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.
My wife is 45 years old. We just had got first ivf cycle done by using doner eggs. It was 3AA embryo. It was a successful transfer. Results confirmed a beta HCG of 565 then doubling and tripping. But suddenly in sixth week my wife start bleeding and periods started. Ultrasound confirm a full miscarriage. We still have 3 embryos left. My wife is totally devastated and feeling emotionally scared for second cycle.
Hi respected Sir,
its my 5th ivf and i m prescribed oral utrogestan 200mg 6th day post transfer along with progesterone pessaries and dose increased too after serum progesterone from 600 to 800…..None of my fellow patients had this issue.they did scan too with similar uterine lining…uprogest orally is making me dizzy n visually confused….thanx in advance.
Hi Zara,
This is definitely something you need to discuss with your personal RE.
Good luck!
Geoff Sher
Dear Dr. Sher,
I’m 41 years old, close to 42, and I’ve had several failed IVFs. We have 2 frozen embryos, blastocysts. How many embryos would you recommend us to transfer? We’re waiting on PGS results.
Both!
Geoff Sher
Hi Dr. Sher,
I am currently a patient in the nyc location. I am thinking of doing a fet. Can you please explain why I am out on BCP? I would be doing a medicated transfer with Lupron. I am 43. Do I have a better chance of success with lupron??
What could delay this transfer?
There are many approaches to preparing for frozen embryo transfer (FET). Some are better than others. This is the approach I prefer and which I have found to work best:
The frozen embryo transfer cycle is initiated by administering an oral contraceptive (OC) to the recipient. This is later overlapped with Lupron daily for 5-6 days. The OC is then withdrawn, but the daily Lupron injections are continued until the onset of menstruation. Next, the Lupron dosage is reduced and intramuscular (IM) estradiol valerate (Delestrogen) is administered every 3 days. The objective of the estradiol is to achieve and sustain an optimal plasma E2 concentration of 500pg/ml-1000pg/ml and a 9mm endometrial lining as assessed by ultrasound examination. Intramuscular and/or intravaginal progesterone is administered daily starting about 6 days prior to the FET and continued along with twice weekly IM Delestrogen until the 10th week of pregnancy or until it has been confirmed that the patient is not pregnant.
Daily oral dexamethasone commences with the Lupron start and continues until a negative pregnancy test or until the completion of the 8th week of pregnancy. Then it is tapered down and discontinued. The recipient also receives prophylactic oral antibiotics starting with the initiation of Progesterone therapy, until the day after ET. Usually we would thaw vitrified blastocysts with the objective of having 1, 2 or 3 for transfer; depending on a couple’s stated preference. Commencing on the day following the ET, the patient inserts a vaginal progesterone suppository daily and this is continued until the completion of the 8th week of pregnancy or until a negative pregnancy test.
As an alternative regimen for women who cannot tolerate intramuscular Progesterone (PIO), we prescribe either Crinone vaginal gel or Endometrin vaginal inserts according to protocol. If you’d like to explore one of these options, talk to your physician. For blastocyst FET’s, the blood pregnancy tests are performed 13 days and 15 days after the first progesterone administration is commenced.
Geoff Sher
Hi Dr. Sher,
I am about to begin a FET using injectable delestrogen. I started my period today earlier than expected and due to a mixup, I will likely not receive the delestrogen until Thursday, which would be the third day of my cycle. In your opinion, is that too late to take the first injection? If so, would you recommend taking another form of estrogen in the meantime? Thank you so much!
I think it should bed OK!
Geoff Sher