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,
We are getting ready to go through our first IVF cycle with ICSI, due to MFI. We are both 30. My husband has a very low count (between 2ook-2 mil/ml), normal motility, normal morph. I have cd3 FSH 9.9, AMH 2.96, E2 28, TSH 2.05, Prolactin 3.8, Free T4 1.2. Should we request the use of PICSI (physiologic ICSI, with the use of hyaluronic acid (HA)-binding sperm selection)? Also, what is your opinion in general on the use of PICSI? Thanks!
Also, my husband’s FSH is 9.6, LH 5.8, testosterone 509.1, E2 <25. He has a tiny varicocele which is not problematic, and no known cause of the low count.
Frankly Jennifer, I do not believe PICSI helps.
Geoff Sher
Hello Dr. Sher,
I have a question about gender selection. We have 3 frozen embryos (from our fresh IVF cycle in 2012), they are 5 day old blasts. We have twin boys from our fresh IVF cycle. We’d like to add to our family and are wondering if we could do PGD testing on any of our frozen embryos to see if there is a girl in there or not. Is this possible?
It takes a toll as it is stressful on the embryos to thaw them, test them, refreeze and then thaw later for the ET…but it can be done.
Geoff Sher
Hi Dr Sher, how much LH is too much for older women? I am 43 and am on 187.5IU Fostimon and 150IU Merional (4mg Zomacton on alternate days). I understand that 150IU of Merional would contain 150IU of LH. I have 23 follicles and E2 is 1251 on day 7. I haven’t been 100% diagnosed with PCOS but I was told that I do have some symptoms that are suggestive of PCOs.
Thanks so much for a response in advance!
Hi Sheena. It is not primarily LH in the menotropin but rather hCG. However that works in the same way. I personally try to keep the menotropin dosage at no more than 75U.
Good luck!
Geoff Sher
Hello Dr. Sher,
I fell pregnant with my very first IVF (endometrium at 15mm) but unfortunately had to have a D&C for a missed abortion. Since then I have a thin endometrium (approx. 7,5mm before ovulation) and had 5 failed Embryo Transfers. I was wondering if vaginal sildenafil would help? I am planning for a natural FET, does vaginal sildenafil has any negative impact on the hormones or ovulation or is it fine to use in a natural cycle? Also I read that a low lining is more a problem in a fresh than in a frozen Embryo Transfer. Is that correct? If yes, I would only do FETs in the future.
Your help is highly appreciated.
Best
Anne
Hi Anne,
If your thin lining is due to a damaged endometrium because of post-abortal endometritis (inflammation), then the Viagra might not help. A lining of >8mm is OK but ideally it needs to be >9mm.
Good luck!
Geoff Sher
Dr Sher, please could you tell me how soon I could start medication for a fet after a failed fresh cycle? Is it ok to start straight away on the bleed from the failed fresh cycle or should I leave a break? My clinic only use estrogen for a fet to stop the follicles from growing and ovulating. They do not use Lupron at all. Do you think this is ok or would you also recommend Lupron?
Also one further question. At the age of 36 soon to be 37 how many blastocysts would you recommend having frozen in an attempt to get 2 babies, one now and one in a couple of years?
I recommend at least one rested cycle between the Fresh and FET.
Ideally you would want at least 4 blastocysts cryobanked in my opinion.
Geoff Sher