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.
I had an IVF and am pregnant. 6w 3 days.
Good hcg rising . At 6w 3 days my us scan showed 120 heart beat. My doc was happy but my sisters doc in india says its low and need to be checked again because its lower normal rate. We did pgs but im worried
120bpm is OK as far as I am concerned!
Geoff Sher
Sir, I am doing excessive masturbation from the age of 13 till i reached 18. Now I have stopped this habit but I have developed many problems like loss of self esteem, gynaecomastia, my shoulders are not broad enough ec. Sir please tell me how long will it take me to recover from all of my problems.
I really cannot advise. I suggest you talk to your primary care physician and be referred for counseling.
Good luck!
Geoff Sher
Hi
I just attempted to have a collection done yesterday and they could not find the follicles. I don’t understand can follicles disappear within 36 hours? I am waiting to see my doctor tomorrow but i don’t know how to feel in the meantime. What does this mean. I am 43 does this mean i may not be able to have a child. Can I try again. What can I do to enhance my chances.
That is strange…unless you ovulated in advance. When this happens it often points towards “premature luteinization” which usually means that the protocol used for stimulation needs a serious review and revision.
Perhaps 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.
Geoff Sher
Dear Madam,
My wife has undergone ICSI 3 Day embryo Transfer. 1 cell is compact grade and others are Grade B. She got pregnant successfully and Values were @ DPT 14 577 Hcg & 23 Progesterone level and @ DPT 16 Hcg 1577 & 23 Progesterone level. Also she had undergone TVS and spotted SAC at 5 weeks. Then after two days she started to experience light bleeding for one day and stopped afterwards. Again as per Doctor advise, we have done Beta HCG @ Day 20 and It came 3200 . The doctor said that since three embryos have transferred, there might be bleeding and changes in BHCG and they told that finger crossed and Hope for the best at Final scan scheduled on DPT 25. Please let me know Do we have hope for Viable pregnancy?
Dear Dr.Sher,Sorry for called you as Madam,
Yes, there is hope but you will need to perform an US examination to look for a HB and appropriateness of growth at about 7 weeks to arrive at a more reliable answer.
Good luck!
Geoff Sher
Hello sir,
age of my wife is 32. We are trying to get a baby for last 1 year but she was not able to conceive because she had ovarian cyst. After a long period she is now cured from cyst. Her menstrual cycle is 27 days but in current cycle she has already crossed 29 days and this is happening for the first time. Currently she is taking 1 capsule of Folinext D twice a day, Ecosprin 75 once a day and Dheapreg sr 75 once a day. Is these medecine are safe now ?
Thank you.
Saikat Das.
India
I do not prescribe DHEA or aspirin. The rest is probably regular.
Dehydroepiandrosterone (DHEA), is steroid hormone produced by the adrenal glands and ovary. It is involved in producing the male hormones, androstenedione testosterone and also estrogen. DHEA blood levels tend to decline naturally with age.
Under the effect if luteinizing hormone (LH), DHEA is metabolized to testosterone in ovarian connective tissue (theca/stroma). Thereupon the testosterone is transported to the granulosa cells that form the innermost layer of the ovarian follicles where, under the influence of follicle stimulating hormone (FSH)-induced desmolase and aromatase enzymatic activity the testosterone is converted to estradiol. As this happens, granulosa cells multiply, follicle fluid volume increases along with estrogen output and egg development is promoted.
It is recognition of the essential/indispensable role that male hormones (mainly testosterone) play in follicle and egg development that prompted the belief that by giving DHEA and boosting ovarian testosterone production might benefit follicle/egg development. This belief was given some credence by an Israeli study that in 2010 reported on improved fertility when a group of infertile women were given the administration of 75mg of oral DHEA for 5 months. However, this study was seriously flawed by the fact that it did not separate out women who had diminished ovarian reserve, older women and those with PCOS, all of whom have increased LH-induced production of testosterone. In fact, we recently completed a study (currently being processed for publication) where we conclusively showed that when follicular fluid testosterone levels exceeded a certain threshold, egg quality was seriously prejudiced as evidenced by a marked increase in the incidence of egg chromosomal defects (aneuploidy).
Consider the following: Ovarian testosterone is needed for follicular development. However, the amount required is small. Too much ovarian testosterone spills over into the follicular fluid and has a deleterious effect on egg/follicle development. Some women (women with diminished ovarian reserve –DOR, older women and those with polycystic ovarian syndrome-PCOS) who tend to have increased LH biological activity, already over-produce testosterone. To such women, the administration of DHEA to such women, by “adding fuel to the fire” can be decidedly prejudicial, in my opinion. Young women with normal ovarian reserve do not over produce LH-induced ovarian testosterone, and are thus probably not at significant risk from DHEA supplementation. It is noteworthy that to date, none of the studies that suggest a benefit from DHEA therapy have differentiated between young healthy normal women with normal ovarian reserve on the one hand and older women, those with DOR and women with PCOS on the other hand.
In Some countries DHEA treatment requires a medical prescription and medical supervision. Not so in the U.S.A where it can be bought over the counter. Since DHEA is involved in sex hormone production, including testosterone and estrogen, individuals with malignant conditions that may be hormone dependent (certain types of breast cancer or testicular cancer) should not receive DHEA supplementation. Also, if overdosed with DHEA some “sensitive women” might so increase their blood concentrations of testosterone that they develop increased aggressive tendencies or male characteristics such as hirsuites (increased hair growth) and a deepening voice. DHEA can also interact other medications, such as barbiturates, corticosteroids, insulin and with other oral diabetic medications.
BUT the strongest argument against the use of routine DHEA supplementation is the potential risk of compromising egg quality in certain categories of women and since there is presently no convincing evidence of any benefit, why take the risk in using it on anyone.
Finally, for those who in spite of the above, still feel compelled to take DHEA, the best advice I can give is to consult their health care providers before starting the process.
Addendum: One potential advantage of DHEA therapy if used appropriately came from a study conducted by Washington University School of Medicine in St. Louis, MI and reported in the November 2004 issue of the “Journal of the American Medical Association” which showed that judicious (selective) administration of 50mg DHEA daily for 6 months resulted in a significant reduction of abdominal fat and blood insulin in elderly women.
Geoff Sher