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.
What are the effects of thc and cbd on fertility and ivf implantation success?
It has no effect on embryonic development(limited research)!
Geoff her
hi dr sher i read all the protocol you suggest. i am advanced age.. my doctor decided to start 300gonalf cd2 a few days later we will have cetrotide.. i know you prefer different protocol.. my guestion is that if i start cetrotide on cd2, sameday with gonalf.. is it possible to block LH surge by this way.? öy second question is
some time my dr gives luveris or menapour 75mg with gonalf
is it better than only gonalf. i prefer not to use luveris because i think luveris could affect my fsh or lh in a bad way. what dou you think
I really cannot comment on the protocol you doctor has prescribed. If your doctror intends to give you a GnRH antagonist (e.g. Cetrotide), starting on day 2, it should block LH in a timely manner.
Good luck!
Geoff Sher
If endometriosis is not bothering you physically does it need to be removed if you are treating it with ivf and immune therapy like IVIg, prednisone and lovenox? Will removing it best they can help at all or will the previous mentioned treatments suffice?
IVIG therapy has by and large been supplanted with Intralipid therapy which cost a fraction of the former, has far fewer side effects and risks and is not a blood-derived product.
Unless you have advanced endometriosis with large endometriotic (chocolate) cysts, surgery will not add or detract from IVF treatment.
Women, who have advanced endometriosis, often have endometriotic ovarian cysts, known as endometriomas. These cysts contain decomposed menstrual blood that looks like melted chocolate…hence the name “chocolate cysts”. These space occupying lesions can activate ovarian connective tissue (stroma or theca) resulting in an overproduction of male hormones (especially testosterone). An excess of ovarian testosterone can severely compromise follicle and egg development in the affected ovary. Thus there are two reasons for treating endometriomas. The first is to alleviate symptoms and the second is to optimize egg and embryo quality. Conventional treatment of endometriomas involves surgical drainage of the cyst contents with subsequent removal of the cyst wall (usually by laparoscopy), increasing the risk of surgical complications. We recently reported on a new, effective and safe outpatient approach to treating endometriomas in women planning to undergo IVF. We termed the treatment ovarian Sclerotherapy. The process involves; needle aspiration of the “chocolate colored liquid content of the endometriotic cyst, followed by the injection of 5% tetracycline hydrochloride into the cyst cavity. Such treatment will, more than 75% of the time result in disappearance of the lesion within 6-8 weeks. Ovarian sclerotherapy can be performed under local anesthesia or under conscious sedation. It is a safe and effective alternative to surgery for definitive treatment of recurrent ovarian endometriomas in a select group of patients planning to undergo IVF
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.
•Anti Mullerian Hormone (AMH) Measurement to Assess Ovarian Reserve and Design the Optimal Protocol for Controlled Ovarian Stimulation (COS) in IVF:
•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!
•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
•How Many Embryos should be transferred: A Critical Decision in IVF?
•Endometriosis and Immunologic Implantation Dysfunction (IID) and IVF
•Endometriosis and Infertility: Why IVF Rather than IUI or Surgery Should be the Treatment of Choice.
•Endometriosis and Infertility: The Influence of Age and Severity on Treatment Options
•Early -Endometriosis-related Infertility: Ovulation Induction (with or without Intrauterine Insemination) and Reproductive Surgery Versus IVF
•Treating Ovarian Endometriomas with Sclerotherapy.
•Effect of Advanced Endometriosis with Endometriotic cysts (Endometriomas) on IVF Outcome & Treatment Options.
•Deciding Between Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF).
•Intrauterine Insemination (IUI): Who Needs it & who Does Not: Pro’s &
•Induction of Ovulation with Clomiphene Citrate: Mode of Action, Indications, Benefits, Limitations and Contraindications for its use
•Clomiphene Induction of Ovulation: Its Use and Misuse!
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ADDENDUM: PLEASE READ!!
INTRODUCING SHER FERTILITY SOLUTIONS (SFS)
Founded in April 2019, Sher Fertility Solutions (SFS) offers online (Skype/FaceTime) consultations to patients from > 40 different countries. All consultations are followed by a detailed written report presenting my personal recommendations for treatment of what often constitute complex Reproductive Issues.
If you wish to schedule an online consultation with me, please contact my assistant (Patti Converse) by phone (800-780-7437/702-533-2691), email (concierge@SherIVF.com) or, enroll online on then home-page of my website (www.SherIVF.com).
PLEASE SPREAD THE WORD ABOUT SFS!
Geoff Sher
Good morning Sher. What is the best kind of birth control to use to help aid in getting rid of a cyst? Cancelled IUI because too many follicles and still have a cyst despite taking the trigger to release the eggs. I have read your blog posts about cysts and the doctor has never aspirated a cyst and I don’t want to be the Guinea pig. I really would appreciate your advice
Any combined BCP such as Desogen, Lo’Ovral; lowestrin etc would be OK!
Geoff Sher
Hi Dr Sher
I have had 2 early miscarriages after seeing a healthy hb on the 2nd pregnancy
We have just found out we have a DQ alpha gene match
Me
HLA-DQA1 (6.7) 1:02/08/09/11
5:05/09/11/13
Husband (2,7) 05:01,
05:05/09/10/11
Could you please tell me what this means for us and whether there is treatment that can help us?
We do not match on HLA-DR or HLA-DQB1
Is there hope for us to have a biological child together?
Thanks in advance for your time
The presence of a DQ alpha match alone does not compromise th pregnancy unless there is a concomitant activation of Natural Killer cells (NKa as measured by the K-562 target cell tst or uterine endometrial cytokine analysis).
Geoff Sher