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 Dr Sher,
I was on 0.75mg dex starting w stims and ending with the negative beta, but I forgot to wean off and stopped cold turkey and only remembered a week after having stopped. Have I damaged my adrenal glands? Is it really bad that I did this? I’ve been really exhausted since this occurred
No…you should be fine now!
Geoff Sher
Dear Dr Sher.
It was about 10 months back that I had a mid-trimester miscarriage which doctors suspect was due to an incompetent cervix.
Since then, iv gone through two failed FET’s and am currently pregnant after my 3rd FET. I am 6 weeks by dates right now.
After 2 failed FETs, my RE had me do a few immunological tests.
SLEslide : Negative
Lupus anticoagulant:Negative
Anti-TPO (5.86) / Anti TG – ( <10.0)
Anti Cardiolipin IgG(<2) /
Anti-B2Glycoprotein IgG(1:1280
Right after my 3rd FET, i was started on baby Aspirin and Heparin; in view of the positive and elevated ANA.
I consulted a rheumatologist who said he didnt think steroids were needed at present even though the ANA was high. He ordered a few other tests for which results are still pending.
Unfortunately, i started bleeding PV at 5+3wks. I was devastated. I contacted my RE who advised me to continue on with the baby aspirin and heparin till my follow up. The bleeding continued on fr 4 days, and on the 3rd day, my RE advised me to stop the aspirin and heparin. By the time i stopped the medicines, the color of the blood which was initially red had already started to become dark and was like minimal brown spotting ,till today.
I was quite anxious, as its been a bit of a ride getting to this point; and so my RE had me go in for a scan. Things looked to be ok on the TVS to my surprise ; but my blood tests showed progesterone levels were low. ( i had missed my morning dose )
Progesterone was 6.
My RE gave me a shot of proluton depot(250mg), prescribed duphaston 10mg x BID ; and advised me to continue with the Cyclogest pessaries (400mg BID X PR).
I came back home to notice mild fresh bleeding again.. 🙁
I would really appreciate if you could help me out with the following concerns Dr Sher.
1) Could missing the morning dose alone cause progesterone levels to drop?
2) Should the proluton depot be continued every 4 days or once a week? How soon does the injection take effect?
3)Most importantly, should i be concerned that iv had to stop the aspirin and heparin since i do have a high ANA ? What do you do for your patients in my position, Dr? Isnt in unwise to stop both; yet, what can one do when there is PV bleeding?
I am terribly worried and afraid..
I feel like my Dr isnt too concerned about the ANA because my midtrimester miscarriage was due to IC, and because the baby was alive and well when i went into labour. I was told that id have experienced fetal demise prior to going into labour IF it was due to an immunological factor; but im terribly afraid, and want to avoid a tragic outcome by all means. I understand that this early pregnancy bleeding isnt a good sign itself, but, i want to have all bases covered as i try to hold on to this pregnancy and hopefully have a favoroable outcome.
Your expert opinion is much needed. Thank you in advance Dr Sher
1) Could missing the morning dose alone cause progesterone levels to drop?
A: Not in my opinion!
2) Should the proluton depot be continued every 4 days or once a week? How soon does the injection take effect?
A:I would continue as prescribed by your RE.
3)Most importantly, should i be concerned that iv had to stop the aspirin and heparin since i do have a high ANA ? What do you do for your patients in my position, Dr? Isnt in unwise to stop both; yet, what can one do when there is PV bleeding?
A: Again , I suggest you follow the directions of your RE.
Good luck!
Geoff Sher
Im not sure whats happening. Cant seem to enter ANA result.
Last try
ANA was positive. Homegenous > 1 : 1280
Sorry Dr Sher
Hi Dr Sher! Merry Christmas!!! I just have a question I’d like to ask. If someone switched from lurpon to 1/2 dose ganirelix on day 1 of period and they had a cyst, wouldn’t the antagonist help to resolve the cyst before stims are commenced? or is that only achieved with lupron?
I doubt it Abigail. You would need to wait until the cyst disappears before starting the stimulation.
Geoff Sher
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Hi Dr Sher! Should estrogen level on day of menses be less than 70 pg/ml or less than 50 pg/ml? Some clinics say less than 50, but you say less than 70 on a down regulation cycle or an agonist/antagonist conversion protocol. What do you prefer? Should you see any follicles at a baseline scan?? should they all be <10mm on day of menses if adequately down regulated?
I require the E2 to be <70pg/ml.
Geoff Sher
Hello Dr Sher! Impressive website you have here! I have a question re trigger night. In your eBook you say that agonist or antagonist and FSH injections need to be stopped on the trigger night. Does that mean a patient takes her last dose on trigger night or is the last dose of FSH injections and agonist/antagonist taken the night before trigger? I ask because I always have FSH injections (2 hours before trigger) and the agonist or antagonist the morning of trigger day. I am now wondering if that’s been the wrong thing to do and the only thing I should be taking on trigger night is just the trigger, nothing else.. can you confirm please?
Frankly, I do not think it would matter. I usually have my patients take their shots as per usual all the way up to the trigger.
Geoff Sher