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.
Hi Dr Sher…..Here is another question from my Facebook group:
………………………………………………..Anyone ever had to do the methotrexate shot to end a pregnancy in an unknown location? Do you know if your hcg has to be below a certain number for the shot to work or will it work anytime? My hcg is still rising and is in the 5000’s now but they can’t find anything on a scan (had 2 so far and final one is this afternoon). Transfer was July 12 so should be close to 8 weeks…….
thanks lynn
You almost certainly have an ectopic pregnancy. And, NO your hCG does not have to drop below any specific thresh hold before MTX is given.
Geoff Sher
Hi Dr Sher, How long do you normally down regulate for on the long protocol? Would stimulation generally start on day 2-3 of the cycle? Many thanks!
I prefer that the DR be up to 10 days but not be longer than 14 days. I strat the stimulation as soon as possible after bleeding commences.
geoff Sher
I’m 34 years old and just recently completed my first IVF cycle and my USG report says
Foetal parameters are
For FA
CRL=9.2 mm; corresponds to 7 weeks 0 days; FHR= 145 beats/ min.
For FB
CRL=9.0 mm; corresponds to 6 weeks 6 days; FHR= 158 beats/ min.
For FC
CRL=4.8 mm; corresponds to 6 weeks 1 day; FHR= 113 beats/ min.
Please let me know whether I need to go for selective reduction as I don’t want triplet and like to have twins. My doctor suggested that the last one will be dissolved automatically.
I agree with your Dr. Baby-C might not make it. I would give it another few weeks and then reassess. Remember, the later in the 2nd trimester that a reduction of pregnancy is done, the safer.
Geoff Sher
Hi Dr sher I am 5 weeks pregnant with donor egg. I have nk cells so I had intralipids before and after transfer approx 24 days apart. My re wants me to continue Intralipids every 2 weeks until week 12 . My question is is there any harm in doing that. I know u say for auto immune one after the post I’ve beta is enough. I have never been tested for alloimmune. I am also on steroids for high tpo levels. Thanks
No harm would likely be done in my opinion, but if this is autoimmune you would not need to repeat thd IL after the 2nd infusion.
Geoff Sher
how common is sub chroinic hemorrhage with IVF? With our last 2 pregnancies I had them, the first was not as bad as the second, the second resulted us in giving birth to our daughter at 22 weeks the hemorrhage was so bad that when they biopsied the placenta the clot covered the whole entire placenta. I guess what I am trying to get at is we have 4 more frozen embies and would like to try again, and we are worried that it might happen again. It didn’t happen with our first son, just with our second son and our baby girl.(RIP) Our first was a Fresh cycle, the others were frozen.
In my opinion, this could be due to an implantation dysfunction such as an autoimmune or alloimmune immunologic implantation issue, linlked to NK cell activation or it could be associated with an undiagnosed hereditary clotting defect (thrombophilia).
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.
•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!
•Thrombophilia
•Endometrial Thickness, Uterine Pathology and Immunologic Factors
•Vaginally Administered Viagra is Often a Highly Effective Treatment to Help Thicken a Thin Uterine Lining
•Traveling for IVF from Out of State/Country–
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