A RATIONAL BASIS FOR SELECTIVE OVARIAN STIMULATION IN OLDER WOMEN AND THOSE WITH DIMINISHED OVARI...

A woman is born with all the eggs she will ever have.

Starting Your Journey With SFS

Infertility treatment encompasses a wide range of possibilities, of which IVF is only one option.

How to Avoid Implantation Failure During IVF with Dr. Geoffrey Sher

Dr. Geoffrey Sher joins Dr Aimee Eyvazzadeh and this time they are going to talk about implantation failure.

Treatment of Recurrent Pregnancy Loss (RPL) due to Alloimmune Implantation Dysfunction : Compari...

Egg Freezing for Future Fertility

Many patients come to me in their late 30s and 40s to either assess their relative fertility or to start fertility treatments, and they are often unpleasantly surprised to find ou

Endometriosis Mechanism of Infertility

Endometriosis is known to have a profoundly significant negative effect on fertility.

The Best Ovarian Stimulation Protocols for IVF episode with Dr. Sher

Dr. Sher and Dr. Aimee discuss how he individualizes ovarian stimulation protocols to optimize egg embryo quality.

“Silent” Endometriosis

Endometriosis is a pelvic inflammatory disease attributable to ectopic implants of uterine lining (endometrium) establishing a foothold in inappropriate locations in the pelvis...

"What is IUI?" on The Egg Whisperer Show

Dr. Geoffrey Sher and Dr Aimee Eyvazzadeh discuss Intrauterine Insemination, or IUI.

Controlled Ovarian Stimulation (COS) for IVF: Selecting the ideal protocol

In order for any organism to attain an optimal state of maturation (ripening) it must first undergo full growth and development. A fruit plucked from a tree before having developed fully or a poorly developed fruit might stil...

Diagnosing and Treating Infertility due to Diminished Ovarian Reserve (DOR)

Ovarian reserve is the term used to describe the extent of a woman’s ovarian egg supply. Diminished ovarian reserve (DOR) refers to a reduction in the total number of eggs left in the ov

Hereditary Clotting Defects (Thrombophilia)

Thrombophilia (Hereditary Clotting Defect) is defined as the genetic predisposition to developing intravascular thrombosis. It is due to hypercoagulability of blood leading to impairment of initial vascula

IVF: FACTORS AFFECTING EGG/EMBRYO “COMPETENCY” DURING CONTROLLED OVARIAN STIMULATION (COS)

The potential for a woman’s eggs to undergo orderly development and maturation, while in large part being genetically determined can be profoundly influenced by the woman’s age, her “ovarian reserve” and proximity to menopaus...

Preimplantation Genetic Sampling (PGS) Using: Next Generation Gene Sequencing (NGS): Method of Ch...

About 10 years ago, Levent Keskintepe PhD and I introduced Comparative Genomic Hybridization (CGH) into the clinical IVF arena, as a preimplantation genetic sampling (PGS) method that enables full karyotyping (numerically chr...

Centers for disease control (CDC)IVF: The Economic Realities

Patrick Steptoe and Robert Edwards were responsible for the birth of the world’s 1st IVF baby, Louise Brown, in 1978.

Egg Freezing and Banking: What are the Merits? (Case Report)

I am considering pursuing egg freezing in a few months.

Embryo Banking/Stockpiling: Slows the “Biological Clock” and offers a Selective Alternative to IV...

An ever increasing number of American women first seek IVF treatment in their late 30’s or early 40’s. This

Endometriosis and Infertility

Endometriosis is a condition that occurs when the uterine lining (endometrium) grows not only in the interior of the uterus but in other areas, such as the Fallopi

Selective Banking of Genetically Tested Donor Eggs

As a woman ages beyond 30 years, the quality of her eggs starts to decline progressively and with it also her fertility potential.

Egg Donation-Fashioning Rational Expectations: Preparation; Donor Selection; Using Fresh versus F...

Immunologic Implantation Dysfunction (IID) -Making the Diagnosis

Currently there are fewer than a dozen immunology reference laboratories in the U.S that are capable of analyzing the required elements with a sufficient degr

Immunologic Implantation Dysfunction (IID): Treatment

In the United States, effective treatment of NK/CTL activation associated with either alloimmune or autoimmune implantation dysfunction requires the administration of primarily Intralipid (IL)o

IVF-Gestational Surrogacy: An Overview

IVF surrogacy involves the transfer of one or more embryos into the uterus of a surrogate, who provides a host womb and carries the baby to term, but doe

Launching Ovarian Stimulation with a BCP: How Does it Affect Response?

In natural (unstimulated) as well as in cycles stimulated with fertility drugs, the ability of follicles to properly respond to FSH sti

Frozen Embryo Transfer (FET): What Does it Involve?

Frozen Embryo Transfer (FET) A frozen embryo transfer cycle is initiated by administering an oral contraceptive (OC) to the recipient.

Immunologic Implantation Dysfunction (IID) & Infertility (IID): PART 1-Background

In 15-20% of women who have infertility or RPL, the cause will be immunologic implantation dysfunction (IID).

Implications of Empty Follicle Syndrome and Premature Luteinization

Frequently, when following vigorous and often repeated flushing of follicles at egg retrieval

Preventing Severe Ovarian Hyperstimulation Syndrome with “Prolonged Coasting”

I do not use antagonists in high responders (e.g., PCOS) because it interferes with the assay of E2 (often causing the value to be understated),

Secondary Infertility: Addressing the Root Causes

There are many factors that contribute to the problem of secondary infertility.

