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.
Hello dr. Sher. My husband and I are in fertility treatment with donor egg.
We both did the blood test for DQ Alpha Genotype and we both got the same result: 0103, 0501. Could you explane what does it mean? And what our chances to get a child with donor egg are?
Thank you. Best Regards, Ana
Hi Ana,
You and your husband seem to have an absolute alloimmune (DQa) match. If (and only if) you in addition also have activated natural killer cells n(by the K-562 target cell test for by uterine cytokine analysis), then you have a very severe immunologic implantation dysfunction that would need specific treatment that might even require gestational surrogacy, in my opinion. If you have a total match but NO activation of NK cells, then you could still achieve and carry a pregnancy to term.
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
•IVF Failure and Implantation Dysfunction:
•The Role of Immunologic Implantation Dysfunction (IID) & Infertility (IID):PART 1-Background
•Immunologic Implantation Dysfunction (IID) & Infertility (IID):PART 2- Making a Diagnosis
•Immunologic Dysfunction (IID) & Infertility (IID):PART 3-Treatment
•Thyroid autoantibodies and Immunologic Implantation Dysfunction (IID)
•Immunologic Implantation Dysfunction: Importance of Meticulous Evaluation and Strategic Management:(Case Report
•Intralipid and IVIG therapy: Understanding the Basis for its use in the Treatment of Immunologic Implantation Dysfunction (IID)
•Intralipid (IL) Administration in IVF: It’s Composition; How it Works; Administration; Side-effects; Reactions and Precautions
•Natural Killer Cell Activation (NKa) and Immunologic Implantation Dysfunction in IVF: The Controversy!
•Endometrial Thickness, Uterine Pathology and Immunologic Factors
•Vaginally Administered Viagra is Often a Highly Effective Treatment to Help Thicken a Thin Uterine Lining
•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
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 on dexamethasone (0.75mg) which my RE put me on and have been since ovarian stimulation started. I am now 8 weeks pregnant and puzzled as to why the energy that the steroids gave me at first (I was markedly more energetic and even needed melatonin to sleep) has dissipated. I am exhausted all the time now and my RE doesn’t think that the dose I am on should have even made me energetic in the first place but I really felt it, very obviously until about week 6 of pregnancy. In your opinion is it normal that these effects are wearing off now? I have also been on vaginal progesterone which I am aware increases fatigue but I was also on that since the start.
I agree with your
I have been diagnosed as a poor responder with DOR. I’ll be 41 in September. Only 1 out of 20 eggs made it to day 5 (aneuploid). I didn’t respond at all to gonal-f so my FS has been using menopur (with Synarel or orgalutran) and an HCG trigger. My FSH, LH etc have only been tested once – day 23 in the month before my first cycle. My FSH = 5, AMH = 6, LH = 6.7, progesterone = 42.5 and oestradiol = 408. I have started a long down regulation cycle (BCPs) which will again use menopur, Synarel and now melatonin. My FS said Elonva was not suitable, and I’ve had no response to gonal-f in the past. I don’t think I have been properly monitored and after reading many of your articles, I am concerned about using menopur again. Is menopur OK following a long down reg? Should I be having more blood tests? Is it LH I need to be concerned about? It’s 2 weeks since my last egg collection and the first time in 6 months my head isn’t foggy from all the drugs. Hoping you can guide me in the right direction, as I don’t think I’m getting the care I should be. Thank you in advance.
Hi Dr Sher,
I had an abnormal pregnancy with Down syndrome 4 years ago and I had 4 IUIs with Clomid and Ovidrel shot for the last 2 years, all failed with no pregnancy. I just did one IVF cycle last month and one embryo at blastocyst stage tested but the PGS result came back abnormal again with Down syndrome. I would like to get your opinion on what I should do now.
1) Should I take DHEA 50-75 mg daily for about 2 months to improve my egg quality before I try another IVF cycle? Should I take DHEA without my doctor monitoring my DHEA level? Is DHEA safe with the dose mentioned above and used for long term? My doctor said DHEA does not give me benefits but I think it does not hurt to take it.
