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.
Urgent advice for possible testing, my daughter is 3o years old, she is on her 2nd ivf 5 day frozen genetically tested embryo transfer. She lost the 1st at about 5 weeks. She is now 6 and half weeks, her first hcg level was 24, two day later 70, and it continued to double. She went in for an 5 and half week ultra sound, saw and egg sac, she went in yesterday at 6 and half weeks and saw a heart beat and a smaller than normal fetal pole, the doctor said she most likely will miscarry this week, she has a 10% chance of the pregnancy progressing. She has PCOS and Celiac (she has been gluten free for 6 years and is on a very strict no gluten no sugar diet) I want to know if she does miscarry are there any test she should have immediately to find out if it is a chromosome issue or immunology issue. I am at a lost and just want to help my daughter.
Sincerely,
Marla Carroll
Hello Dr. Sher,
Today is cd 13 and my lining is only 6.7 (after 6 days of taking Viagra).
The clinic wants me to continue increased estradiol 3x40mg vaginally (E level in blood is 2700!)
I am to repeat ultrasound in two days and if lining gets above 7, the following day I am supposed to start Crinone 8% for 5 days prior to FET.
1. Would you advise to wait longer then 15 cd for lining to grow?
If yes, would it matter that I only have Viagra for 2 more days until 15cd (because my clinic is overseas, I will not be able to arrange more. But I have regular Sildenafil pills if those could be used)
2. I don’t think my lining had triple pattern today on 13cd… if it doesn’t develop this triple pattern by the time of starting progesterone, would you cancel this cycle?
2. I am supposed to take Crinone gel 8% only once a day (if lining will be acceptable by that time)- is it enough in your opinion? I thought it should be twice a day?
In May I had miscarriage followed by D&C, so I am very worried about this lining I didn’t really have problems with thickness before.
I am also worried that if we cancel this cycle, next one could be worse. But in the same time I do not want to waste good tested embryo… I feel that the clinic wants to move forward with the transfer next Wednesday, but I have doubts…
Thank you so very much for being here!
Zuza
1. Would you advise to wait longer then 15 cd for lining to grow?
If yes, would it matter that I only have Viagra for 2 more days until 15cd (because my clinic is overseas, I will not be able to arrange more. But I have regular Sildenafil pills if those could be used)
2. I don’t think my lining had triple pattern today on 13cd… if it doesn’t develop this triple pattern by the time of starting progesterone, would you cancel this cycle?
A: Thickness is more important than the trilaminar appearance. Frankly, if the Viagra did not work, , increasing the estrogen will be unlikely to work either.I personally do not continue the cycle if the lining is <8mm.
2. I am supposed to take Crinone gel 8% only once a day (if lining will be acceptable by that time)- is it enough in your opinion? I thought it should be twice a day?
A: I personally use double that dosage.
Good luck!
Geoff Sher
Hello,
I have a question about NK cells related to implantation issues. Im curious how accurate the test is when looking at the levels. We all have NK cells in the body from my understanding and if they are elevated does it just indicate that there is inflammation in the body at that time? I know I have a fibroid on the outside of my uterus that I was told would not affect implantation but having this fibroid, could this show an elevated result of NK cells in my bloodstream? I’m wondering if these cells fluctuate from day to day and when our bodies are sick. also, with elevated NK cells does a person have any symptoms or any risk factors for any other health issues? I’m trying to make sense of all this I will be getting tested soon. I’ve been reading your articles and they are helpful but still wondering about this test and interpretation of the results.
Thanks.
Hi Anna,
The concentration of CD56 lymphocytes (NK cells) in the blood is not relevant. It is the activation of these cells as evidenced by a special test, the k-562 target cell test or by measuring uterine ncytokines that matters and this remains relatively stable.
Good luck!
Geoff Sher
Dear Dr. Sher,
Thank you for your advice regarding folic acid. I will take only methyl folate.
But can you explain what are the potential dangers to the pregnancy if while having MTHFR C677T heterozygous mutation, additionally to methyl folate, regular folic acid 5mg is taken?
I am asking because this is how a lot of clinics in Europe prescribes it so hearing that regular folic acid could be harmful is troubling…
Thank you!
I think risks have been overblown. I prescribe methyl folate alone and that should suffice.
Geoff sher
A time sensitive question. Dear Dr. Sher, I’m scheduled for an FET on 09/02 of 2 blasts.
1ST FET resulted in a live birth
2ND FET was a negative we were very surprised as my lining, levels etc were optimal.
My Third FET is scheduled for 09/02 and we are planning on transferring two Blasts. I had my U/S E2 and Progesterone check today
and my levels are as follows. MY E2 is 189 and my Progesterone is <0.2
I'm on IM injection .2 ml of Estradiol and my last injection was Friday the 25th.
Do you think the lining itself irrespective of the E2 level is fine for transfer?
Is it possible to increase lining with addition of meds?
Will I most likely loose the window and how broad is the window for transfer?
Thank you
Respectfully,
In my opinion the E2 is too low. It should ideally peak at 500 and 1,000pg/ml.
Good luck!
Geoff Sher