Staggered IVF: An Excellent Option When Advancing Age and Diminished Ovarian Reserve (DOR) Reduce...

Many physicians treating infertile women over 40 years old who h

The Role of Nutritional Supplements in Preparing for IVF

It is important to take care of yourself mentally and physically when preparing and going through your IVF journey.

Thyroid autoantibodies and Immunologic Implantation Dysfunction (IID)

Between 2% and 5% of women of the childbearing age have reduced thyroid hormone activity (hypothyroidism).

Understanding Polycystic Ovarian Syndrome (PCOS) and the Need to Customize Ovarian Stimulation Pr...

Polycystic ovary syndrome (PCOS) is a common

IVF Failure and Recurrent Pregnancy Loss with guest Dr. Geoffrey Sher

We were among the first people in the world to start giving treatment for immunologic factors that affected implantation in IVF.

CASE REPORT

Case Report: Egg Freezing versus Banking of PGS-Tested Blastocysts, in a Young Woman with prematurely Diminishing Ovarian Reserve (DOR)

Raised Blood Prolactin

Prolactin (PRL) is a protein hormone (closely related to human growth hormone) that is secreted by specialized cells in the anterior part of the pituitary gland.

Diminished Ovarian Reserve: The Sher Philosophy

It appears from my vantage point that the proportion of patients suffering from diminished ovarian reserve is on the increase.

Acupuncture and IVF: Does it Improve Success?

Acupuncture involves the insertion of thin needles into the skin along so called meridians (energy channels). It has been used in China for centuries to regulate and treat many health disorders including a

Endometriosis and IVF

When women with infertility due to endometriosis seek treatment, they are often advised to first try ovarian stimulation (ovulation Induction) with intrauterine insemination (IUI). As with essentially all reasons for infertil...

Why did IVF fail?

Whenever a patient fails to achieve a viable pregnancy following embryo transfer (ET), the first question asked is “Why?” Was it simply due to bad luck? How likely is the failure to recur in future attempts and what can be do...

Embryo Transfer: Simply Crucial in IVF

Embryo transfer (ET) is undoubtedly a rate limiting factor in IVF. The IVF doctor’s expertise in performing ET is one of the most important factors determining IVF outcome. It requires the dexterity, skill, and gentle touch t...

A Thin Uterine Lining: Vaginal Viagra may help

In 1989, Dr. Sher first published a study that examined the correlation between the thickness of a woman’s uterine lining (the endometrium), and

Diagnosing and Treating Immunologic Implantation Dysfunction (IID)

Central to making a diagnosis of an immunologic implantation dysfunction (IID) is a need for the appropriate interpretation of Natural Killer Cell Activity (NKa). In this regard, one of the commonest and most serious errors, ...

Raised Blood Prolactin Levels (Hyperprolactinemia) in Women Undergoing Infertility Treatment

Prolactin (PRL) is a protein hormone (closely related to human growth hormone) that is secreted by specialized cells in the anterior part of the pituitary gland. In addition, the hormone is also produced and secreted by a bro...

What Is Diminished Ovarian Reserve?

Ovarian reserve refers to the reproductive potential left within a woman’s two ovaries based on number of eggs (oocytes). If you have diminished ovarian reserve, this means that the number of your egg

Violet™ Artificial Intelligence (AI)-based Software: A Break-through in the Field of Egg Banking ...

In order for a human embryo to develop into a viable, healthy pregnancy it needs to be “competent” (capable, upon being transferred to the uterus, of propagating a viable

Total Absence of Sperm in the Ejaculate due to Complete Obstruction of the Vas deferens: Congenit...

Following male orgasm, sperm are ejaculated after traveling rapidly in sequence through the vas deferens duct, t

Egg Banking-Fertility Preservation

The bottom line is that because of the traumatic effect of freezing on egg viability and "competency" the statistical chance of each frozen/ thawed egg ultimately resulting in a baby is only at best 6-8%. So, while success ra...

Recurrent Pregnancy Loss (RPL)

When it comes to reproduction, humans are the poorest performers of all mammals. In fact we are so inefficient that up to 75% of fertilized eggs do not produce live births, and up to 30% of pregnancies end up being lost withi...

Prolactin (PRL)

Prolactin (PRL) is a protein hormone (closely related to human growth hormone) that is secreted by specialized cells in the anterior part of the pituitary gland. In addition, the hormone is also produced and secreted by a bro...

EZ-IVF

EZ-IVF: Sher Fertility Solutions (SFS)-NY is proud to announce the introduction of EZ-IVF, a low-cost, low risk, and highly successful alternative to Mini/NC-IVF.

EZ-IVF: AN IMPROVED , LOW-COST, LOW-STIMULATION, SAFE & SUCCESSFUL ALTERNATIVE T0 MINI-IVF AND NA...

Geoffrey Sher MD Drew Tortoriello MD Mini-IVF is a procedure that involves ovarian stimulation with oral fertility drugs such as clomiphene or letrozole to promote the development

Hormonal Treatment of Male Infertility

There exists in the man a cyclical production of spermatozoa where the duration of spermatogenesis from takes approximately 90 days. It follows that, any treatment aimed at enhancing sperm production requires approximately a ...

