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.
Esteemed Dr. Sher,
BLESS YOU!!!!!!!!!! I am a gestational surrogate and my clinic has told me I will be taken of meds (PIO and Estrace) at only 8 weeks gestation! We just transferred last month, 2/7, a 6 day embie. This clinic does not check estrogen nor progesterone levels at all. I did not ovulate prior to the transfer. I am super nervous about this as most clinics have surros on meds until 10 to 12 weeks gestation. This clinic claims the placenta begins to take over hormonal production once the embryo has a beating heart, but all the info I’ve run across says the placenta does not take over until 10 weeks. Please advise! Thank you kindly! I appreciate your advice immensely! Cathy
Respectfully Cathy…I tend to agree with you somewhat. The full transition to the placenta taking over, occurs by around 10 weeks. It starts earlier (around 8 weeks) is not complete untill then. So I prefer to continue hormone support until the 10th week.
Geoff Sher
Hi Dr Sher, I have had my scan and have 18-20 follicles altogether and I am almost 31 years old. I have been prescribed gonal f 150 and cetrotide for my cycle. I am a bit worried that I won’t get many eggs because I won’t be taking menopur as well, and the gonal f dosage is quite low? But they said because of my age I should respond well. Also I have read people have had menopur only cycles, so I am unsure why I am on only gonal f? Any help or advice is appreciated.
I think you know that I believe in a little Menopur (or Luveris) being added from day 3 of stimulation, but that is using a different protocol where the LH effect is virtually nullified by the long down-regulation approach. With your protocol where Cetrotide is added only from day 6-8 of stimulation there might be enough pituitary LH around to compensate….so it could be OK to avoid using any Menopur.
Geoff Sher
Dr Sher what percent of embryos arrest between day 3 and day 5? Today at day 3 i got one embryo still growing and we are culturing it to blast
It depends on the age of the women and her oivarian reserve. On average however, in younger women about 40% progress to blastocysts.
Geoff Sher
I have SLE and APS. I am about to undergo IVF with donor sperm and eggs. I take ciclosporin, hydroxichloroquine and heparin. I have been in remission for 2 years since rituximab infusion. I will start aspirin 75mg at basline scan, would you recommend steroids too. If so, how much/how long?
I would recommend that you be evaluated thoroughly for an immunologic implantation dysfunction before unde4rgoing 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.
• 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
• Use of GnRH Antagonists (Ganirelix/Cetrotide/Orgalutron) in IVF-Ovarian Stimulation Protocols.
• 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?
• 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
• Cervical Ureaplasma Urealyticum Infection: How can it Affect IUI/IVF Outcome?
• Treating Out-of-State and Out-of-Country Patients at Sher-IVF in Las Vegas
• Should IVF Treatment Cycles be provided uninterrupted or be Conducted in 7-12 Pre-scheduled “Batches” per Year
• 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.
Hi Dr. Sher, my scans this morning showed lead follicles around 18, and then a bunch of 15, some 14. my clinic decided to trigger tonight. my estrogen is 2360. Just seems too early to trigger, or will the 15 mm or so ones mature from the Ovidrel? i thought they waited for 20 mm?
No they will probably not…in my opinion. If the leads are only 18mm and the rest 15mm or less, then in my opinion, 1 aditional day might help.
Geoff Sher