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 Dr Sher,
is it possible that i miscarried but i still have the gestational sac? i am 5wks pregnant and had heavy bleeding with clots and cramps. So I went to the ER and was told that everything is fine after all the ultrasounds and tests and that HCG is at 8,000. the following day, i went to my OB and in about 18 hrs my HCG was down at 6000. With all the clots and bleeding i had i thought i passed the sac but when they did my transV ultrasound at OB office, gestational sac is still there. my bleeding subsided to spotting with no cramps. is this still going to be a normal pregnancy?
thank you
You should take a wait and see approach and repeat the ultrasound in a week from now at which time you will almost certainly have a definitive answer.
Geoff Sher
Dear Dr. Sher,
Thank you for sharing this valuable information with the public.
I am a 40 year old woman and have been diagnosed with DOR. My AMH level since my initial testing at age 36 has stayed steady at about 0.6 and my FSH at about 8. My cycles are regular and last about 25 days. I was on BCP until age 37 and have never had a pregnancy. My AFC varies between 7 and 10. My husband has no fertility issues. I have had 3 IUI attempts in the last year using gonal f which produced 1 measurable follicle during treatment 1 and 3 measurable follicles (with multiple unmeasurable) during treatment 2. Two were unsuccessful and the 3rd was cancelled due to high estrogen at baseline.
I am currently in the middle of my first (and probably only) IVF. I have been on 600 IU of gonal f and 75 IU of menopur for 12 days. Prior to starting my RE put me on BCP for 20 days. My E2 at baseline was 8, P4 0.9 and AFC 7. At day 4 my E2 was 35, LH 10 and P4 0.49. At day 8 my E2 was 285, LH 4.4 and P4 0.56 with two follicles at 11 mm and 2-4 more on each ovary < 11 mm. The evening of day 8 my RE added 250 mcg ganirelix to the list of medications. On day 11 my E2 was 693, LH 2.0 and p4 3.6 with two follicles at 16 mm each and 2-4 more on each ovary < 11 mm. Today is day 12 and I am still on 600 IU gonal f, 75 IU menopur, and 250 mcg ganirelix. I have another u/s and bloodwork appointment tomorrow. My question to you is should I go through the egg retrieval process with only 2 follicles and have them PGS tested or should we cancel the cycle? Since we have no insurance coverage does it make sense for us to even try another round of treatment with my own eggs?
Best regards,
Marie
Hi Dr Sher
I am a 35 year old woman, with good health, and have regular, ovulatory cycles (confirmed by serum LH and ultrasound). When I was 17 I experienced arthritis type joint pain and was diagnosed as having ‘juvenile sero-negative autoimmune inflammatory arthritis’. I was treated with methatrexate and prednisone for 12 weeks, after which I was symptom free and have remained so ever since.
I fell pregnant naturally in October 2017, but it was discovered at +-8w that the pregnancy was ectopic and led to the removal of my right tube. During the laparoscopy, it was noted that there was no evidence of endometriosis, adhesions, PID or any scarring from STD’s such as chlymidia. Though, the surgeon did note that the left tube ‘looked slightly inflamed’. His recommendation was to try naturally for another 6 months, and if no luck, to seek fertility advice.
After recovering from the ectopic, we decided to begin trying in around April 2017 and continued, with no luck until December 2017. In Jan 2018 we decided to see a fertility specialist who suggested a sperm analysis, HSG for me and day 3 blood tests for me. The SA came back with ideal scores in all outcomes; the HSG showed a normal uterine cavity and a patent left tube, although there was some minor distention in the mid-tube area. My day 3 blood tests all came back in the ideal range (FSH 5.6; TSH 1.67; AMH 3.9 / 27.85. A blood test done 7 days after ovulation showed progesterone at >30.
The doc’s opinion was that we could continue to try on our own and see what happened, or else we would be good candidates for IVF.