Cyclical Estrogen Therapy Prior to Embryo Transfer, in Post-Menopausal Women and those with Prolo...

An absence of menstruation (amenorrhea) in reproductive age women is usually due to an

The Role of IVF in the Management of Infertility Caused by Pelvic Inflammation

Pelvic Inflammatory Disease (PID) refers to inflammation of pelvic structures including the uterus, fallopian tubes, ovaries, bowel, and the smooth membrane that lines the surface of the pelvic cavity (the peritoneum).

Case Report: Can Intralipid/Steroid Therapy be Used Without Undergoing IVF?

Question posed by by Patient X: Can oral steroids (prednisone) and IL therapy be done without IVF? I have had 2 failed IUI's 2 years ago, but I do not like taking ovulation stimulating hormones. I have endometriosis (no

Hormonal Supplementation in IVF

Ovulation occurs within 38-42 hours of initiation of the spontaneous luteinizing hormone (LH) surge (which can be detected in the blood or urine prior to this event) and/or hCG administered following controlled ovarian stimul...

A Message on COVID-19

Watch a video for a message on COVID 19.

Advising Women who Contemplate undergoing Infertility Treatment and who Test Positive for Hepatit...

Hepatis B Viral infection (HPV) can be transmitted to the conceptus in about 10% of cases. If it does transmit, the consequences can be very serious but this would depends

The Number of Embryos/Blastocysts Transferred & PGT: Effect on IVF Outcome:

A "competent" embryo is one that is chromosomally, genetically and metabolically capable of propagating a viable conceptus in-utero. Such an embryo will have the same chance of resulting in a baby whether it is transferre

Case Report: Egg Donation-Mother Uses her Daughter’s Eggs to conceive

The case involves D.R, a recently remarried, premenopausal woman in her late 40's, who had a daughter (N.R.) some 33Y ago, in a prior marriage. D.R. inquired whether I would be willing to do IVF on her daughter, fertilize the...

Case Report: The Diagnosis of “Unexplained” Recurrent IVF-Failure is Sometimes a Cop-out

Ingrid (37y) and Jesse 41y had been trying to conceive for 6 years. The couple was "thoroughly tested" and had been "labeled" as having "unexplained infertility". Ingrid had patent fallopian tubes, a normal (

Case Report: IVF in a 32y old with Premature-Menopause Following Cancer Chemotherapy.

Malia (33y) and her husband, Paul (41y), presented to me a few months back. with 3 years of primary infertility (she had never conceived in the past). Paul had initiated 3 pregnancies in a previous marriage and b

Case Report: Intractable Damage to the Uterine Lining (Asherman Syndrome ) causing Failed Implant...

Marissa (39y) and her husband, Pete (43y) presented with a history of having had 2 healthy children together. Marissa was a normally menstruating/ovulating lady with a fertile husband. The birth

Selecting the Ideal Protocol for Controlled Ovarian Stimulation!

  "IVF is neither a pure art or a pure science. Rather it is a blend of both!" "Virtually nothing that we do clinically in IVF can be fully supported or validated by "gold standard statistical analysis. This is because in t...

Case Report: Endometrios Causing IVF Failures due to Embryo Implantation Dysfunction (IID)

After 4 years of trying to conceive without any success, Rosa (35y) and her husband Jim (42y), achieved a spontaneous pregnancy in 2014. Sadly, the pregnancy miscarried at 5 weeks. Jim had perfectly normal s

Case Report: Woman with Diminished Ovarian Reserve (DOR) and Age-related Secondary Infertility w...

Juanita, a 42y old who, between 2003 and 2007, had delivered 3 children in a prior relationship. Carlos, her new partner of 3 years,

Case Report: Recurrent IVF Failure due to Uterine Adenomyosis and Intrauterine Fibroid Polyps, Re...

Linda (43y) and her husband Graham (49y) had been trying to conceive for 6 years. She had been pregnant once before in 1993. This pregnancy, which was initiated in a previ

Endometrial Receptivity Array (ERA): Is There an actual There, There?

The blastocyst and the endometrium are in a constant state of cross-talk. In order for successful implantation to take place, the blastocyst must be at the appropriate stage of development, and needs to signal a well synchron...

Case Report: “Unexplained” Recurrent IVF failure: Was the Underlying Cause Overlooked?

Mary, a 37y female had never conceived in spite of 6 years of trying. . She had undergone multiple (failed) cycles of IVF-with intracytoplasmic sperm injection (ICSI). Her husband, Brian, was originally diag

Case Report: Patient with Repeated IVF Failures, Diminished Ovarian Reserve (DOR) and Autoimmune ...

Beryl, 39y and her husband Jack is 36y presented with a history of 5 years of infertility. They had failed 2 attempts at IVF (both in 2918). Beryl had normal regula

Case Support: Diminished Ovarian Reserve (DOR) + Male Infertility

CASE REPORT #1: Advancing age, Diminished Ovarian Reserve (DOR) + Male Infertility Geoffrey Sher MD Case History: Mary D. (42y) and her husband, Chris (43y) recently had a SKYPE consultation with me. The couple had been ...

