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.
Good evening Dr Sher,
My name is Milindie and I’m 30 years old. Went for IVF transfer on the 30 May 2016 (transferred 2 eggs) and went for my first hcg test on the 6/6 and level was 133.9 and then again on the 9/6 and level was 290.3
Started light spotting toningt and I’m stressed out, is it normal or not?
I really would not be over-concerned. This kind of early bleeding is not uncommon and often inconsequential.
Good luck!
Geoff Sher
Hi Dr Sher, At the age of 44 I have collected 7 embryos (of good to top quality) to day 3. Today I collected a further 8 eggs which are being fertilised. The intention is to do PGS testing. My AMH is 17.1 and FSH 9.1. My traditional Chinese doctor believes the high AMH is do to PCOS. I did tests in 2009 which showed signs of PCOS but the tests showed this was borderline and inconclusive.
How many embryo banking cycles would you recommend we should do (we have already had 2)? How many chromasomally normal embryos do you recommend we need to aim to collect?
Thanks so much!
In my opinio at 44y you probably need to collect, biopsy and bank at least 8 blastocysts before PGS testing. This is because the chance of an egg or early embryo being chromosomally normal is under 10% about 1:14 and the probability of a blastocyst being normal…about 1: 6-8 and ideally you would want 2 (or more) more chromosomally, numerically normal (euploid) blastocysts for transfer.
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.
•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
•Ovarian Stimulation for IVF using GnRH Antagonists: Comparing the Agonist/Antagonist Conversion Protocol.(A/ACP) With the“Conventional” Antagonist Aproach
•Anti Mullerian Hormone (AMH) Measurement to Assess Ovarian Reserve and Design the Optimal Protocol for Controlled Ovarian Stimulation (COS) in IVF.
•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?
•Blastocyst Embryo Transfers Should be the Standard of Care in IVF
•Blastocyst Embryo Transfers Done 5-6 Days Following Fertilization are Fast Replacing Earlier day 2-3 Transfers of Cleaved Embryos.
•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 Testing (PGS) in IVF: It Should be Used Selectively and NOT be Routine.
•Preimplantation Genetic Sampling (PGS) Using: Next Generation Gene Sequencing (NGS): Method of Choice.
•PGS in IVF: Are Some Chromosomally abnormal Embryos Capable of Resulting in Normal Babies and Being Wrongly Discarded?
•PGS and Assessment of Egg/Embryo “competency”: How Method, Timing and Methodology Could Affect Reliability
•Traveling for IVF from Out of State/Country–
•A personalized, stepwise approach to IVF
•Treating Out-of-State and Out-of-Country Patients at Sher-IVF in Las Vegas:
•How Many Embryos should be transferred: A Critical Decision in IVF.
•The Role of Nutritional Supplements in Preparing for IVF
•IVF Egg Donation: A Comprehensive Overview
•
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
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.
Hello Dr. Sher,
I am 31 years of age and undergoing PCOS infertility treatment with medication for hormonal imbalance correction (last 3 months). May 2016 was my very first ovulation induction using Clomiphene for 5 days. I have always had lengthy, irregular cycles – 35 day cycles from past 8-9 months. However, 11th June 2016 was my cycle day 40 — I still have no periods and home pregnancy test was negative. In a vaginal scan, on CD 40, a mature follicle of size 22 mm was found in my right ovary and the doctor said it was a very rare thing. He however believed that the egg might have got dissolved (almost no chance for conception) and since he didn’t want this mature follicle to cause trouble for the next cycle, he gave me a HCG 10,000 iu injection on CD40.
So I wanted to ask you if you think there is a change for a pregnancy in case we have intercourse 24 hours after the injection, i.e, CD 41 to CD 45? Also, have you come across women who have had mature follicles even on CD 40?
P.S. I had taken Duphaston for 10 days between CD16 and CD 25.
Yes indeed, there is a chance of pregnancy, but if you do not conceive, bear in mind that women whose periods are >45 days apart, often do not respond well to clomiphene. You might be advised to use injectable gonadotropin therapy ifyou need to try another stimulation with IUI.
Geoff Sher
Hi Dr. Sher,
I had an embryo transfer yesterday of one PGS tested embryo. The transfer went well and I continued to lay down for 20 minutes after the transfer as I was instructed to do. When I got up I accidentally knocked over my water and without thinking grabbed some paper towels and wiped up the floor. Could this kind of crouching down to the floor only 20 minutes after the embryo was placed jeopardize my transfer in any way? Thanks in advance.
Dottie
It is highly unlikely to have an ill effect!
Don’t worry!
Good luck!
Geoff Sher
9dp5dt beta was at 102.
13dp5dt beta was 830.
15dp5dt was 1712.
17dp5dt beta was 3195.
I feel like it is taking a little longer for hcg to rise the more they draw blood. Is this normal? Should I be concerned???
I think this rise is adequate and I predict that all will be well! I hope I am right here. I suggest that you have a pelvic ultrasound done to confirm such.
Geoff Sher