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.
Dr Sher
What is a good substitute for delestrogen? We used your frozen transfer protocol and it was a success but I am not in the USA and the pharmacy that compounds it will not make more before I run out of this vile. I am afraid a drop in estrogen could be detrimental. My levels 5 days after transfer were 1,298 in US measurements. Before transfer it was just over 500 as is your preference ( you said between 500-1000) so it was perfect.
Thank you so much.
You can take oral estradiol valerate (Progynova) or use estradiol skin patches.
Good luck!
Geoff Sher
Hi Dr. Sher,
I am 25 dpo with a very strong control line still. My Dr did a vaginal US and bloodwork on 14 DPO – 240 HCG and progesterone was 44. Day 22 DPO – 10,888 HCG and progesterone was 36. He could see the sac with an echo but no heart beat yet so he thinks I’m 5 weeks along. Just had a MC in October and he also found an ovarian cyst on my US at my 22 DPO exam which is why I’m having severe stomach cramping. Do these numbers look promising? Very nervous to have another MC but my doctor is telling me this is all moving along great.
Yes they do look “promising. However, only time will tell!
G-d bless!
Geoff Sher
Hi Dr. Sher,
It’s me again. You suggested that I get a follow up ultrasound in a week’s time, which I fully plan on doing but since the labs won’t be opening until Tuesday, I am just looking to get your take on this in the meantime.
At the time of my ultrasound, I was 6 weeks 1 day pregnant based on my LMP on November 9. The ultrasound reports that I am dating 7 weeks 4 days with a gestational sac with an average diameter of 2.3 cm with a maximum diameter of 3 cm. There is also a slight distortion in the gestational sac. The yolk sac is a bit small, measuring 2 mm in diameter. There was also no embryo identified and my betas at the time were 88, 888 IU/L.
The radiologist states that this is concerning based on the findings, would you agree? Also what does “2.3 cm with a maximum diameter of 3 cm” mean? What is the MSD?
I think that these early US’s are often unreliable and depending on the quality of the US machine and the skill of the US-technologist, failure to see a conceptus at this stage is not unusual. Also, while the hCG level is high, this could still be a viable pregnancy. Only time will tell. Please keep me in the loop!
Happy holidays!
Geoff Sher
Hi Dr. Sher,
I am 6 weeks 1 day pregnant based on my lmp. I went in for an ultrasound today and only a gestational sack and yolk sac could be seen. I asked the technician what I was dated as and she said 7 weeks 4 days. Not sure if she knew what she was talking about because she looked confused. I went to go get bloodwork done to check my beta HCG immediately after and it is 88888 IU/L. I am in Canada and am attaching the reference ranges from the lab below:
5 – 6 weeks 10,000 – 100,000
6 – 8 weeks 15,000 – 200,000
If my HCG is this high, shouldn’t there at least be an fetal pole visible?
I also started to have morning sickness today. What are your thoughts?
Six weeks can be a little early to detect fetal viability in certain ultrasound settings. Give it a week and repeat the US! That should be definitive.
Good luck!
Geoff Sher
Hi Dr. Sher,
In your articles, you recommend taking BCP prior to start of cycle, and usually menstruation starts after 5-7 days off BCP. I have read that some women might not start their period for several months after stopping BCP as it takes some time for body to adjust. Have you seen that happen in your practice? If so, is there anything that can be done besides waiting?
Secondly, I read that taking protein supplements increases fertility. Your thoughts on that?
Thank you and Happy Holidays.
In >30 years, I have probably seen this no more that 2-3 times.
Geoff Sher