Launching of Sher-Fertility Solutions and Future Case Supports

With the launching of Sher-Fertility Solutions (SFS), I will as of April 1st, take on a new and expanded consultation role. Rather than having hands-on involvement with IVF procedures I will, through SFS, instead provide fert...

Are SART- Reported Clinic-specific, Annual IVF Outcome Statistics Reliable?

IVF practitioners, and consumers have little reason to feel confident about the validity and reliability of SART published ART outcome statistics and here is how I reach this conclusion: About 30 years ago, I was a member

SHER FERTILITY-SOLUTIONS (SFS): AN EXCITING NEW CHAPTER IN MY PROFESSIONAL CAREER

Sher-Fertility Solutions (SFS)  Through SFS, I provide online fertility consultations (via SKYPE and FaceTime) to an ever-growing number of patients (from 40 countries) with complex Reproductive Dysfunction (RD)

SFS Fertility Seminar in Las Vegas

This February 13th is the day you get closer to having the family of your dreams. Join SFS Fertility Las Vegas for a patient-focused seminar where you can: ✨ Win a Donated IVF Cycle ✔️ Schedule a Free Consult to Review Your...

Ovarian Hyperstimulation Syndrome (OHS): Its Evolution & Reducing its Incumbent Risks.

Ovarian hyperstimulation syndrome (OHS) is a condition where a woman receiving fertility drugs (usually gonadotropins) over-responds by developing a large number of ovarian follicles which upon administration of

Sher-IVF Success Rate

Given rapidly changing practices in the IVF arena, it is becoming increasingly implausible to reliably interpret current national reports expressing IVF outcome statistics as birth rate per initiated treatment cycle, per egg ...

IVF SUCCESS RATE EXPRESSED AS VIABLE PREGNANCY RATE PER EMBRYO TRANSFERRED (PRPE): A PROPOSED NE...

Given rapidly changing practices in the IVF arena, it is becoming increasingly implausible to reliably interpret current national repor

Genetically Testing IVF Embryos

Preimplantation genetic testing (PGT) involves testing pre-implantation embryos for chromosomal numerical abnormalities (aneuploidy). Preimplantation genetic diagnosis (PGD) involves genetic testing of embryos for specific ge...

Management of Immunologic Implantation Dysfunction (IID)

In the United States, effective treatment of NK/CTL activation associated with either alloimmune or autoimmune implantation dysfunction requires the administration of primarily Intralipid (IL). Such treatment is much more lik...

Management of Immunologic Implantation Dysfunction (IID)

In the United States, effective treatment of  natural killer cell /cytotoxic lymphocyte (NK/CTL)-activation associated with either alloimmune or autoimmune implantation dysfunction requires the administration of primarily Int...

Does Frozen Embryo Transfer (FET) Improve IVF Success?

"I am in full agreement with researchers at Cambridge University in the United Kingdom who following a recent published a report on their observation that FET enhances IVF outcome, stated that this could represent one of the ...

Performing Embryo Transfer: The “Process”

Embryo transfer (ET) is undoubtedly a rate limiting factor in IVF. The IVF doctor's expertise in performing ET is one of the most important factors determining IVF outcome. It requires the dexterity, skill, and gentle touch t...

IVF: Selecting the Best Quality Embryos to Transfer

The numerical chromosomal configuration of a cell is referred to as its karyotype or ploidy. A cell with an irregular chromosome number is referred to as aneuploid while one with a normal karyotype, as euploid. It is predomin...

A Case for Transferring Blastocysts on Day 5-6 Post-Fertilization Rather Than on Day 2-3 as Clea...

Embryo transfer (ET) is undoubtedly the single most important step in IVF. It takes confidence, dexterity, skill and timing to optimally perform ET. Of all the procedures conducted in IVF,

IVF And Diminished Ovarian Reserve (DOR): A Rational Basis for Selecting the Optimal Protocol for...

When it comes to the selection of ovarian stimulation protocols for older women and those who have DOR there is in my opinion, no justification for the use of a "one size fits all"

Agonist (Lupron) Therapy in IVF

All gonadotropin releasing hormone (GnRH) agonists act by rapidly expunging reservoirs of follicle stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland. GnRH agonists can be administered by intramus...

A Fresh Look at The Indications for IVF

Today, due to a myriad of factors, IVF is regarded as one of the main thoroughfares for helping couples achieve the goal of creating a family. However, no two IVF candidates are exactly alike and there is no single approach t...

Recurrent “Unexplained” IVF Failure with Good Quality Embryos.

Background: CJ, a 34-year-old, and her husband RJ, age 35) presented to me with a six-year history of infertility. Based on semen analysis, RJ, who had initiated two pregnancies in a prior relationship, was found to be perfec...

Endometriosis Presenting as “Unexplained Infertility”

Background: "Jamie" consulted with me when she was 34 years of age, after 3 years of failed treatment and a diagnosis of "unexplained infertility." A laparoscopy had revealed her to have mild (Stage 1) endometriosis, which wa...

Why Did So Few of My Eggs Fertilize and Make it to Blastocyst?

One of the commonest questions asked by patients undergoing IVF relates to the likelihood of their eggs fertilizing and the likely "quality of their embryos. This is also one of the most difficult questions to answer. On the ...

Early Pregnancy Loss: Causes and a Rational Approach to Management.

There is nothing more stressful to patients and to caring physicians than dealing with recurrent early pregnancy losses (RPL). There is also no greater imperative in such cases than to carefully identify the underlying cause ...

