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.
Dear Dr Sher,
I am 39 years with high LH fluctuations several times in a cycle. Since my LH is high through the cycle is it better to prime with Estrogen from 21st day of prior cycle and continue through the new cycle till trigger or is it more effective to start Ganirelex from CD1 and continue till trigger stopping Estrogen priming on 2nd or 3rd day of period?
If
In my opinion…no! I think you need a modified, , long pituitary down-regulation protocol coming off a BCP. I would use an agonist/antagonist conversion protocol with human growth hormone (HGH) augmentation and might would recommend Staggered IVF with embryo banking of PGS (next generation gene sequencing)-normal blastocysts.
Please visit my new Blog on this very site, http://www.DrGeoffreySherIVF.com, 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 promptl
•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?
•Premature Luteinization (“the premature LH surge): Why it Happens and how it can be Prevented.
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
Hi Dr. Sher,
I just recently did a fresh ivf cycle. I had 2 day 5 blastocysts tranfered. Yesterday with was 8 days past transfer I had my first beta which was <1. I have my second beta tomorrow. … so pretty sure this cycle of ivf failed. My nurse said sometimes it will go up. Have you seen that? Anyways, my real question is coming up. I have a hydrosalpinx… not sure which side. But definitely the one only. I hate the idea of having a true surgery and be on life support to get it removed and afraid they might damage something else near the tube as well. So my question is should I try a frozen transfer before going to surgery or is there something else we can do? We have 3 frozen embryos. Thanks, Teresa
I would do the surgery before doing FET.
Geoff Sher
Dear Dr,
What is the cause for follicles just not growing with stimulation or even when observing Natural IVF cycle but Estrogen increasing normally and surge taking place normally and periods are normal? I have done 2 cycles and my follicles remain at about 7-9mm and don’t increase despite Estrogen increasing and LH surging at time of ovulation and period arriving 2 weeks after ovulation.
Hellen,
As I am sure you can understand, I would need much more information to provide an authoritative opinion.
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
Dear Doctor,
What is the longest stimulating time that is acceptable? Is 20 to 25 days of stimming abnormal for a 40 year old?
That is far too long. I have seen it take 15 days or so but really no longer.
Geoff Sher
Hi Dr Sher, I have just completed my first round of egg/embryo collection. I started with 23 follicles but only 9 grew. 9 eggs were collected (1 egg was immature and 1 was damaged during ICSI). At day 3 we managed to get 7 embryos (5 top quality, 2 good quality. 2 embryos were slower at development). The embryos have now been frozen. We have been advised to do another cycle and then PGS all the embryos.
Do you have any thoughts on how many embryos we should look to collect to get a successful result. What are your thoughts on the numbers above? I am 44 years old (AMH 20, FSH 8).
Do you have an opinion on how long we should wait for the next round. My TCM doctor has suggested waiting 2-3 months if not I will not get as many embryos. But the clinic said one month is sufficient.
Any thoughts or advice you can offer would be greatly appreciated.
Many thanks, Sheena
It is disappointing to have 23 eggs and end up with such a low yield of good embryos. In my experience, while there may be other factors, the protocol used for ovarian stimulation is the most important consideration. In my opinion, this needs to be carefully reviewed and even revised so as to optimize the yield and quality of eggs generated…see below!
Please visit my new Blog on this very site, http://www.DrGeoffreySherIVF.com, 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 promptl
•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.
•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?
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