Not wanting to waste further time, we decided to go ahead with IVF. I responded well to pretty low-doses of Pergoveris and we retrieved 13 eggs after 10 days of stims before I triggered. Of the 13, 11 were mature and 9 fertilised normally, with no ICSI required. We ended up with 6 blastocysts: 3x AA (2 expanded and 1 hatching) and 3xBA (full blasts, but not yet expanding). My endometrial lining was measured at 11mm and was trilaminar. We did a fresh 5-day transfer of the hatching blast with progesterone support (Crinone) and froze the other 5 embryos. 5 days later, I had a positive home test which was confirmed by bHCG, which doubled normally with follow up tests.
At 6w I had my first scan and it showed everything perfect, with a heartbeat. We were ecstatic. One thing that I noticed is that around day 3 after transfer, I experienced mild flu-like symptoms such as chills, sore throat, headache and a stuffy nose. However this seemed to clear up shortly after the positive beta. Another thing that seemed odd to me is that I had absolutely no symptoms of pregnancy – no sore breasts or nausea, both of which I had experienced in the weeks before my ectopic was discovered. But my doctor assured me no symptoms don’t mean anything.
When I went back at 8w, there was no heartbeat and the fetus was only measuring at 7w3d. My HCG and progesterone levels came back well within normal limits for 8w and the doc said it was a missed miscarriage, most likely due to chromosomal issues. My miscarriage was then induced medically.
We then took a few months off to recover mentally and physically and then decided to go ahead with an FET. Again, we did a natural cycle with >10mm trilaminar lining and luteal phase progesterone support and a 5-day transfer of 1 expanded AA blastocyst. 5 days later I had a positive pregnancy test but the beta turned out to be very low and then dropped. Again, I had noticed sore throat and sinus-like symptoms around what would have been implantation. Doc said ‘chemical pregnancy’.
We decided to go straight into another FET and followed the same protocol as above. This time the beta was negative. My doctor suggested that we take a break and then come back in the new year (2019) and try a controlled, medicated cycle with a Plasma Rich Protein infusion 48 hours before transfer to enhance endometrial receptivity. He also offered to do a scratch the cycle before our next transfer. I said I would think about it. Then, 2 weeks later he emailed me to say he had gone through my chart and wanted me to have some immune testing done. He ordered ANA/ENA (CTD); ANF titre; Lupus anticoagulant and Anti-phospholipid antibodies.
My results were as follows:
Lupus anticoagulant – negative
ANF titre – 1:1280, nuclear coarse speckled pattern
ANA/ENA Elia screen – negative
Cardiolipin IgM – negative
Cardiolipin IgG – negative
Anti B2 glycoprotein IgM and IgG – both negative
He then referred me to a rheumatologist who performed a urine test and a full physical exam and said he was happy that I had no underlying disease activity such as Lupus. I spoke with him about the juvenile arthritis as a teenager and he said it was likely to be related but since I am symptom free, he’s not overly concerned. He prescribed Plasmoquin (anti-malarial) 5x weekly and Ecotrin (aspirin, 81mg) daily and said it ‘should be enough to suppress the immune response for pregnancy.’
2 months later we did another FET in January this year with the PRP infusion as suggested. Lining was good etc. 48 hours after transfer I started feeling very flu-like with extremely sore throat and swollen glands, bad headache and a very runny nose, with thick mucous. I felt like this was a good sign given my previous experiences, and I had a faint positive home test on day 5. Later that day, my flu-symptoms vanished within hours. I went for a beta 2 days later (it was weekend) and it came back very low and has subsequently dropped to negative.
My doc is convinced that I have an implantation problem and is pushing for controlled medicated cycles. This does not make sense to me since I seem to have implanted almost every time, but then the pregnancy fails. My lining has always been perfect as well, and I’m not sure what else a controlled medicated cycle would achieve. I have also read many clinical papers citing much better outcomes for natural cycles than for medicated cycles.
I can’t help but think I have an autoimmunity issue that is obviously not being treated by the Plasmoquin and Ecotrin sufficiently to allow pregnancy to occur. When I asked my doc his thoughts about NK cells (something my acupuncturist who trained in the US mentioned to me after the 2nd chemical) he said that I could have them tested but that there is no treatment for them.
To investigate further, I then bought Dr Beer’s book “Is your body baby friendly”, which I see you also contributed to, hence why I am contacting you.
My question is this: do you think I should be having any additional testing done, and if so, what?
