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, First ,thank you for this blog. I just found your blog and Ive learned so much already. I’m 46.5y/o. started this journey 10 months ago.FSH usually between 8-10. AMH .7 and AFC usually 6-7. Ive had I failed IUI with follistim 100 iu resulting in (1) 17mm and (2) 15 mm follicles.
Attempted IVF, took estrace 2mg 2x a day 5 days prior to period. Day 3-11 follistim 450 iu and low dose HCG 50 units day 4 to day 11. Follicles were not growing. Day 10 and day 11 ganirelix. 1 follicle barely 15 mm on day 12, which RE said looked like I ovulated already and converted to IUI. but unsuccessful.
2nd attempt at IUI with clomid 50 mg for 5 days. resulted in 2 follicles . 1 at 20 mm and 1 at 18 mm but unsuccessful. Since taking clomid 2 months ago, my FSH went up to 19.
I usually ovulate on my own, husband has low morphology 0-1% but other semen parameters normal.Now scheduled for mini ivf with clomid and option for birth control in prior luteal phase and low dose follistim. Reading about negative effects of clomid with advanced age on your blog, but also very confused that the medications I took for IVF had a worse response, I am not sure what to do. Any thoughts on the medications for IVF being too aggressive for my age?
Hi Stacey,
Respectfully, at 46Y , the chance of a baby with IVF using own eggs is virtually zero. I know this is hard to accept, but your only rational option is IVF with egg donation. Anything else would in my opinion be very ill-advised.
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
•Treating Out-of-State and Out-of-Country Patients at Sher-IVF in Las Vegas:
•Traveling for IVF from Out of State/Country–
•A personalized, stepwise approach to 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.
Dear Dr Sher,
I am 38 years old and have never become pregnant despite never using contraception during my failed marriage. My new partner had a vasectomy over ten years ago and a pelvic ultrasound for me revealed bilateral hydrosalpinges (just tiny drops of fluid no swelling). Is it even worth it for us to go down the IVF path or will we only end up poorer and upset?
Thank you for your time,
Tamara
I cannot tell you what to do, but if you decide to try, then clearly with bilateral hydrosalpinges, you will need IVF after the damaged tubes have been surgically ligated as they leave the uterus, or removed. Your husband’s previous vasectomy would require a procedure known as testicular sperm aspiration or extraction…see below. Provide you have adequate ovarian reserve and you do not waste precious time, you might still be able to have a child.
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.
•The “Biological Clock” and how it should Influence the Selection and Design of Ovarian Stimulation Protocols for IVF.
• A Rational Basis for selecting Controlled Ovarian Stimulation (COS) protocols in women with Diminished Ovarian Reserve (DOR)
•Diagnosing and Treating Infertility due to Diminished Ovarian Reserve (DOR)
•Controlled Ovarian Stimulation (COS) in Older women and Women who have Diminished Ovarian Reserve (DOR): A Rational Basis for Selecting a Stimulation Protocol
•Optimizing Response to Ovarian Stimulation in Women who Have Compromised Ovarian Response to Ovarian Stimulation in Women who Have Compromised Ovarian Reserve: A Personal Approach.
•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
•Treating Out-of-State and Out-of-Country Patients at Sher-IVF in Las Vegas:
•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
•The Basic Infertility Work-Up
•Pelvic Inflammatory Disease (PID), Tubal Damage and Hydrosalpinx: Preparing for IVF
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.
Hi, 35 yrs old and been trying for 6 months. I ovulate on my own but did 1st round of clomid. Cycle day 21 progesterone test level was 119. Doctor retested the next day and it was 98. I’m now almost 4 days late for my period (today is day 31) and no period and negative pregnancy tests results. Any idea what’s going on?
Thank you!
You probably have a clomiphene-induced simple corpus luteum ovarian cyst that will absorb and you will have a period. I do not believe there is anything serious wrong. BUT if coincidence ask your GYN to do a confirmatory ultrasound.
Good luck!
Geoff Sher
Dear Dr Sher,
4 hours after an LH surge what causes a big drop in E2 and LH?
The rupture of the follicle…It is normal!
Geoff Sher
Dear Dr Sher,
Do follicles continue to grow after trigger shot?