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.
Dr Sher, what are your thoughts on poppy seed oil (Lipiodol) flushing?
I have no clue what that would do!
Geoff Sher
Hi Dr. Geoffrey,
I have multiple IVF failures in the past and wanted to understand if Intralipds might beneficial. I have high NK 26 and have RA.
I had 3 miscarriages at 6 weeks and have used prednisone (20 mg, plaquenil 200 mg, lovenox 40) as part of the protocol. I have my upcoming transfer (25 yr old, PGS tested) and was wondering if Intralipds can reduce the NK significantly as have heard that the preferred NK is <15. I have also read that for some patients their NK increased after Intralipds. Is IVIG recommended for such a high Nk ?
Thank you
PS
Dear Dr. Sher,
I read your blogs and posts almost on a daily basis and they are insightful and inspiring! I am a 40 year old woman that has gone through two ivf cycles. Each time I had about 17 eggs retrieved, 10 eggs fertilized, but only one made it to blastocyst. I know you don’t have my charts or anything, but what do you think is the reason that fewer than ten percent making to blastocyst? If it’s egg quality (easy to suspect egg quality obviously because of my age), how could I improve the egg quality? Would taking HGH help? Thank you!
It is very likely largely due to the impact of age on egg “competency” HGH might be advisable, but bthere is no evidence that it would reduce the incidence of chromosomal aneuploidy!
Geoff Sher
Dr Sher, why do you half the dose of lupron to 5iu on a long cycle? Is it because 10iu can be suppressive on ovaries? Curious.
Yes in my opinion….to both questions.
Geoff Sher
Good morning dear Dr. Sher,
I am from India and ardently follow your blogs and Discussion Forum and would like to take your valuable inputs on the below issue before discussing next steps with my fertility specialist.
I am a case of 5 failed ICSI procedures (Repeat implantation failure) , have DOR , close to 40 years. While all our tests including immune have come out negative, and everytime, the 2 or 3 embryos reach to beautiful blastocysts stage, the only visible issue appears to be evidence of adenomyosis in the uterus using Ultrasound. My doc mentioned that typically adenomyosis is not a significant limiting factor in IVF , however since in my case , that appears to be the only explainable cause, she has asked me to get a MRI-Pelvis for a confirmation. Can you pls. share inputs on the below 2 questions?
1. As per your blogs, your recommended approach to DOR patients, who respond poorly is typically antagonist / estrogen priming protocol. However, since estrogen would be a deterrent in case of adenomyosis patients, do you still advocate estrogen priming protocol or long downregulation in my case.
I would also like to inform you that all my failed cycles so far have been using antagonist protocols.
2. Secondly, before we proceed with the next round, do you think we should do anything more to address the adenomyosis issue or do you think that it is not a limiting factor in embryo implantation process.
Thank you Doctor and wish you a great day ahead.
Regards
Anu
1. As per your blogs, your recommended approach to DOR patients, who respond poorly is typically antagonist / estrogen priming protocol. However, since estrogen would be a deterrent in case of adenomyosis patients, do you still advocate estrogen priming protocol or long downregulation in my case.
I would also like to inform you that all my failed cycles so far have been using antagonist protocols.
A: Short term estrogen priming would not exacerbate the adenomyosis.
2. Secondly, before we proceed with the next round, do you think we should do anything more to address the adenomyosis issue or do you think that it is not a limiting factor in embryo implantation process.
A: If the endometrial lining is thick enough, the adenomyosis would in my opinion, not affect implantation.
Geoff Sher