Also, given that the ANA came back as a high positive, is there a treatment protocol that you can recommend – I see from the book that usually a combination of prednisone, IVIg and aspirin are used?
Finally: what are your thoughts on intralipids – are they as effective as IVIg? I hear they are far more affordable than IVIg and better tolerated. My fertility clinic offers them as a treatment during IVF.
I’m sorry for writing a thesis but I have tried to be as complete as possible for you.
I would so appreciate any advice, thoughts or suggestions you may have to offer me. I live in South Africa, so I unfortunately am not able to come and see you in person.
Many thanks
Lauren
Hi Lauren,
You almost certainly have an implantation dysfunction, which given your history is likely to be autoimmune (but possibly alloimmune) in origin but this cannot be taken for granted. The tests you have done are NOT in any way adequate to identify and typify this etiology. These should be done at one of 4 or 5 Reproductive Immunology Laboratories in the United states. I use ReproSource in Boston, MA. The tests you need are : ANA/NKa/APA/ATA/RIP/DQ alpha/HLA. Your husband should be tested for DQ alpha and HLA. Once you have the results of these, you and I should have a talk. Depending on these test results you might require IL/steroid and Lovenox. IL works just as well as IVIG and has very few side effects. It also costs 20 times less and is not a blood product. Aspirin is in my opinion redundant and endometrial “scratch” is ineffective. I do not understand fully how, following evidence of Tubal disease (damaged tube and a prior ectopic), trying anything other than IVF was even considered seriously. Finally you should be doing PGS testing of embryos and remember, the protocol used for ovarian stimulation is critical.
Whenever a patient fails to achieve a viable pregnancy following embryo transfer (ET), the first question asked is why! Was it simply due to, bad luck?, How likely is the failure to recur in future attempts and what can be done differently, to avoid it happening next time?.
It is an indisputable fact that any IVF procedure is at least as likely to fail as it is to succeed. Thus when it comes to outcome, luck is an undeniable factor. Notwithstanding, it is incumbent upon the treating physician to carefully consider and address the causes of IVF failure before proceeding to another attempt:
1.Age: The chance of a woman under 35Y of age having a baby per embryo transfer is about 35-40%. From there it declines progressively to under 5% by the time she reaches her mid-forties. This is largely due to declining chromosomal integrity of the eggs with advancing age…”a wear and tear effect” on eggs that are in the ovaries from birth.
2.Embryo Quality/”competency (capable of propagating a viable pregnancy)”. As stated, the woman’s age plays a big role in determining egg/embryo quality/”competency”. This having been said, aside from age the protocol used for controlled ovarian stimulation (COS) is the next most important factor. It is especially important when it comes to older women, and women with diminished ovarian reserve (DOR) where it becomes essential to be aggressive, and to customize and individualize the ovarian stimulation protocol.
We used to believe that the uterine environment is more beneficial to embryo development than is the incubator/petri dish and that accordingly, the earlier on in development that embryos are transferred to the uterus, the better. To achieve this goal, we used to select embryos for transfer based upon their day two or microscopic appearance (“grade”). But we have since learned that the further an embryo has advanced in its development, the more likely it is to be “competent” and that embryos failing to reach the expanded blastocyst stage within 5-6 days of being fertilized are almost invariably “incompetent” and are unworthy of being transferred. Moreover, the introduction into clinical practice about a decade ago, (by Levent Keskintepe PhD and myself) of Preimplantation Genetic Sampling (PGS), which assesses for the presence of all the embryos chromosomes (complete chromosomal karyotyping), provides another tool by which to select the most “competent” embryos for transfer. This methodology has selective benefit when it comes to older women, women with DOR, cases of unexplained repeated IVF failure and women who experience recurrent pregnancy loss (RPL).
3.The number of the embryos transferred: Most patients believe that the more embryos transferred the greater the chance of success. To some extent this might be true, but if the problem lies with the use of a suboptimal COS protocol, transferring more embryos at a time won’t improve the chance of success. Nor will the transfer of a greater number of embryos solve an underlying embryo implantation dysfunction (anatomical molecular or immunologic).Moreover, the transfer of multiple embryos, should they implant, can and all too often does result in triplets or greater (high order multiples) which increases the incidence of maternal pregnancy-induced complications and of premature delivery with its serious risks to the newborn. It is for this reason that I rarely recommend the transfer of more than 2 embryos at a time and am moving in the direction of advising single embryo transfers …especially when it comes to transferring embryos derived through the fertilization of eggs from young women.
