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.
For a 37 year old woman interested in banking embryos, how many embryos do you need to bank to have 3 children? I plan on banking with PGS so only genetically normal embryos will be banked. Does embryo quality matter more or does genetic normalcy matter more when considering FET in 5+ years?
I would shoot for at least 6, PGS- normal blastocysts…if possible. It is the chromosomal integrity of the embryo that is most important here. I would use a modified, robust, long pituitary down-regulation protocol. I would use an agonist/antagonist conversion protocol with human growth hormone (HGH) augmentation and would recommend Staggered IVF with embryo banking of PGS (next generation gene sequencing)-normal blastocysts, to make hay while the sun still shines.
Please visit my new Blog at o to http://goo.gl/4hvjoP , find the “search bar” and 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
•Ovarian Stimulation for IVF using GnRH Antagonists: Comparing the Agonist/Antagonist Conversion Protocol.(A/ACP) With the“Conventional” Antagonist Aproach
•IVF: Factors Affecting Egg/Embryo “competency” during Controlled Ovarian Stimulation(COS)
•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)
•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?
•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 Sampling (PGS) Using: Next Generation Gene Sequencing (NGS): Method of Choice.
•IVF Failure and Implantation Dysfunction: The Role of Endometrial Thickness, Uterine Pathology and Immunologic Factors
•Why did my IVF Fail
•Traveling for IVF from Out of State/Country–
•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
I invite you to call 702-699-7437 or 800-780-7437 or go online on this site and set up a one hour Skype consultation with me to discuss your case in detail.
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
I invite you to call 702-699-7437 or 800-780-7437 or go online on this site and set up a one hour Skype consultation with me to discuss your case in detail.
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
Thank you so much Dr. Sher!
Hi I was wondering if these betas look okay 1st beta at 15dpo was 62.7, 2nd beta at 18dpo was 150. Do these numbers look good to you?
Just got my 3rd beta at 20dpo 273 so now you have 3 beta results to refer to what do you think are these numbers to low or what.
So far so good!
Good luck and G-d bless!
Geoff Sher
Dear Dr. Sher,
I’ve been trying to be pregnant for 1.5 years. I know that I have alloimmune and NK problems, in 2014 I had an examination where they found elevated NK cells (23) and other problems (MLC and TH1/TH2 was bad as well). Last week I went to repeat this examination (10th March 2016). I was on my 22nd cycle day. On that day morning I got a very faint positive HCG test. So I asked them also to do a HCG blood test. It came back 13.8 IU/l. My tests are stronger now, I was today also at a blood test but I don’t know my result now. I go tomorrow to have a HCG blood test again just to see how it is going.
My problem is that the biologist just called me and told me that my NK cells are elevated again (19) and he said that I should get an IVIG therapy as soon as it is possible to regulate my NK levels. I wanted to wait today’s and tomorrow’s HCG levels just to see whether it is worth to get an IVIG or not.
What do you think how long can I wait to get an IVIG in this situation? Do you think that Intralipid can be enough at first to regulate my NK levels (I have Intralipids at home so I can organize it very quickly). I am really looking forward to your answer,
Kind regards, Nora
I personally do not think that waiting 1 day will make a difference. I also beleive that IL is just as effective as IVIG. However, that is my perspective and you should follow the recommendation of your RE.
Good luck!
Geoff Sher
Hi Dr. Sher,
I was wondering if there is a cut-off for determination of whether ICSI would be needed. My husband’s post-wash count is 2.5 million on average. Do you think this warrants ICSI or would traditional IVF be enough?
I absolutely would recommend ICSI.
Geoff Sher
Dear Dr. Sher,
Thank you for creating such wonderful Q&A section and blog on IVF.
I am just curious why my doctor instructed me to use Estrace during ovulation and before the next IVF cycle begins. They mention the estrace is to prim the follicles so that they are a bit more receptive to the medications when they are administered. Can you please explain if this is correct, I thought estrace is used during implantation?
Estradiol does prime follicle cell FSH receptors, but in my opinion, priming for stimulation is only beneficial in cases of very severely diminished ovarian reserve (DOR).
Geoff Sher