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.
Hi there,
I’d love to get some insight into what has been a pretty stressful situation.
On July 18, I transferred one very good quality frozen 5-day blastocyst. My initial beta 9dp5dt was 152, two days later it was 378. At 6 weeks, 4 days, my first ultrasound showed a sac and yolk sac measuring on target but fetal pole measuring 5 weeks 3 days with no detectable heartbeat. My RE told me that this was likely a miscarriage and booked me for a follow-up scan 5 days later to confirm. We were devastated.
At that second scan 5 days later, however, the fetal pole measured 6 weeks, and the heartbeat was just barely present—the doc thought it had just started beating that day.
5 days after that, we had another scan—so at that point I was 7+6. The fetal pole measured 6+4 with a heartbeat of 123. The yolk sac and the amniotic sac were still measuring exactly on target for 7+6.
My RE says that it’s an encouraging sign that the fetal pole is growing and the heartbeat is picking up, but she’s also cautioned me that the fact that the CRL is lagging 9 days behind is very concerning. She says that she has seen “slow starters” like this turn out okay, but nothing I have read is very encouraging. I have another scan on Thursday; I’m trying not to drive myself crazy before then. Any thoughts?
Thank you!
Obviously the HB was missed at 6w. That is not surprising and it only speaks to the need to be very cautious in diagnosing a missed abortion so early on.
I agree that a slight lag in growth is not always indicative of a disaster. Give it a few weeks and you might be pleasantly surprised to learn that all is well.
Geoff Sher
Hello Dr Sher,
I am in preparation for FET and in panic: today is 9th day of the cycle and 3rd day of taking spetially formulated Sildenafil 4x25mg vaginally.
Today my lining was only 4.58.
(Usually on this day 9 it used to be 7.5 or 8mm)
1.Is it possible that Sildenafil instead of improving my lining worked oposite?
2. I am also taking 3x2mg estradiol vaginally since cd 3 now I am told to add orally.
Is it possible that vaginal Sildenafil (with cocoa butter ) prohibited vaginal estradiol from absorbing adequately and this resulted in this thin endometrium?
3. Would you advise to continue Sildenafil or stop it?
4. Do you think there is still a chance for FET this cycle? Or should this be canceled?
Thank you,
Zuza
PS:
Not sure if it matters:
I had miscarriage in May followed by D&C. Then I had two irregular cycles. And then I was on BCP for 42 days. During that time, I had water sono and it was good.
After stopping BCP, on day 4 there was only small spotting and the following day lining was 3.1.(during previous cycles used to be about 4.5 on cd2.) Next day I started Estradiol 3x2mg vaginally.
I forgot to include blood work from today cd9:
LH 2.67
E 976
P <0.20
1.Is it possible that Sildenafil instead of improving my lining worked oposite?
A: In my opinion…definitely not!
2. I am also taking 3x2mg estradiol vaginally since cd 3 now I am told to add orally.
Is it possible that vaginal Sildenafil (with cocoa butter ) prohibited vaginal estradiol from absorbing adequately and this resulted in this thin endometrium?
A: I doubt it…but check your blood estrogen level to see. By the way,I prefer injections and patches of estrogen
3. Would you advise to continue Sildenafil or stop it?
A: I would give it a few more days first.
Good luck!
Geoff Sher
4. Do you think there is still a chance for FET this cycle? Or should this be canceled?
Thank you,
Dear Dr. Sher.
Is is possible to take too much progesterone?
Today my P4 level was 110, and a few days ago on ET day, it was 74.
My clinic has me taking progesterone IM shots every 2 days, plus vaginal pessary 2x daily, plus rental pessary 2x daily, plus oral tablets 3x daily.
It seems like a lot of progesterone. Can anything bad happen if it’s too high?
Thank you!
It probably will do no harm but the levels are very high and the dosage of progesterone could safely be reduced.
Geoff Sher
Dr Sher,
I am currently in a FET protocol to transfer my PGS normal embryo (1st transfer). The protocol I’m on does not use BCP or Lupron. I have been on Estrogen for 10 days (patches and suppository) and today my lining measured 5.5mm. I had a hysterosonogram 2 months ago and it came back all clear. My question is, what changes do you recommend I make for the next attempt at FET to potentially improve lining and why?
Thank you so much!
Paulina
Hi Paulina,
I would need a great deal more information to be able to provide an authoritive opinion. We should talk.
If you are interested in seeking my advice or services, I urge you to contact my concierge, Julie Dahan ASAP to set up a Skype or an in-person consultation with me. You can also contact Julie by phone or via email at 702-533-2691/ Julied@sherivf.com You can also apply online at http://www.SherIVF.com .
*FYI
The 4th edition of my newest book ,”In Vitro Fertilization, the ART of Making Babies” is available as a down-load through http://www.Amazon.com or from most bookstores and public libraries.
Do u have conscious sedation as a way to aid in egg retrieval during IVF process i don’t want to be put to sleep?
That is precisely how we do our ER’s in almost all case!
Geoff Sher