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, we live overseas and would like to explore options of doing FET at your center. Can we transfer our frozen embryos from overseas to your center? And is there a way of knowing the gender of the embryos without going through PGD? How long do we need to stay in the center, if we are doing artificial cycle FET?
Thanks!
We would be delighted to be of service. Please email/call 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
Geoff Sher
P.S there is no way to do gender identification of the embryo without PGS and that is not ideal since we would need to thaw the embryos to biopsy them , then freeze them again while awaiting results only to thaw them for FET….too traumatic
Hi Dr. Sher, I was wondering if it is possible to transfer frozen embryos from overseas lab to yours so that we can go through just an FET cycle instead of a fresh cycle? Is it possible to know the gender of these embryos without going through PGD? And how long do we need to be in the States for an artificial cycle FET? Thanks so much!
It is absolutely possible. We often do this and arrange everything from here.
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
Geoff Sher
Hello Dr. Sher-
I am 34 and my partner has MFI but viable sperm so we are planning for IVF.
Day 3 Estradiol – 60.3,
Day 3 LH – 10.9
Day 3 FSH – 10.7
AFC – 13
AMH – 3.64 ng/mL
TSH – 2.34
We are going to see our doctor soon, but I’ve read that 10.7 may be a slightly elevated FSH. However, the reference range listed on the blood test had a range of 3.5 – 12.5. I’ve read that different assays have difference reference ranges so that should be taken into account.
1. Is my FSH of 10.7 elevated even though the reference range (LabCorp test) goes to 12.5?
2. If you think the FSH is elevated, I also appear to have a good AMH and decent AFC levels, so would I be expected to have an average response to IVF or somewhat reduced because of the FSH?
Much of the literature I’ve read said that AMH is a better predictor and even if my FSH is elevated, it is only slightly so. Am I on the right track with this assessment? Thanks!
1. Is my FSH of 10.7 elevated even though the reference range (LabCorp test) goes to 12.5?
A: AMH is a far better predictor than basal FSH/LH
2. If you think the FSH is elevated, I also appear to have a good AMH and decent AFC levels, so would I be expected to have an average response to IVF or somewhat reduced because of the FSH?
A: I would ignore the FSH level.
Good luck!
Geoff Sher
This may be a too much information kind of question.. but is it okay to masturbate during your two week wait? I am 7 days past my 3 day transfer would it harm anything if I did masturbate?
Sure…no problem!
Geoff Sher
I was going to a fertility doctor and had a procedure where did was put inside of my body along with a camera to find out where the blockage was. I had to have both fallopian tubes removed due to a condition called hydrospinx, which meant water in the tubes. This took place in 2008. The cause was unknown. The doctor said my uterus and cervix looks good, but I must have in vitro. Do you think I would be a good candidate at the age of 40. My health is good as far as I know.
I think it would be your only option and the sooner the better. Given your age, consider the following:
Older women as well as those who (regardless of age) have diminished ovarian reserve (DOR) tend to produce fewer and less “competent” eggs, the main reason for reduced IVF success in such cases. The compromised outcome is largely due to the fact that such women tend to have increased LH biological activity which often results in excessive LH-induced ovarian testosterone production which in turn can have a deleterious effect on egg/embryo “competency”.
Certain ovarian stimulation regimes either promote excessive LH production (e.g. short agonist/Lupron- “flare” protocols, clomiphene and Letrozole), augment LH/hCG delivered through additional administration (e.g. high dosage menotropins such as Menopur), or fail to protect against body’s own/self-produced LH (e.g. late antagonist protocols where drugs such as Ganirelix/Cetrotide/Orgalutron that are first administered 6-7 days after ovarian stimulation has commenced).
I try to avoid using such protocols/regimes (especially) in older women and those with DOR, favoring instead the use of a modified, long pituitary down-regulation protocol (the agonist/antagonist conversion protocol-A/ACP) augmented by adding supplementary human growth hormone (HGH). I further recommend Staggered IVF with embryo banking of PGS (next generation gene sequencing/NGS)-normal blastocysts in such cases. This type of approach will in my opinion, optimize the chance of a viable pregnancy per embryo transfer procedure and provide an opportunity to capitalize on whatever residual ovarian reserve and egg quality still exists, allowing the chance to “make hay while the sun still shines”.
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.
•The “Biological Clock” and how it should Influence the Selection and Design of Ovarian Stimulation Protocols for IVF.
•Diagnosing and Treating Infertility due to Diminished Ovarian Reserve (DOR)
•Controlled Ovarian Stimulation (COS) in Older women and Women who have Diminished Ovarian Reserve (DOR): A Rational Basis for Selecting a Stimulation Protocol
•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?
•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
•Implications of “Empty Follicle Syndrome and “Premature Luteinization”
•Premature Luteinization (“the premature LH surge): Why it happens and how it can be prevented.
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.
Geoff Sher