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 husband have been trying to conceive a second baby after the birth of our little girl (Born August 31st 2019 as a result of our first IVF due to MFI). Ive just turned 38 and my husband is 35. Husband was born with an undescended testicle which was not corrected until he was older which is believed to be the cause of his issues. So far this year we’ve gone through 2 full cycles this year as follows:
ICSI 04/05/2020:
Protocol: Short Gonal-F 450iu, Luveris 150iu, Cetrotide 0.25mg.
Result: 10 eggs(majority right ovary), 9 mature, 5 fertilised, 2 x 5 day blastocysts. Freeze all.
FET 15/06/2020:
Protcol: Lubion 25mg 1 daily, one Crinone pessary 1 daily, Fematab 2mg 3 x daily.
Result: BFP August 4th at almost 5 weeks (confirmed in clinic with HCG level of 2836). Miscarried same day. Blood tests confirmed that progesterone levels too low to sustain a pregnancy. Due to an administrative mistake on our treatment plan we had accidentally stopped all injections and support meds almost 1 week earlier at 4 weeks when we should have been on it for 12 weeks. The clinic said this may have been a contributing factor. We have one frozen embryo left but due to may age and now potential egg issue (low fertilisation rate) we chose to complete a new cycle in the hopes of producing more eggs.
ICSI 18/09/2020:
Protocol: cq10, and DHEA supplementation for approx 6 weeks in advance of cycle. Short Cycle. Gonal-F 450iu, Luveris 225iu, Cetrotide 0.25mg.
Result: 6 eggs (majority left ovary), 2 mature, 1 fertilised. 5 day results pending.
Most recent fertility results and dates were as follows:
08/05/2020 AMH 15.5pmol/L
21/09/2020 FSH 2.3 IU/L
21/09/2020 Antral follicle count 10 (right) 11 (left)
On our first round of IVF (which resulted in the birth of our daughter) the protocol was much gentler with just Gonal-f at 150 if I recall correctly and no Luveris. That cycle resulted in a high number of mature eggs of which 2 made it to blastocyst, one negative transfer and one positive. For our recent cycles the consultants approach was to “hit the ovaries hard” given my age, to maximise the egg harvest. At that point we had no reason to believe that my egg quality was an issue. However it appears that with each increase in medication, we’ve had a corresponding reduction in the growth of follicles and a further reduction in the number mature eggs. I’ve come off the DHEA as I was never tested for high testosterone in advance in advance of being prescribed it, thus I don’t know if this was a contributing factor. Clinic now believe that my egg quality is very poor and have advised this if our one remaining embryo does not make it to day 5/implantation we may want to consider donor eggs. I was hoping you could provide some advice on how we should proceed as I would rather exhaust all options first? Perhaps a different protocol?
Dear Dr. Sher,
I have a persistent thin uterine lining and based on your comment on the blog post and advice on the website, I am currently giving viagra a shot to thicken it. Can I also take low dose aspirin and vitamin E for uterine blood flow or would that be too much?
Yes you could, provided your treating doctor agrees!
Geoff Sher
I have endometriosis and had several IVF attempts. Always responded well but on 1 or 2 made it to blastocyst stage. Unfortunately ended in miscarriage on both of these cycles. After taking DHEA for 4months a 3 cycles produced 5 embryos which made it to blastocyst stage. This cycle was not successful and neither was the following frozen transfers. I am keen to look in immune issues now, however my doctor is not that supportive and states it’s just bad luck. I have researched and feel I would benefit from further investigation. I am now 39 so I know time is against us. I am in the uk, what would you recommend? Thank you xx
Hi Dr Sher,
I am almost 5 weeks pregnant and have been having some very light spotting along with cramps and back pain. Is this normal?
Thanks.
Jess
It is quite common. As long as the bleeding and pain does not escalate!
Good luck!
Geoff Sher
Hello Dr. Sher,
I am 35 years old and have just completed my first cycle of IVF due to unexplained infertility. We ended up with 6 embryos, but unfortunately our first FET (2 embryos transferred) ended in a biochemical pregnancy.
We are now left with 4 embryos (2 are grade 5AA, 1 is grade 5AB and 1 is grade 4AB). Our doctor does not recommend PGT-A testing, and prefers to transfer 2 embryos again.
I agree with holding off on the PGT-A testing, as I do not have a history of miscarriage and both my partner and I have undergone Karyotype testing and all is normal. However, I am a bit concerned about transferring 2 embryos again.
What is your recommendation?
Thank you so much for your time!
I concur with your RE’s recommendations!
Geoff Sher
Is it true that in an ivf cycle, after the first few days of stimming the follicles would keep growing on their own even if a woman stopped the Gonadotropins?
It can sometimes happen, but only after the follicles have ex ceded 14mm.
Geoff Sher