Optimizing Access to Sher-IVF, Las Vegas from Afar

"Over the years Sher-IVF has performed IVF on many patients that often journeyed from as far away as, France, South America, China, Europe, Africa, Central/South America, Canada, Japan, the Middle East, Russia, etc. Almost al...

Selecting an IVF Program: Willingness to Share Financial Risk with Patients, Builds Confidence!

Unlike virtually every other form of medical treatment in America, IVF is largely not covered by insurance.  To make matters worse, patients often require more than one attempt to have a reasonable chan

Deciding between Egg and Embryo Banking for Fertility preservation (FP)

Women should not delay trying to have a baby, thinking that as long as they are ovulating regularly the biological clock can simply be put on hold or that they can simply to freeze their eggs and then later decide if/when to ...

How can stress affect IVF?

There is little doubt that stress and emotional lability plays a role in the normal physiological/hormonal regulation of the menstrual cycle. After all, Eskimos often stop ovulating and menstruating during long dark winters, ...

IVF: Immature and Post-mature Eggs: What does this mean and how can it be prevented?

One commonly hears patients undergoing IVF report that they had too many "immature eggs", and inferring that had more time been allotted to ovarian stimulation and the administration of the "trigger shot been del

How Old is Too Old to Do IVF Using Your Own Eggs?

There is little doubt that age is a very important determinant of IVF outcome.  This is mainly because a woman's eggs undergo deterioration in quality as her age advances to and beyond her mid 30's.  Remember, eggs have been ...

(NEW) IVF: Approach to Selecting the Best Embryos for Transfer to the Uterus.


The numerical chromosomal configuration of a cell is referred to as its karyotype or ploidy. A cell with an irregular chromosome number is referred to as aneuploid while one with a normal karyotype, as euploid. It is pr

Gestational Surrogacy for a Case of Rokitansky Syndrome: 2 Frozen Embryo Transfers Yields 3 Babie...

[CASE REPORT] This is a re-Post for purposes of follow-up (see post-script at the end). Background: Mary, 30 years of age and married to a fertile male partner, presented to me about four years ag

IVF: After How Many Tries Should I Give Up?

Because of the emotional, physical, and financial toll exacted by IVF, it is preferable that no one undertake a one‑shot attempt. If a couple can only afford one treatment cycle, IVF is probably not the right course of action...

IVF & Polycystic Ovarian Syndrome (PCOS): Reducing the Risk of Severe Ovarian Hyperstimulation Sy...

Polycystic ovary syndrome (PCOS) is a common hormonal system disorder among women affecting between 5% and 10% of women of reproductive age w

Deciding Between Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF)

Many infertile patients, are erroneously advised by their physicians to first try IUI several times before resorting to IVF. Additionally many misguided insurance providers often, purely for economic reasons, require

How Does Advancing Age and Diminished Ovarian Reserve (DOR) Affect Egg/Embryo “Competency” and Ho...

It is primarily the egg (rather than the sperm) that determines the chromosomal integrity (karyotype) of the embryo, the most important determinant of egg/embryo comp

IVF Outcome in Patients with Polycystic Ovarian Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a common hormonal system disorder among women affecting between 5% and 10% of women of reproductive age worldwide. Women with PCOS may have enlarged ovaries that contain multiple small coll...

Mini-IVF: A Blessing or a Curse?

Mini-IVF is a procedure that involves ovarian stimulation using low dosage medications (often oral drugs like clomiphene and letrozole) under the premise that it is a "safer" and less expensive than conventional gonadotropin ...

Advanced Endometriosis with Endometriotic Cysts

Advanced endometriosis is often associated with ovarian endometriotic cysts, known as endometriomas. The cysts contain decomposed menstrual blood that looks like melted chocolate – hence the name "chocolate cysts." They are s...

Staggered IVF with PGT - Selection  of “Competent” Embryos Greatly Enhances the Utility & Efficie...

Staggered-IVF involves the use of Preimplantation Genetic Testing of advanced embryos (blastocysts) to identify those that are euploid ("competent") and thereupon  the subsequent transfer to

Early-Endometriosis-related Infertility: Ovulation Induction and Reproductive Surgery vs. IVF

Endometriosis is a complex condition where, the lack or relative absence of an overt anatomical barrier to fertility often belies the true extent of reproductive problem(s). All too often the view is exp

IVF and the Imperative to minimize the Incidence of Multiple Pregnancies

All multiple pregnancies pose a risk to both mother and offspring. Pregnancy induced maternal complications such as miscarriage, pre-eclampsia, antepartum and post-partum hemorrhage become progressively more prevalent the hig

How Preparation and Implementation Enhance the Quality of Life after an IVF Birth

Most pregnancy induced placental complications that compromise placentation and intrauterine development have their origin in conditions that present prior to conception. As such, a patient requiring IVF presents her

The Importance of Individualizing Ovarian Stimulation Protocols in IVF “Poor responders” and “Hig...

Indiscriminate selection and use of protocols of Controlled Ovarian Stimulation (COS) can be decidedly detrimental to egg and embryo competency/quality especially when it comes to IVF con

VEGAS BABY Commentary

Oscar-nominated director Amanda Micheli's provocative documentary, Vegas Baby followed several aspiring parents, who desperately wanted to have a baby but were struggling with infertility as well as the high cost of treatmen...

