide again when the follicle is mature.
In your opinion is that adequate to lower LH or are bcp/lupron still needed?
Thanks.
In my opinion, I would use a different approach.
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, and/or biological activity, of LH. This can result in excessive ovarian male hormone (predominantly testosterone) production. This 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.
Hi Dr Sher
It’s Sara again with all the beta levels and cramping/bleeding. The bleeding stopped last night. Maybe an hour after it started. No cramping anymore.
Had the beta repeated this morning.
6016 Tuesday dec 4
9379 Thursday dec 6
13,268 Saturday dec 8 (TODAY)
Ultrasound tech wouldn’t tell me much except that ultrasound showed a yolk sac and a gestational sac. She said I’m dating 5 weeks 2 days.
My period before ivf was Nov. 2
Retrieval was Nov 13 and transfer was 3 days later on Nov 16.
She said she can’t tell me if there’s a subchorionic hemorrhage. That I need to follow up with my doctor.
I haven’t been able to eat all day. Nervous wreck over here!
What are your thoughts on the viability of this pregnancy?
Probably is a subchorionic bleed. Hopefully it will resolve and all will be OK!
Good luck and G-d bless!
Geoff Sher