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 Dr Sher, I’m 39 and I have not been able to fall pregnant naturally. However, when I used testosterone gel for 21 days before the start of my period, I fell pregnant naturally, twice! However, I miscarried. Is it a co-incidence or is there some benefit of testosterone gel?
In my opinion it is likely coincidental!
Geoff Sher
Hi Dr Sher, I stumbled upon your article where you say:
“Pretreatment with estrogen/progestin oral contraceptive pill is important to establishing an estrogenic environment. The dual actions of progestin-mediated LH suppression and estrogen-mediated stimulation of sex hormone binding globulin result in decreased follicular androgen levels”.
Doesn’t lupron on its own (without BCP) work to decrease follicular androgen levels? When Lupron is administered, it has an immediate dumping effect on LH and FSH. If LH is responsible for the follicular androgen levels, I was of the view that it achieves the same thing as the BCP, but I am not expert!
Lupron administered from the mid-luteal phase of the cycle will initially cause FSH and LH to be expunged from the pituitary gland. Initially these will surge but after about 4-5 days the levels will indeed come down. Thus the ultimate effect would be similar to the BCP.
Geoff Sher
Hello! I’m hoping you can give me some advice! I turned 43 in Sept. I’ve never been pregnant but have been trying for years. Over the past 2 years, I’ve gone through 3 IVF cycles. My last one in Jan 2017. That resulted in ONE normal embryo (we did do PGS testing). Because we only have one normal, everything MUST be perfect before we can transfer. Since Jan 2017, my lining hasn’t grown to more than 5ish. Most often I’m around 4-4 1/2. We’ve tried estrogen, tamoxifin, viagra, mock stems, etc. I feel like we’ve tried everything. Currently I’m on a double dose of viagra and estrogen in hopes that it will grow. I go to the doctor again tomorrow to be measured. I measured at 5ish 4 days ago. My lining was at 8 in Jan when I stimmed which is the reason for the mock stems we tried but no luck. Any ideas or other suggestions?
It sounds as if you could have an intractable (not-reversible) cause for such a thin lining. The commonest cause (although by no means the only one) for this is a prior endometritis (inflammation of the uterine lining) secondary to a prior pregnancy where there was retained products of conception that god infected.
Unfortunately, if the treatment referred to above does not solve the issue, your only recourse could be gestational surrogacy…
Good luck and G-d bless!
Geoff Sher
Such a great website you have! Do you have a view on Decapeptyl? Is it the same as Lupron?
Yes it is also a GnRH-agonist!
By the way, thanks for the kind sentiments you expressed here.
Geoff Sher
Hi Dr. Sher,
Thank you so much for your input and having such a useful forum. I am 35-year-old female, with low AMH (0.4) and FSH 4.9 and recently tried Farama (2.5mgX3/Menupur 150IU which was increased to 225 IU by CD 7, my two lead follicles were about 21mm, and two small at 13-15mm, they gave an extra day before I was triggered with Novarel and Luperon. Did the egg retrieval after 35 hours of the trigger. Immediately my RE reported that those eggs were not mature. If the eggs are not mature from the 20mm+ follicles then it is not genetically normal egg and they did not mention about the small follicles. But, reading your past blog, I am wondering if this was the right protocol for me. Do you think, I might have premature LH surge and had released two large follicles and eggs were not mature.
Looking for your opinion on this. I have three failed IVF now.