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, I was wondering if I could have some impartial advice. I have just had ivf using a donor. The donor is 30. 15 eggs were collected, 12 fertilised and all was well. Today a 5 days I went in for my egg transfer. I was told that they would transfer 1 grade B and 1 grade C embryo. There were 2 grade C that they were not sure about freezing and would let me no at the end of the day. They called and said they would freeze both but if there had only been would not have done. I feel devastated. I thought we would have higher grade embryos and more of them. If it does not work this time around, is it worth transfering two c grades or saving the money to start again? I would be very grateful for any advice. Kate
I would give it a try with the lower grade blastocysts. However, if you later need to try a fresh cycle, you need to review/revise the protocol for ovarian stimulation. This issue is in my opinion, by far the commonest cause of poor egg/embryo quality.
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.
•The IVF Journey: The importance of “Planning the Trip” Before Taking the Ride”
•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 Approach
•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 “Biological Clock” and how it should Influence the Selection and Design of Ovarian Stimulation Protocols for IVF.
• A Rational Basis for selecting Controlled Ovarian Stimulation (COS) protocols in women with Diminished Ovarian Reserve (DOR)
•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
•Optimizing Response to Ovarian Stimulation in Women with Compromised Ovarian Response to Ovarian Stimulation: A Personal Approach.
•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
•Blastocyst Embryo Transfers done 5-6 Days Following Fertilization are Fast Replacing Earlier day 2-3 Transfers of Cleaved Embryos.
•Frozen Embryo Transfer (FET) versus “Fresh” ET: How to Make the Decision
•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.
•IVF: Selecting the Best Quality Embryos to Transfer
•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
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
Hi Dr. Sher,I am 37 years old. I just did first ivf cycle and 20 eggs were retrieved and 7 made it to blastocyst stage but after PGS test because of my previous recurrent miscarriages, we got only one euploid embryo out of seven. Then when we transfered the frozen embryo, there was no pregnancy. Please what do you think that caused this poor outcome of embryo and do you suggest any better treatment for myself or my husband to improve the quality of the embryos during next ivf cycle. Thanks.
Hi Dr. Sher.
I did my first IVF cycle in November. I had a 5 day embryo transfer on November 8. My test results have been weird and my doctor predicts that this is a non-viable pregnancy. I would like to please hear your opinion on my situation. Today, I should be 8 weeks, 4 days pregnant. The ultrasound this morning showed that there was a sac in the uterus, but it’s measuring at 5 weeks. They did detect a sac, but no yolk, fetal pole or heartbeat. My beta this morning was 1352. My doctor has prescribed Misoprostol; should I take this now? I would like to speed up the process if this is for sure a non-viable pregnancy’ as it has really taken an emotional tow on us.
Please provide your expert opinion.
Thank you very much
This does not look good. I suggest you follow your doctor’s recommendation.
Geoff Sher`
On 12/5 I had 2 embryos (day 3 transfer ) implanted. My beta test was today and the level is 4.66. The nurse said anything over 3 is considered positive but 4.66 is low and we have to repeat in 2 days. Is there a chance that I have a viable pregnancy?
It does not look very promising I am afraid. But I would repeat the blood test in 2 days in the hope that I am wrong.
Geoff Sher
Dr Sher,
Thank you for helping even when on vacation. I have a question on the problem of eggs maturing next day after retrieval. I had more than 20 eggs retrieved but all were immature. Luckily we got 8 mature the next day and only 3 fertilize. I used HCG 10,000 for trigger. In your experience, what could be the cause of so many immature eggs apart from bad egg quality? Also could ICSI (which we used) decrease fertilization rate?
Protocol, gonal f 300 u and Menopur 150 u.
Thank you and happy holidays
Hi mair,
You are no bother and questions that are eating on you deserve an answer.
I have little doubt that this is likely to be a stimulation protocol issue and no, ICSI is not the culprit.
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.
•The IVF Journey: The importance of “Planning the Trip” Before Taking the Ride”
•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 Approach
•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.
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.