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.
Dr. Sher,
When do you recommend PGS? My husband is 43, I am 32 and we just did our first IVF retrieval. 27 eggs retrieved, 25 mature, 17 fertilized with ICSI, only 3 made it to blast at 5 days (excellent grade) and we did a freeze all as I over stimulated. My doctor did not suggest PGS (because I am under 35 and have no history of miscarriage) but I am wondering now if we should have done it, considering we got so few blasts. We have never had a positive pregnancy test; FET is planned for November 15.
Our diagnosed issues were a blocked tube and PCOS for me and <1% normal morphology with all other parameters normal for my husband. Thank you in advance!
I agree with your RE that PGS should not be routinely used. At 35Y at least one in two expanded blastocysts should be be euploid. Thus if you simply transfer 2, the chance of a pregnancy should be about 50:50 at age 35y.
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
•Anti Mullerian Hormone (AMH) Measurement to Assess Ovarian Reserve and Design the Optimal Protocol for Controlled Ovarian Stimulation (COS) in IVF.
•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
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.
Our first hcg, 12 days after implant was 87, is this good?
It depends when the ET was done. Was it on day 3 or on day 5-6 post fertilization. If the former then the level is OK but not great. If the latter, then it is very promising!
Good luck!
Geoff Sher
Hi Dr. Sher,
I am a 32 year old woman with blocked tubes. My tests conducted on 3rd day of my menstrual cycle are as follows: Progesterone: <.200, LH: 5.67, FSH: 13.1, Estradiol 30.3. I have undergone 4 IVF cycles and have no embryos to show for it. I have had about 40-45 eggs retrieved combined, and only about 20-25 have bee mature. Of those, very few reached blast stage and none survived the freeze/thaw for PGS.
I am now about to undergo my 5th cycle. I have switched REs, but do not see any indication of any major changes that this RE would make over my previous RE. We discussed possibly stimulating for one day longer, but that was about it. I asked him about the fact that most of my eggs turn out to be immature, but he basically said there is no way to treat that and no change in protocol will affect the maturity of my eggs.
Is this really the case? Is there really nothing that can be done to increase egg maturity? As an example, in one cycle, I had 19 eggs retrieved and only 6 were mature. 4 fertilized and 2 reached blast stage. Both were biopsied and frozen. PGS determined none were normal. Is there a certain protocol that can help with this problem? I would greatly appreciate your input.
Hi Sarah,
In my opinion, it is highly unlikely that you have an intractable /inheent egg defect and unless your husband has a formidable sperm dysfunction manifest in the regular semen analysis, it is highly unlikely that this is due to male DNA contribution. The most likely explanation has to do with the selection and/or implementation of the protocol for ovarian stimulation….I think we should talk.
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
•Anti Mullerian Hormone (AMH) Measurement to Assess Ovarian Reserve and Design the Optimal Protocol for Controlled Ovarian Stimulation (COS) in IVF.
•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
•Why did my IVF Fail
•Frozen Embryo Transfer (FET): A Rational Approach to Hormonal Preparation and How new Methodology is Impacting IVF.
•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.
•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
•IVF: The first Choice for Infertile Women 40 to 43 Years of Age!
•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
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.
I am on linzess for irritable bowel syndrome.. will taking this effect my fet or trying to conceive? I took it this morning before my transfer.
Should not be a problem!
Good luck!
Geoff Sher
I had asked u a question today,after few hours I found that my question was not seen in the screen? Was it deleted ?
I do not know…please re-post and I will address promptly.
Geoff Sher