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.
I have been reading more and more about the ERA test to check for uterine receptivity. I thought I read in another post that you do not recommend tgis test to your patients. However, you never explained your reasoning behind that thought. It seems that more doctors and facilities are becoming more open to it because they have been seeing more success with it.
Thank you for sharing your thoughts.
Elyse
In my opinion, the data is NOT conclusive and in trying the approach in our setting, it has not been beneficial.
Geoff Sher
I know you probably told me this answer already but I lost the information.. But what did you say is a good estrogen level to have 5 days prior to your FET? or in general for an FET? As well as what is a good Lining thickness to have?
An E2 of 500-1000pg/ml when using the estradiol valerate injection approach and a lining of >8mm.
Good luck!
Geoff Sher
Hello Dr Sher, I had a follow up appointment with My Dr after my 3rd failed frozen transfer after a medicated HRT cycle . He basically told me that due to my husband and I having a shared DQ alpha gene and me having elevated NK cells a surrogate may be the only way to have a baby. I tried Intrallipids last cycle with Dexmethesone, progesterone, aspirin, filgrastin. He then went on to give me the option to try my chances with IVIG instead of the Intralipids. Should I give the IVIG a try or am I wasting my time ? My embryos have all been tested and are good quality.
There is much more to this: It revolves around a) whether you have a “partial” or a “complete” match with your partner, b) whether the timing and dosage of Intralipid administration is implemented, c) whether steroid therapy is added (an important consideration), d) how many embryos are transferred. If this is a partial match then in my opinion, transferring more than one at a time is prejudicial e) Whether PGS was performed to improve the likelihood of a “competent embryo being transferred.
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.
•Preimplantation Genetic Testing (PGS) in IVF: It Should be Used Selectively and NOT be Routine.
•Preimplantation Genetic Sampling (PGS) Using: Next Generation Gene Sequencing (NGS): Method of Choice.
•PGS in IVF: Are Some Chromosomally abnormal Embryos Capable of Resulting in Normal Babies and Being Wrongly Discarded?
•PGS and Assessment of Egg/Embryo “competency”: How Method, Timing and Methodology Could Affect Reliability:
•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!
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 Dr Sher,
I have just failed mu 3rd ICSI and it looks like it’s purely implantation failure each time. I transferred 1x3AA blast and 1x2AA blast this time. My doctor put me on prednisolone, intralipids, clexane and aspirin and still no joy. I have had karyotype testing done which is all clear. I am 31 years old with stage 3 endometriosis, amh 11.7 and my husband is 35 with 1% morphology. Are we missing something here? I am worried that if we go to donor eggs, this won’t solve the problem with implantation?
Any advice would be helpful.
I would need access to all your testing before I could comment authoritatively. Also I would want to know whether there is an alloimmune component (DQalpha/HLA match) between you and your partner because that would profoundly influence treatment.
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 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
•Why did my IVF Fail
•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
•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.
Hi Dr. Sher,
i am recently pregnant through IVF – we implanted 2 embryos back on 8/10. We found out 8/21 that i was pregnant and when we went in for my first ultrasound at 5+ weeks the doctor saw two babies. Next appt at 6 1/2 weeks we saw two heartbeats and babies were measuring on track. Then 7 1/2 weeks same two heartbeats and measuring on track. My 8 1/2 week ultrasound there was no heartbeat on baby b and it had stopped growing. So I lost the baby sometime between 7 1/2 – 8 1/2 weeks. I had no symptoms at all – no spotting/bleeding or cramping. I have a few questions. What happens to the remaining baby that I miscarried? Also, I wanted to take the maternit21 test because I miscarried one of the babies will that mess up the test results? I am very nervous about the other baby since I had no indication that i had lost the other baby – could that happen again? Most of the time does the other baby end up being ok?
So sorry! But do not fret because the one baby will absorb on its own. You can take the supplement. It should not have any interfering effect.
Good luck!
Geoff Sher