Diagnosing and Treating Male Factor Infertility

About 1/3 of infertility is caused by a male factor, one third by a female factor and another third is due to a combination of both male and female factors. Thus, in more than 50% of cases, a male factor causes or contributes...

Embryo Mosaicism: What You Need to Know

In 2005, my associate Levent Keskintepe PhD and I introduced Preimplantation Genetic Testing (PGT) with the ability to identify all chromosomes in the embryo's cells, into the field of IVF. This approach, which is now widel...

The Causes of Infertility

Neither sex contributes more heavily than the other to infertility problems. Roughly one‑third of all infertile couples can trace their infertility to the woman, one‑third to the man, and one‑third to both partners. In practi...

Vegas Baby Documentary

I am very proud to be featured in a new documentary film, VEGAS BABY, which follows several of my patients gambling on infertility treatment and the emotional, physical and financial costs involved.  Amanda Micheli, the direc...

Unexplained IVF Failure

IVF treatment always exacts a profound emotional and financial toll on patients/couples. Needless to say, the financial burden is often crippling; however, ask any woman who has undergone IVF, and she will likely tell you tha...

Announcing my Retirement in the Year Ahead: A Letter of Thanks From Me to You!

Everything Has its Season Geoffrey Sher MD Dear Patients and Friends, After some 35 years in the field of Assisted Reproduction (AR), having founded the First Private (non-university based) IVF program in the United S

Having Realistic Expectations Regarding IVF Outcome: When is it Time to Stop or Change Course?

It is important for patients/couples contemplating IVF with their own eggs, to be aware that usually, in more than 50% of cases a single attempt will not result in a live birth and furthermore that the c

Why Did so Few of my Eggs Fertilize into Embryos, and so Many More Fail to Reach Blastocyst?

One of the most common questions asked by patients undergoing IVF relates to the likelihood of their eggs fertilizing and the likely "quality" of their embryos. This is also one of the most difficult quest

Egg Maturation in IVF: How Egg “Immaturity,” “Post-maturity,” and “Dysmaturity” Influence IVF Out...

There is a great deal of confusion when it comes to defining egg "quality." Most people interpret terms such as "mature/immature/post-mature" eggs as implying that the timing of egg retrieval was

Embryo Transfer: The "Holy Grail" of IVF.

Embryo transfer (ET) is undoubtedly a rate limiting factor in IVF. Unquestionably, the IVF doctor's expertise in performing ET as one of the most important factors that will determine IVF outcome. It takes confidence, dexteri...

Egg Banking: Preserving Fertility in Female Cancer Patients

It is only through propagation of our biological offspring that we as humans can leave a lasting legacy of our existence. Perhaps this explains why the desire to have children is a basic human instincts and why an inability t...

IVF: Should Treatment Cycles be Uninterrupted or be Conducted in Pre-scheduled Batches?

The conventional way of conducting IVF treatment is to provide patients with opportunity to undergo treatment any time they are ready to do so. But such delivery of services in fact often falls short of affordi

Reflecting upon the Use and Misuse of Intrauterine Insemination (IUI): Time for a Serious Reality...

It is hard for me to believe that more than three decades have flown by since I first introduced intrauterine insemination into the clinical arena (Journal of Fertility Sterility, April, 1

GnRH Antagonists (Ganirelix/Cetrotide/Orgalutron) in IVF-Ovarian Stimulation Protocols

Conventional GnRH Antagonist (GnRHa) Protocols: GnRH antagonists (e.g. Ganirelix, Cetrotide, and Orgalutron) are currently used with many controlled ovarian stimulation (COS) protocols. The conventional approac

Testing for Immunologic Implantation Dysfunction (IID): Who Should be Tested, Where Should Testin...

Unless tests for immunologic implantation dysfunction (IID) immunologic implantation dysfunction are performed correctly and conducted by a one of the f

Cervical Ureaplasma Urealyticum Infection: How can it Affect IUI/IVF Outcome?

Ureaplasma urealyticum is a bacterium that belongs to the mycoplasma family. It can be detected in the reproductive tract of as many as 40% of individuals (male and female). Ureaplasma probably does not prevent normal co

Multiple Pregnancies Carry Serious Risks: How Many Embryos Should we Transfer at One Time?

All multiple pregnancies pose a risk to both mother and offspring. Pregnancy induced maternal complications such as miscarriage, pre-eclampsia, antepartum and post-partum hemorrhage become progressively more

A Fresh Look at Ovarian Hyperstimulation Syndrome (OHSS)

Ovarian hyperstimulation syndrome (OHSS) is a life-endangering condition that occurs following ovarian stimulation for the treatment of infertility. It occurs due to overstimulation of the ovaries with the development of nume...

IVF: Selecting the Best Quality Embryos to Transfer

The numerical chromosomal configuration of a cell is referred to as its karyotype or ploidy. A cell with an irregular chromosome number is referred to as aneuploid while one with a normal karyotype, as euploid. It is predomin...

Male Infertility

Male factor problems as a contributing cause of infertility are very common. Male infertility is reported as a factor in 30-50% of infertility cases. In fact, many fertility specialists will recommend a semen analysis as one ...

