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, I am currently researching your protocol to try for my next round of IVF. I have just completed a MDL protocol with fair result (8 follies = 2 empty, 2 abnormal, 4 MIIs but only 3 fert). We are planning to do PGD. `I am 36, my FSH is 5 and AMH is 1.6 ng/l. We are cycling in a diff country.
Also, i will appreciate it if you can send me your protocol schedule and directions on rosejoy1980@gmail.com if it’s not too much to ask. Thank you!
My questions are listed below:
1. On average, how many days does one stim for on the AACP protocol before trigger (I need to plan travel etc).
2. I think I will be on on your LA-6 protocol (you see I have read all your articles and blogs 🙂 ). Do i have to start cetrotide immediately i get my period or can I continue on the reduced dose of lucrin for a while, and then add 0.125 cetrotide after about 3 – 4 days of stims? The main reason for this is cost for me as we will be cycling on a very low budget.
4. About how many eggs do you envisage I might get? I am just looking for an educated guess here 😀
3. With an FSH/LH of 5, do you think I need the Estrogen priming?
Sorry, I cannot send you the protocol .
QUESTIONS:
1. On average, how many days does one stim for on the AACP protocol before trigger (I need to plan travel etc).
A: About 8-11 days
2. I think I will be on on your LA-6 protocol (you see I have read all your articles and blogs ). Do i have to start cetrotide immediately i get my period or can I continue on the reduced dose of lucrin for a while, and then add 0.125 cetrotide after about 3 – 4 days of stims? The main reason for this is cost for me as we will be cycling on a very low budget.
A: I would start with the gonadotropin stimulation.
4. About how many eggs do you envisage I might get? I am just looking for an educated guess here
A: Hard to say but given your AMH…I would say 10+
3. With an FSH/LH of 5, do you think I need the Estrogen priming?
A: Not at all!
Good luck!
Geoff Sher
Dear Dr Sher,
Does estrogen and progestrone levels have to be checked after fresh embryo transfer and can increasing doses help implantation if levels are low during 2ww?
My clinic gives 1cc progestrone and estriodal patch starting day after transfer every other day and progestrone staring day after retrieval every day as a general rule for most patients but never checks levels during 2ww. I worry that if either E2 or Progestrone goes out of balance implantation maybe affected?
If these hormones are administered correctly, there is rarely a need to measure their levels , in my opinion.
Geoff Sher
Dear Dr Sher,
after about 4 or 5 hours after giving Progestrone shot, I get restless leg and hand on the side the shot is given. It lasts for at least several hours before it goes away and I am able to sleep. Restless leg and hand only happens on side the shot is given. other side has no issue. why does this happen? And can it affect the outcome of the transfer?
It is possible that the shot is not ideally positioned and that it is deposited too close to the sciatic nerve. Discuss the ideal positioning with your RE.
Geoff Sher
Hi Dr. Sher,
We spoke about a month ago about the possibility of abnormal embryos being capable of producing a live birth. I am going to be retesting some of my abnormals as I have no more money to retrieve more embryos and I am too old now. I have many frozen but was wondering which from this list you think are most worth retesting and possibly transferring:
1: day 5 grade 322 – xxy monosomy 4,14,22
2: day 5 grade 323- trisomy 11
3: day 6 grade 233- monosomy 16
4: day 6 HBl grade 533- monosomy 7,19,20
5: day 5 HBl grade 523- trisomy 1, 7, 16
6: day 6 HBl 532- trisomy 9, monosomy 19
Thanks for your help.
In my opinion, #2;, #3 and #6 are worth considering as possible mosaics.
Geoff Sher
Hello Dr. Sher. I cannot take BCP so my RE wants to use estrogen/progesterone to suppress ovulation to fit into her schedule. My AMH is .9 and my AFC is 10. Are the effects of estrogen/progesterone the same as BCP on those with DOR? I know you recommend overlapping BCP with an GnRH agonist. Would you recommend the same with estrogen/progesterone? Or no? Also is this what is referred to as “estrogen priming?” Thank you.
The effects are identical.
Geoff Sher