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.
Hello Sir,
I went through the frozen embryo transfer on the 12th of May wherein two blastocysts were transferred.
My beta HCG levels are as follows:
13th day after embryo transfer: 2087.76 mIU/mL
15th day after embryo transfer: 5664.95 mIU/mL
17th day after embryo transfer: 16460.00 mIU/mL
19th day after embryo transfer: 31933.96 mIU/mL
As you could see here, the doubling time for the Beta HCG is slowing down. For the first three Beta HCG results, the doubling time was around 33 hours which has now slowed down to around 50 hours.
I am getting extremely nervous about this slowing down of the Beta HCG. How to interpret these results please guide us.
Thanks & Regards,
–Mrs.Saana Ghosh
It looks good to me and could even be a multiple pregnancy. I suggest you have an ultrasound examination early next week to assess!
Good luck!
Geoff Sher
Hi doc,
My age is 32 and I have been married for 9 years and had a missed abortion at 9 weeks in 2011 and no pregnancy since then. I started IVF last month to start with 15 follicals but got only 3 eggs retrieved that too were unmatured and even after culture for a day none of them grew. My ovarian reserve is not good. What ate my chances with my own eggs??
Thanks
15 antral follicles and only 3 eggs retrieved does not sound like severely diminished ovarian reserve to me. Perhaps the ;protocol used for ovarian stimulation needs to be reviewed and revised.
Here is the protocol I advise for women, <40Y who have adequate ovarian reserve.
My advice is to use a long pituitary down regulation protocol starting on a BCP, and overlapping it with Lupron 10U daily for three (3) days and then stopping the BCP but continuing on Lupron 10u daily (in my opinion 20U daily is too much) and await a period (which should ensue within 5-7 days of stopping the BCP). At that point an US examination is done along with a baseline measurement of blood estradiol to exclude a functional ovarian cyst and simultaneously, the Lupron dosage is reduced to 5U daily to be continued until the hCG (10,000u) trigger. An FSH-dominant gonadotropin such as Follistim, Puregon or Gonal-f daily is started with the period for 2 days and then the gonadotropin dosage is reduced and a small amount of menotropin (Menopur---no more than 75U daily) is added. This is continued until US and blood estradiol levels indicate that the hCG trigger be given, whereupon an ER is done 36h later. I personally would advise against using Lupron in “flare protocol” arrangement (where the Lupron commences with the onset of gonadotropin administration.
I strongly recommend that you visit https://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.
• 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
• “Triggering” Egg Maturation in IVF: Comparing urine-derived hCG, Recombinant DNA-hCG and GnRH-agonist:
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.
Geoff Sher
What do you think of thawing frozen blastocysts, doing PGS testing trophodecterm biopsy, re freezing and then thawing the normal ones? If you don’t recommend, why????
There have been babies born following this thaw…biopsy…refreeze to allow for testing and then re-thaw for FET, but in my opinion it is traumatic and i do not advise it.
Geoff Sher
Dear dr.Sher
I got my results of AMH hormone -3,47 ng/mL (normal range is 0,35 – 19.0). Is this showing that I have low ovarian reserve and that I will not respond ok in ivf?
No! It is above normal! 2.0 is normal.
Geoff Sher
How many times do you need to have intralipid after a BFP? It appears the protocol has changed since I had my daughter. Thanks in advance.
It depends on the cause…whether autoimmune or alloimmune. In the case of the former…twice (once 10-14days prior to ET and the second after the chemical (blood hCG) diagnosis of an implanting pregnancy. With the latter, the IL is thereupon repeated 2-4 weekly until mid-pregnancy.
Geoff Sher