The IVF Journey: The importance of “Planning the Trip” Before "Taking the Ride”

The objective with In Vitro Fertilization is to consistently transfer competent embryos into a receptive uterine environment. This requires a very individualized and meticulous approach to evaluating and addressing tho

Are Injectable Fertility Drugs Safe?

I have all too often heard it said that medical providers knowingly place unsuspecting infertile women at risk of developing cancer through the fertility injectable drugs and treatment they administer and that we knowingly pl...

IVF Failure and Implantation Dysfunction

Implantation dysfunction is unfortunately often overlooked as an important cause of IVF failure. In the pursuit of optimizing outcome with IVF, the clinician has a profound responsibility to meticulously assess and address th...

Cervical Incompetence: A Common Cause of Late Miscarriage, Premature Birth and 2nd Trimester Recu...

With cervical Incompetence (CI) the cervix starts to shorten (efface) and dilate too early in the pregnancy giving rise to late (2nd trimester) miscarriage or premature birth

The Pro’s and Con’s of Preimplantation Genetic Testing (PGT) : It Should be Used Selectively

About a decade ago, I, along with my associate, Levent Keskintepe PhD were the first to introduce full chromosome Preimplantation Genetic Testing (PGT) into the IVF clinical realm to try and identify euplo

Case Report: Treating Hydrosalpinx by Surgical Removal (Salpingectomy) as a Prelude to IVF

Case Report: **For the purposes of anonymity, I will be referring to the patient as RL throughout this blog.** RL, a 31-year-old woman, presented with a 7 year history of inability to conceive, in spite of

CASE REPORT: A woman in her Early 40’s who has Diminished Ovarian Reserve Requiring IVF with Embr...

Hi Dr Sher, I'm 42 years of age. Until very recently, I knew nothing about IVF, and I now find myself in a scramble to optimize my chances with it. Despite a lifelong dream of havi

Defining and Addressing an Abnormal Luteal Phase

Following ovulation, what remains of the ruptured follicle transforms itself into a structure called the Corpus Luteum (CL) which produces progesterone. The purpose of progesterone is to prepare the uterus to accept and suppo...

IVF Should Supplant Tubal Fertility Surgery

A progressive increase in success rates with IVF versus tubal fertility surgery has over the last 25 years brought about a shift away from the latter to the former. And so it should be, because even in young women, attempted ...

Endometriosis and Immunologic Implantation Dysfunction (IID) and IVF

More than half of women who have endometriosis harbor antiphospholipid antibodies (APA) that can compromise development of the embryo's root system (trophoblast). In addition and far more serious, is the fact that in about on...

IVF: A Personalized Step-by Step Approach

The ability to grow a healthy plant requires that a "good" seed be planted in a "fertile soil" and then be properly nurtured until it can thrive on its own….independent of intervention. Similarly, successful IVF requires the ...

IVF: How many tries should be considered before stopping?

Because of the emotional, physical, and financial toll exacted by IVF, it is preferable that no one undertake a one shot attempt. If a couple can only afford one treatment cycle, IVF is probably not the right course of action...

IVF: The first Choice for Infertile Women 40 to 43 Years of Age

Consider the fact that between 40 and 43 of age, the success rate per cycle of treatment with injectible fertility drugs alone, with or without intrauterine insemination (IUI) is 2- 3%. Since it is 6-8 times higher with "conv...

“Unexplained” Infertility : Often a matter of the Diagnosis Being Overlooked!

For about 10% of all infertile couples, the cause of the infertility cannot be readily determined using conventional diagnostic methods. Such cases are often referred to as "unexplained infertility." The truth however is

The Role of IVF in Cases of Tubal Damage

Tubal damage is one of the commonest causes of infertility. It is most often due to pelvic inflammatory disease (PID) caused by sexually transmitted bacterial infection with chlamydia trachomatis and Neisseria gonorrhea. Acut...

Ovarian Stimulation in Women Who have Diminished Ovarian Reserve (DOR): Introducing the Agonist/A...

The use of GnRH antagonists, as currently prescribed in ovarian stimulation cycles, i.e. the administration of 250mcg daily from the 6or 7th day of stimulation with gonado

The Link Between Fertility Drugs and Ovarian Cancer

Ever since January 1993 when a study was reported by researchers at Stanford University suggesting that the use of fertility agents increased the risk of ovarian cancer, there has been tremendous concern and anxiety among wom...

Intralipid (IL) Administration in IVF Explained

Intralipid (IL) is a solution of small lipid droplets suspended in water. When administered intravenously, IL provides essential fatty acids, linoleic acid (LA), an omega-6 fatty acid, alpha-linolenic acid (ALA), an omega-3 f...

Prevention, Recognition, and Treatment of Hydatidiform Molar Pregnancies

A hydatidiform molar pregnancy happens when tissue that normally forms the placenta instead becomes a growth, that triggers symptoms of pregnancy. A hydatidiform mole is a benign tumor of the root system (trophoblast) of the

IVF Pregnancy with a “Vanishing Twin"

Today, in first world environments where there is ready access to advanced medical technology, many women undergo ultrasound diagnosis of pregnancy as early as 5-6 weeks after their last menstrual period. As a result, multipl...

Optimizing Response to Ovarian Stimulation in Women Who Have Compromised Ovarian Reserve: A Perso...