4.Implantation Dysfunction (ID): Implantation dysfunction is a very common (often overlooked) cause of “unexplained” IVF failure. This is especially the case in young ovulating women who have normal ovarian reserve and have fertile partners. Failure to identify, typify, and address such issues is, in my opinion, an unfortunate and relatively common cause of repeated IVF failure in such women. Common sense dictates that if ultrasound guided embryo transfer is performed competently and yet repeated IVF attempts fail to propagate a viable pregnancy, implantation dysfunction must be seriously considered. Yet ID is probably the most overlooked factor. The most common causes of implantation dysfunction are:
a.A“ thin uterine lining”
b.A uterus with surface lesions in the cavity (polyps, fibroids, scar tissue)
c.Immunologic implantation dysfunction (IID)
d.Endocrine/molecular endometrial receptivity issues
e.Ureaplasma Urealyticum (UU) Infection of cervical mucous and the endometrial lining of the uterus, can sometimes present as unexplained early pregnancy loss or unexplained failure following intrauterine insemination or IVF. The infection can also occur in the man, (prostatitis) and thus can go back and forth between partners, with sexual intercourse. This is the reason why both partners must be tested and if positive, should be treated contemporaneously.
Certain causes of infertility are repetitive and thus cannot readily be reversed. Examples include advanced age of the woman; severe male infertility; immunologic infertility associated with alloimmune implantation dysfunction (especially if it is a “complete DQ alpha genetic match between partners plus uterine natural killer cell activation (NKa).
I strongly recommend that you visit http://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.
•Ovarian Stimulation in Women Who have Diminished Ovarian Reserve (DOR): Introducing the Agonist/Antagonist Conversion protocol
•Anti Mullerian Hormone (AMH) Measurement to Assess Ovarian Reserve and Design the Optimal Protocol for Controlled Ovarian Stimulation (COS) in IVF.
•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
•IVF: How Many Attempts should be considered before Stopping?
•“Unexplained” Infertility: Often a matter of the Diagnosis Being Overlooked!
•IVF Failure and Implantation Dysfunction:
•The Role of Immunologic Implantation Dysfunction (IID) & Infertility (IID): PART 1-Background
•Immunologic Implantation Dysfunction (IID) & Infertility (IID): PART 2- Making a Diagnosis
•Immunologic Dysfunction (IID) & Infertility (IID): PART 3-Treatment
•Thyroid autoantibodies and Immunologic Implantation Dysfunction (IID)
•Immunologic Implantation Dysfunction: Importance of Meticulous Evaluation and Strategic Management 🙁 Case Report)
•Intralipid and IVIG therapy: Understanding the Basis for its use in the Treatment of Immunologic Implantation Dysfunction (IID)
•Intralipid (IL) Administration in IVF: It’s Composition; how it Works; Administration; Side-effects; Reactions and Precautions
•Natural Killer Cell Activation (NKa) and Immunologic Implantation Dysfunction in IVF: The Controversy!
•Endometrial Thickness, Uterine Pathology and Immunologic Factors
•Vaginally Administered Viagra is Often a Highly Effective Treatment to Help Thicken a Thin Uterine Lining
•Treating Out-of-State and Out-of-Country Patients at Sher-IVF in Las Vegas:
•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
My final IVF cycle at SIRM-LV commences on March 19th and concludes on April 2nd. If you are interested in undergoing a fresh IVF treatment cycle with me or if you have embryos cryopreserved at SIRM-LV and wish to undergo a Frozen Embryo Transfer (FET) prior to my departure, please contact me immediately….. My March cycle is likely to be very much in demand…….So, time is of the essence!