2) Even my husband’s sperm is normal, my Doctor use ICSI for this process. Does ICSI damage egg and might cause abnormal chromosome and birth defects than conventional IVF?
3) With the abnormal embryo last month, and my abnormal pregnancy in the past, is there any hope that I will get a normal embryo next time for my case (40 years old) with recurrence of DOWN syndrome two times which I think it is rare?
4) Is it because of my poor egg quality that I cannot get pregnant over the last 4 years?
5) if you think in my case it is my egg problem, do you think a good option is donor egg? What is the best option for me in your opinion?
Please let me know your opinions. Your insight and response is so much appreciated.
Thank you so much.
Nina
1. I advise against the use of DHEA…see below
2. If done expertly ICSI can be used routinely (see below)
3. The older you get the greater the risk of egg/embryo chromosomal issues. However, you can reduce the risk by using a very strategic protocol (see below)
4.There could be other factors (e.g. implantation dysfunction) . But this requires careful evaluation (see below)
5. Donor egg is an option to consider.
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
•Ovarian Stimulation in Women Who have Diminished Ovarian Reserve (DOR): Introducing the Agonist/Antagonist Conversion protocol
•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.
•Why did my IVF Fail
•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.
•IVF Failure and Implantation Dysfunction:
•The Role of Immunologic Implantation Dysfunction (IID) & Infertility (IID):PART 1-Background
•Immunologic Implantation Dysfunction (IID) & Infertility (IID):PART 2- Making a Diagnosis
•Immunologic Dysfunction (IID) & Infertility (IID):PART 3-Treatment
•Thyroid autoantibodies and Immunologic Implantation Dysfunction (IID)
•Immunologic Implantation Dysfunction: Importance of Meticulous Evaluation and Strategic Management:(Case Report
•Intralipid and IVIG therapy: Understanding the Basis for its use in the Treatment of Immunologic Implantation Dysfunction (IID)
•Intralipid (IL) Administration in IVF: It’s Composition; How it Works; Administration; Side-effects; Reactions and Precautions
•Natural Killer Cell Activation (NKa) and Immunologic Implantation Dysfunction in IVF: The Controversy!
•Endometrial Thickness, Uterine Pathology and Immunologic Factors
•Vaginally Administered Viagra is Often a Highly Effective Treatment to Help Thicken a Thin Uterine Lining
•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
•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.
.
Good day Dr
I have been married for 2 years but my wife is yet to take in. She has done all necessary test prescribed by our dr and she does not have any issue. I have done but it did not come out good. i have three sperm analysis and two culture. The first sperm analysis and culture showed low motility of about 19% and pus cells 2-4. all other parameters were ok. i was placed on supplements for three months and antiboitic. i repeated the analysis after a month but it did not improve instead it droped to 15% and i was occasionally having headaces. i continued with the supplements for the second month with occasional alcohol consumption although i reduced from my former rate. on the third month i could no longer tolorate the headache and i had to check my BP which was raised and i had to stop the supplements. i then repeated the analysis and mcs and it still isolated staphy with pus cells 4-5 also and my motility was 12%. i took iv cipro as against the tabs which i took earlier and started folic acid,vitamin b complex,vitamin e,vitamin c. t=i took these drugs for 3 months before i stopped.
please advice me on what to do next
Hi John,
You clearly are going to need to have a thorough re-evaluation and ultimately you and your wife will more than likely with need IVF/ICSI.
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
•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
•Male Factor Infertility
•Routine Fertilization by Intracytoplasmic Sperm Injection (ICSI): An Argument in Favor
•Male Infertility
•Hormonal Treatment of Male Infertility
•Varicocele and Male Infertility: When and how should it be treated.
•The Sperm Chromatin Structure Assay (SCSA): A Measure of the Potential of Sperm to Help Propagate a Viable Pregnancy
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.