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.
Dear Dr.Sher,
On my previous comment, I forgot to mention the treatment will be an IUI and 26 to 34 hrs after Pregnyl 10000ui as you suggested.
Trigger will be at 2am tomorrow morning. Shall I take Menopur 75 (together with Orgalutran) one more time? Now it s 10am and last dose was last night at 9pm. I dont know what to say for your help.
Again Eleonore..that is definitely something you need to take up with your RE.
Geoff Sher
Dr. Sher, On my medicated cycle I took orgalutran at 5pm (from day 7) and Menopur 75 at 9pm (from day 3). Leading follicule is 17mmx20mm today (day10) so I will trigger ovulation tonight at midnight.
My concern is the Orgalutran dose. Last one was yesterday at 5pm. Shall I take another dose this morning? (Otherwise more than 30 hrs between antagonist and Pregnyl). Thank you!
Eleonore,
This is definitely something you need to discuss with your own RE.
Geoff Sher
Hi I was wondering if I could ask you for advice. I have pcos and last year I had a burst cyst. At the moment I haven’t got any cysts. This year in March I had laparoscopy to remove endometriosis. They fitted in the coil as well. But I’ve recently been having pain everyday. Can endometriosis come back if you are not having periods.
Thank you
Unfortunately it can and does. It is fueled by estrogen.
Geoff Sher
My wife had one embryo transfer 9 days ago. Her 7 day beta was 3.2. Her 9 day beta was 5.2. Any thoughts? Thanks Dr.
Sadly this seems to be a failed implantation…a “chemical pregnancy”
So sorry!
Geoff Sher
Hey Dr. I was wondering your opinion on what would cause a low very AMH of .17 with a high FSH of 18 while still have a pretty normal AFC of 13 at 29 And do you think this will indicate a poor response to IVF medications? I had an endometrioma removed but and lost of endo removed. Not sure how much that is a factor. Would you suggest PGS testing in this case?
Yes! I do believe that this points to diminished ovarian reserve , regardless of the AMH. What tis is telling you is that you are not going to be a good responder, but provided that the protocol used for ovarian stimulation is optimized, whatever eggs you produce should have the same percentage that are genetically normal as would a woman with normal ovarian reserve…..but the protocol should be carefully tailored to your needs. I would use a modified, robust, long pituitary down-regulation protocol. I would use an agonist/antagonist conversion protocol with human growth hormone (HGH) augmentation and would recommend Staggered IVF with embryo banking of PGS (next generation gene sequencing)-normal blastocysts, to make hay while the sun still shines.
Please visit my new Blog at o to http://goo.gl/4hvjoP , 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
•Ovarian Stimulation for IVF using GnRH Antagonists: Comparing the Agonist/Antagonist Conversion Protocol.(A/ACP) With the“Conventional” Antagonist Aproach
•IVF: Factors Affecting Egg/Embryo “competency” during Controlled Ovarian Stimulation(COS)
•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.
•Diagnosing and Treating Infertility due to Diminished Ovarian Reserve (DOR)
•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?
•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 Sampling (PGS) Using: Next Generation Gene Sequencing (NGS): Method of Choice.
•IVF Failure and Implantation Dysfunction: The Role of Endometrial Thickness, Uterine Pathology and Immunologic Factors
•Why did my IVF Fail
•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
I invite you to call 702-699-7437 or 800-780-7437 or go online on this site and set up a one hour Skype consultation with me to discuss your case in detail.
I also suggest that you access the 4th edition of my book ,”In Vitro Fertilization, the ART of Making Babies”. It is available as a down-load through http://www.Amazon.com or from most bookstores and public libraries.
Geoff Sher
Please call or email Julie Dahan, my patient concierge. She will guide you on how to set up an in-person or Skype consultation with me. You can reach Julie at on her cell phone or via email at any time:
Julie Dahan
•Email: Julied@sherivf.com
•Phone: 702-533-2691
?800-780-7437
Geoff Sher