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.
We are getting ready to start our 2nd FET.. This time instead of estradiol pills we are using estrogen patches? Have you had any patients that had success with using Lupron injections, Estrogen patches, and progesterone in oil injections? Do the estrogen patches boost your estrogen more than the pills? because our first FET my estrogen was low is what my dr said.. What is a good level for estrogen to be at for FET?
The administration of estradiol via skin patches or injection is preferred because unlike oral administration where the hormone 1st passes through the liver (where it is altered) before reaching the systemic circulation, estradiol administered via patches or by injection goes directly (unaltered0 into the systemic circulation to the liver. I preferentially prescribe intramuscular estradiol valerate injections twice weekly, because it is best absorbed systemically this way and more evenly so, than via skin patches. But both injections and patches are OK.
Good luck!
Geoff Sher
Hi doc, my wife had embryo transfer on 19th August. B hcg on 1St of Sept is 75.91 3rd 83.9 5th 104. We are worried. Please advise. Thank you
Arjuna,
This sadly does not look good! I hope I am wrong.
G-d bless!
Geoff Sher
Dr Sher first can I say how much I am enjoying your Webinars on YouTube! You are so passionate & informative, your explanation of things using your slides is so clear & detailed! I also love your analogies to describe things, they make me chuckle!
My question is, I am in Sydney Australia and I’d like to know if you have any doctors who you’d recommend here that you’ve come across during your years in the industry. Or even a clinic group you know of? I’d like to find a doctor/clinic who uses similar or the same approach as you. Unfortunately I wouldn’t be able to travel over to the US to become a patient so I’m hoping to find someone with your approach or someone who you’ve had experience with here?
Any recommendations?
Hi Carolina,
Thanks for your kind words, but alas I cannot be of help!
Sorry!
G-d bless!
Geoff Sher
Dear Dr Sher, what is your opinion on using heat (mild) or warmth on the uterus after embryo transfer. When I say heat I mean gentle heat packs/wheat bags, avoiding cold & raw foods & drinks and keeping your abdomen protected from any coldness. This is all promoted in Traditional Chinese medicine. I have read that it can help make implantation more inviting for an embryo. I have also read it can hinder it. What is your opinion?
Tali,
I cannot see any benefit whatsoever.
Geoff Sher
Dear Dr Sher
Many thanks for previous helpful reply regarding possible implantation problems (I have endometriosis and never reach implantation success despite conception clear symptoms and prior polyp removal and laparoscopy for endo (trying naturally at present). Following your advice for IID, my clinic in the UK has advised that with their IVF, they will use steroids for me to resolve the issues raised of possible implantation dysfunction and that this covers APA issue, prostaglandins and raised NK cells, they advised against the NK cell test due to cost, as steroids are used to cover this anyway. Is this sufficient for my treatment, or could you advise on all further specific treatments I would need as part of or prior to IVF in the area of IID (due to endometriosis).
Many thanks for your help, Rachael, UK
Very Respectfully,
If you have NK cell activation (and that is what counts and why the K-562 test is needed), steroids alone are insufficient in my opinion. You would in addition, need intralipid infusions.
Geoff Sher