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,
Can e2 level go up by over 100 within 24hrs? I had 35 -40 E2 for 11 days and then CD12 home flashing smiley face appeared and end of day showed LH surge. My earlier cycle had a similar way with E2 increasing just a few hours before ovulation. I am very confused as to why sudden increase in E2 happens only a few hours before surge but E2 low till then?
Yes it can and indeed often does.
Good luck!
Geoff Sher
Hello Dr Sher,
I had an early miscarriage (7 weeks) last year and 2 months previous to that had a D&C. Even since those 2 events I have had shorter periods. I was on the BCP for many years and when I stopped it my “real” period was never very long, at longest 4 days and never particularly heavy, apart from some months the first day/night would be of a decent substantial flow and then lessen. For about 6 months after the D&C and MC its was barely 1 and half days and now 9 months later has increased to about 2 days with a 3rd day of very light flow/spotting . Still the first day is a quite decent flow but then it tapers off quite quickly. I have had a hysteroscopy to investigate potential Asherman’s but it found a healthy uterus with no adhesions or damage. Is a shorter period an issue in terms of lining and implantation potential? Is there any reason to be concerned that my periods have become shorter? I am a week away from a FET and my lining has consistently shown to be of a minimum 8mm in scans during stimulation cycles. I am age 37yrs.
The length and amount of bleeding is really not relevant. Iyt iks endometrial develoment and thickness that matters.
So you are on the right track!
Good luck!
Geoff Sher
Just wondering if you could clarify the difference between citrotide and suprafact? Do you ever start a stim cycle on day 21 using suprafact vs day 3 and citrotide?
Superfact, like Lupron and Buserilin is an agonist that works by expunging FSH and LH from the pituitary, while Cetrotide (like Orgalutron and Ganirelix) is an antagonism that lowers LH/FSH by blocking its release by the pituitary gland.
Geoff Sher
Hello Dr Sher,
I’m relieved to find your blog. As a 38yo, plus sized woman, I was heart broken when after 4 IUI cycles, my doctor said my chances of successful IVF would only be 15-20%. I considered taking time to lose more weight (I went from BMI 40 to 36) but decided that I just don’t have time on my side. Other than my age and weight, my husband and I have no diagnosed problems, except my egg reserve is “fair” or slightly lower than a woman my age. We went ahead with my doctor’s suggested regime of Lupton flare, Menapur, and Gonal-F to prepare for egg retrevial. I was disappointed that they were only able to retrieve 6 mature eggs. Of those 2 did not fertilize with ICSI, 2 did not develop past 1 cell, and 2 were transfered Aug 20th. The 2 transfered on day 3 were 3 cells and rated B+ and B-. Even though I had initially asked for PGS, for some reason they did not do the screening.
This week, I’ve had HCG tests every other day: Mon it was 13 and Weds 39. I’m told this is good news, however, I began light brown spotting Sun which lasted till Weds. Weds it shifted to red and included clots with increased cramping and backache, and today I’m not in as much pain, but the light bleeding has not stopped.
Tomorrow I go in for another HCG test and I’m really scared. I question the care I’ve been given at my clinic and worry that I will miscarry and future success with IVF is not plausible. What should I do to advocate for myself, and what the chances that I will have a least 1 healthy baby from this IVF experience ?
Thank you for sharing your expertise!
Alas…only time will tell You will need to wait and see whether the hCG levels rise apprpriately and then ultimately for ultrasound confirmation of a viable pregnancy in about 2 weeks +.
I know it is not easy…but there is nothing else to say.
G-d bless!
Geoff Sher
Hello Doctor Sher,
I was told at a young age I have PCOS, and now as a woman in my mid 30’s and after having seen a dietitian and modified my diet & exercise have resolved this & ovaries are normal now. I get good egg numbers but would like to improve egg quality of course. I have read the supplementation of the B-group vitamin Myoinositol can improve egg quality, particularly in those with or a history of PCOS. Also I have read similarly that Melatonin can be used to improve egg quality although there seems to be conflicting opinions on the safety of the use of Melatonin.
Your advice please? Many thanks!
Both are probably safe, but there is no real convincing evidence of benefit, in my opinion.
Geoff Sher