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,
I have been embryo banking. I aim to have three kids. How many pgs normal embryos should I have? All are grade A or B (high quality).
Thanks
Probably 5-6, all other implantation factors being equal.
Geoff Sher
Hi Dr Sher,
I am 39 and had a failed IVF cycle recently. We collected 13 eggs but only 1 fertilized and then we did a FET, but it didn’t take. We are now preparing for another cycle and it has been recommended that we do ICSI and transfer 2 embryos, if we get more than 1 fertilized.
What are your thoughts on transferring 2 embryos? I am hesitant given the risks however I am aware of my age as well and want to maximize my chances of having a baby. Any advice you can give would help. Thanks,
The more embryos transferred the greater the risk of multiple pregnancy which in turn is problematic to both the babies and the mother. However, twins can usually be tolerated well. High order multiple pregnancies (>2) is a different proposition. Here the risks skyrocket. I would prefer transferring one at a time but am willing to transfer up to 2.
Again, all multiple pregnancies pose a risk to both mother and offspring. Pregnancy induced maternal complications such as miscarriage, pre-eclampsia, antepartum and post-partum hemorrhage become progressively more prevalent the higher the multiple gestation. For the babies, it is an escalating risk of premature birth and intrauterine growth retardation that places the offspring at risk.
While even twin pregnancies increase the risk to mother and babies, it is high-order multiples (triplets or greater) that prove to be most dangerous. In fact, in about 50% of such cases severely premature births that commonly occur in such cases, result in death or severe developmental complications such as cerebral palsy, psychomotor retardation, blindness and mental retardation; conditions which severely compromise the quality of life after birth and lead to devastating financial, social and societal hardship.
Most women going through IVF are desperate to have a baby and many are even willing to cast safety to the wind, abandon all cautions, and virtually do anything it takes to achieve success. Such women are highly vulnerable to the (fortunately) few reckless medical practitioners who might exploit such desperation.
IVF, because of an inclination on the part of many practitioners, to transfer multiple embryos at a time in the hope of improving success rates, has in the past contributed vastly in this regard. However, improving IVF technology and the ability to better identify “competent” embryos for transfer has in recent years resulted in a tendency to transfer only one or two embryos, leading to a significant decline in the incidence of high-order multiple IVF pregnancies. Notwithstanding this, the transfer >2 embryos at a time still takes place far too often and with a few exceptions (e.g. in older women with poorer quality embryos) can no longer be justified in my opinion.
There is undoubtedly a need to better inform IVF consumers regarding the risks associated with the transfer of multiple embryos (especially >2) at a time. There is also an urgent need in the United States to introduce enforceable regulations to limit the number of embryos transferred, especially when it comes to embryos derived from the fertilization of young womens’ eggs, ) and when advanced embryos (blastocysts) are transferred.
The introduction of advanced preimplantation genetic screening to identify those embryos that are most likely to propagate a viable pregnancy can more than double the IVF baby rate per embryo transferred. Yes, the time is fast approaching that the transfer of but one (1) embryo will result in one healthy baby more than 50% of the time. Indeed such genetic embryo testing can improve the efficiency of the IVF process reduce miscarriages and minimize the risk of chromosomal birth defects such as Downs Syndrome , thereby providing a “better way” to help patients safely build their families successfully.
The high rate of multiple gestations resulting from IVF is a complex problem that can no longer be justified as an acceptable side effect of treatment. The Hippocratic oath states the cardinal rule of medicine as “primum non nocere; foremost do no harm.” It is imperative that this issue be addressed at multiple levels. This includes educating patients to the risks of high-order multiple gestations, as well as the steps practitioners can take to mitigate those risks, such as tailoring the treatment to the specific needs of each patient and limiting the number of embryos transferred. IVF Technology is one of the successes of modern medicine. It would be unfortunate if this success were to be overshadowed by the creation of an even worse problem. The challenge is ours.
Best wishes,
Geoff Sher
Hi Dr.Sher,
I had a hystroscopy procedure on 26th October 2020. They found adhesion during the procedure and they removed it immediately. How long I should wait till start with midications preparing for Frozen Embryo transfer? Is it ok to start at the begining of Jan 2021.. so the transfer will be at the end of January 2021?
I have another two questions please: 1. Does transfering two embryos increase the implantation chance for each of them?
2. And does transfering one bad quality embryo together with better quality embryo will affect the implantation chances of the good embryo? How many embryos do you recommend to transfer in one cycle?
Thank you very much
had a hystroscopy procedure on 26th October 2020. They found adhesion during the procedure and they removed it immediately. How 1. How long I should wait till start with medications preparing for Frozen Embryo transfer? Is it ok to start at the beginning of Jan 2021.. so the transfer will be at the end of January 2021?
A: You should be fine by the end of January to proceed.
2. Does transfering two embryos increase the implantation chance for each of them?
A: Yes!
3. And does transfering one bad quality embryo together with better quality embryo will affect the implantation chances of the good embryo? How many embryos do you recommend to transfer in one cycle?
A: It does not!
Good luck!
Geoff Sher
Hi Dr Sher. I am a 45 year old healthy female who has been dreaming of becoming a mother for a long time, but never had the right person by my side. Now that I am with an amazing man, I thought I give it a shot. We had 2 egg retrievals with 25 eggs collected, 20 fertilized but only 7 made to the blastocyst stage. All 7 were abnormal embryos. I was on 150 Menopur and 375 Follistim both times. Am I naïve to think I can still get pregnant with my own eggs? On a side note, I personally know 2 wonderful women who are enjoying motherhood thanks to you!
Hi Rose,
If I am not mistaken, you and I are scheduled for an online consultation next week. Lets discuss your options then!
Thank you!
Geoff Sher
I was reading about the DQ alpha gene match problem you wrote about. I have two questions please. First, which SNPs do you look at to see if they match. I see there are many SNPs on the DQA1 gene. Second, what is the NKa you mention? Thank you
I cannot address these issues adequately here. I think we should talk. Please consider calling my assistant, Patti Converse (702-533-2691) to set up an online consultation.
Merry Xmas and Happy 2021!
Geoff Sher