Following my departure from SIRM in mid-April, 2019, I will continue to provide comprehensive consultations to those of you that wish to have my guidance. Upon scheduling a SKYPE consultation with me, you will promptly receive a detailed questionnaire, along with a request that you submit available medical records for my review prior to our consultation. Additional tests and records can/will be requisitioned later, as needed. Your +/- 1 hour comprehensive SKYPE consultation will be followed by a detailed written report which you can also share with your personal Fertility Physician.
I will soon be posting a list of internationally regarded Fertility Specialists whom I endorse and who will have expressed a willingness to implement my suggested approaches, at their discretion. It is to one of these doctors that I would selectively refer you…upon request.
CONTACT INFORMATION:
•Online: Go to sherivf.com and Schedule a Skype Consultation. Upon doing so, you will be able to download a free copy of my new eBook ” Recurrent Pregnancy Loss (RPL) and Unexplained IVF Failure: The Immunologic Link”
•Phone
oIf you live in the USA or Canada: Please call 1-800-780-7437 or 702-533-2691
oIf you reside elsewhere Abroad: Please call 702-533-2691
oEmail: concierge@SherIVF.com
Please monitor this website for future announcements on further developments.
Geoff Sher
What it meant if result of Beta HCG test is 0.952
That is effectively a negative result! But I would repeat it in 2 days to see if it increases…just in case!
Geoff Sher
Hi,
I am am 37 and trying to get pregnant since 4 years and have only had lots of disappointments. As I am a low responder (0.08) all the doctors do not give much hope. I had 2 insemination, andwithin the last 8 months 3 icsi, of which in the first no egg out of 3 follicles could be retrieved, in the second icsi I got 2 eggs which were fertilized and transfered 3 days later but no pregnancy developed.
Last week i had my 3rd icsi and out of 2 follicles only 1 egg was retrieved but could not get fertilized.
I am so frustrated as I think that the stimulation protocol was never the right one (1st icsi pergoveris=0 eggs, 2nd icsi clomifen and 3 days gonal 75=2 eggs and transfer of embryos, 3rd icsi clomifen and menopur=1egg,no fertilization.
Do you think I should try another protocol stimulation or just give up on another icsi? I am really suffering with this uncertainty, especially as I have regular cycles with ovulation each month.
Thank you in advance for your help.
Hi Dominika,
You no doubt have severely diminished ovarian reserve (DOR) and in my opinion, you require a very individualized and aggressive protocol for ovarian stimulation, ASAP. At 37y of age, if you do so, and bank PGS-normal embryos, stockpiling them over >1 cycle, you might still be able to achieve your dream of a baby , using own eggs…but time is absolutely critical. This having been said, the much safer bet would be to use an egg donor.
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
My final IVF cycle at SIRM-LV commences on March 19th and concludes on April 2nd. If you are interested in undergoing a fresh IVF treatment cycle with me or if you have embryos cryopreserved at SIRM-LV and wish to undergo a Frozen Embryo Transfer (FET) prior to my departure, please contact me immediately….. My March cycle is likely to be very much in demand…….So, time is of the essence!
Following my departure from SIRM in mid-April, 2019, I will continue to provide comprehensive consultations to those of you that wish to have my guidance. Upon scheduling a SKYPE consultation with me, you will promptly receive a detailed questionnaire, along with a request that you submit available medical records for my review prior to our consultation. Additional tests and records can/will be requisitioned later, as needed. Your +/- 1 hour comprehensive SKYPE consultation will be followed by a detailed written report which you can also share with your personal Fertility Physician.
I will soon be posting a list of internationally regarded Fertility Specialists whom I endorse and who will have expressed a willingness to implement my suggested approaches, at their discretion. It is to one of these doctors that I would selectively refer you…upon request.
CONTACT INFORMATION:
•Online: Go to sherivf.com and Schedule a Skype Consultation. Upon doing so, you will be able to download a free copy of my new eBook ” Recurrent Pregnancy Loss (RPL) and Unexplained IVF Failure: The Immunologic Link”
•Phone
oIf you live in the USA or Canada: Please call 1-800-780-7437 or 702-533-2691
oIf you reside elsewhere Abroad: Please call 702-533-2691
oEmail: concierge@SherIVF.com
Please monitor this website for future announcements on further developments.
Geoff Sher