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.
Hello
Thank you in advance for taking the time to answer my question. I recently had a shg where they found a polyp as well as uterine synechiae. I am scheduled to have a lap, hsg, and dye next week. My doctor informed me that He does not think he will do a balloon catheter unless it looks worse than he anticipates. I have normal cycles other then mid cycle spotting. My only symptom is secondary infertility. My question is would it be bad if he did not place a balloon catheter after removing scar tissue?
In my opinion, there would be no difference.
Geoff Sher
Hi Dr Sher,
How do you rate an endometrial scratch among options to improve implantation – is it worth doing and likely to benefit – and are there risks of doing damage to the lining (if already combatting thin lining)?
I am considering having one done in the chair (not under sedation) and wondered if there are increased risks that way too… But assume any unlikely infection would clear before embryo transfer time?
Would greatly appreciate your thoughts! Thanks so much.
Respectfully Olivia,
I am absolutely unconvinced that the endometrial Scratch has any merit whatsoever.
Geoff Sher
Dear Dr. Sher,
I am in the middle of prepping for a frozen transfer. My RE started me on PIO on day 14 even though my estrogen was only 161 on day 11. I thought that was wrong but he insisted but did let me have another monitoring on day 14 (after I had already injected the PIO). My estrogen levels came back at 181. That was 6 days pre transfer. I took more progesterone today and he told me this afternoon I could add another estrogen patch if I wanted (now 5 days before transfer). I did but now I am panicking. I have never seen anyone increase estrogen once progesterone administration has begun. Could this mess up my lining or throw something out of sync? I have just one embryo so am very very anxious. Any insight you could offer on what additional estrogen could be doing at this stage in the game would be very very appreciated.
That is a tough quest6ion for me to answer. I am afraid this is something you need to resolve with your RE.
I can tell you that I shoot for an [E2] of 500-1000pg/ml and after 6 days of PIO/estradiol therapy do the blastocyst transfer.
Good luck and G-d bless!!
Geoff Sher
Hello Dr. Sher! I have a question concerning PGS of already frozen embryos. I am a 35 yo with formerly successful IVF cycle in 2014 at 31 yo, which resulted in a live birth after fresh transfer. We froze 6 embryos from the one round of IVF. After a spontaneous conception/miscarriage in Spring 2017, we decided to undergo an FET this month. My RE had previously suggested thaw/PGS/re-freeze as we did not do this in original cycle, but I declined in fear of damaging the embryos. FET resulted in at least a chemical pregnancy, but my numbers are low (6dp6dt – 9 hcg; 8dp6dt – 31.5 hcg; and 14dp6dt – 90.5). While we haven’t stopped meds and am still technically pregnant, RE says it looks bleak and I’m expecting another MC. My question is this: should I reconsider the PGS on my remaining 4 embryos in hopes of achieving a viable pregnancy next round? I have had a Sonohysterography and all is clear. My only other issue is having only one ovary with a 4cm terratoma present. (RE suggested removal prior to FET and I declined.) Any advice you can offer is much appreciated. Happy Holidays to you!
natasha,
I personally would not thaw blastocysts to biopsy them for testing, only to refreeze and then re-thaw for transfer. While viable pregnancies have been reported using this approach, it is traumatic on the embryos and subsequent success rates are significantly lower.
As for the Teratoma, I would have it removed if I were you because (although uncommon, these tumors can go malignant.
Geoff Sher
Dr Sher, if the DNA within the egg is inactive and has been since birth, and the spindle involved in the process of meiosis is old and doesn’t function as well as a younger lady, then why would an IVF protocol make a difference? Can protocol improve the egg’s spindle so it divides chromosomes evenly? My RE says my spindle is old and nothing I do will fix that! Is he right?
Frankly Cynthia, your questions are misplaced. I see no reason why the DNA or spindle would be dead/inactive. Besides, there is no way of determining this even if it were so. I really do not know where your RE is coming from.
perhaps we should talk!
Call 800-780-7437 band set up a Skype consultation with me …if you wish.
Geoff sher