Older women, and those who have diminished ovarian reserve (DOR) with resistance to ovarian stimulation ("poor responders" are often labeled as being producers of "poor quality" eggs and

IVF Pregnancies and Why They Bear a Greater Risk

While most IVF pregnancies will progress normally and without any increased risk to mother or baby, there is little doubt that women who conceive in this manner as well as their babies are potentially at increased risk. In fa...

Treating Out-of-State and Out-of-Country IVF Patients in Las Vegas

For more than three decades, about 70% of the patients that I have performed IVF on, have journeyed to see me from out state or out of country. Over the years, I have been repeatedly asked how, given the distance separates us...

Controlled Ovarian Stimulation (COS) protocols for women with Diminished Ovarian Reserve (DOR) wh...

Two main factors determine the quality of a woman's eggs at ovulation or egg retrieval. First is her age and second is the protocol used for ovarian stimula

Cytomegalovirus (CMV) Infection: What are the Implications Regarding Pregnancy?

Cytomegalovirus (CMV) belongs to the Herpes group and, like Herpes, can remain dormant in the body for long periods of time (even for life). CMV infection is very common, such that by age 40Y 50% of adults will bea

Clomiphene Induction of Ovulation: Use and Misuse

Clomiphene citrate (Clomid) is by far the most commonly used fertility drug in the world. Used in the right circumstances and with appropriate application, it can be and is effective in assisting conception. Ideally the use ...

First Trimester Bleeding: How serious is it?

Vaginal bleeding occurs in about 25% of all pregnancies. When it happens, it almost invariably raises the concern of pregnancy loss (miscarriage). Bleeding can also be a sign of a tubal (ectopic) pregnancy, and in cases whe...

The Basic Infertility Work-Up

After 1 year of unsuccessfully trying to have a baby, it is time to have a basic infertility evaluation. And the urgency increases the older the woman is. A: Preparatory Tests done on the woman: Tests for Ovarian Reserve:...

Testicular Sperm Extraction (TESE) and Testicular Sperm Aspiration (TESA): Surgical Approaches fo...

Men with no sperm in their ejaculates (azoospermia), whether due to non-obstructive or obstructive (usually post-vasectomy

Why the Standard Practices for Embryo Transfers are Rapidly Shifting

Embryo transfer (ET) is undoubtedly a rate limiting factor when it comes to IVF outcome. In fact, in my opinion, it is the single most important procedural step in IVF. Optimal performance of ET takes practice, confidence, de...

Routine Fertilization by Intracytoplasmic Sperm Injection (ICSI): An Argument in Favor.

Intracytoplasmic Sperm Injection ICSI, which began in 1992 as a treatment for severe male factor infertility, involves the direct injection of a single sperm into each egg under direct microscopic vision. Soon

Frozen Embryo Transfer (FET) versus “Fresh” ET: How to Make the Decision

Until less than a decade ago, most women undergoing IVF would have their embryos transferred to the uterus in the same cycle that the egg retrieval was performed ("Fresh" Embryo Transfer). This was because embryo cryopreserva

PGS and Assessment of Egg/Embryo “competency”: How Timing, Process, and Methodology Can Affect Re...

About a decade ago, we, (Sher, and Keskintepe, L; et al) introduced full chromosomal karyotyping for preimplantation genetic sampling – (PGS) to assess egg/embryo "competency" for IVF. We per

Pelvic Inflammatory Disease (PID), Tubal Damage and Hydrosalpinx: Preparing for IVF

Pelvic inflammatory disease (PID) is a condition where inflammation of pelvic structures occurs, as a result of one of the following: sexual transmission via the vagina and cervix, contamination from other inflamed

Sclerotherapy of Ovarian Endometriomas

The precise mechanism by which ovarian endometrioma causes infertility is unknown. In women with ovarian endometriomas, infertility is potentially associated with a decreased oocyte retrieval rate, reduced oocyte quality and ...

The Sampson Theory

The Sampson Theory for the pathogenesis of endometriosis is the oldest, but remains the most widely popular and accepted hypothesis. It is based on observations made as early as in 1938, that that endometriotic implants in th...

Hormonal Treatment of Male Infertility

In 1 to 2 percent of cases, male infertility is the result of problems in an area of the brain (the hypothalamus) and or in a small gland situated just below the base of the brain known as the pituitary gland. The pituitary...

A Rational Basis for Selecting a Stimulation Protocol

Older women, as well as those who (regardless of age) have diminished ovarian reserve (DOR), tend to produce fewer and less "competent" eggs, the main reason for reduced IVF success in such cases. The compromised outcome is l...

Potential Downsides of DHEA Supplementation: Why take the Risk?

 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 nat...

Progesterone-Estrogen Hormonal Supplementation in IVF: How Does it Work and What is its Value?

Ovulation occurs within 38-42 hours of initiation of the spontaneous luteinizing hormone (LH) surge (which can be detected in the blood or urine prior to this event) and/or hCG administered following con

Antisperm Antibodies, Infertility, and the Role of IVF with Intracytoplasmic Sperm Injection

Antisperm antibodies (ASA) are immunoglobulins that attach to sperm. They are most commonly encountered in semen, blood, cervical mucous and follicular fluid. Not all ASA bind to sperm; however, those that

“Triggering” Egg Maturation in IVF: Comparing urine-derived hCG, Recombinant DNA-hCG and GnRH-ago...

Ideal egg development sets the scene for optimal egg maturation that occurs 36-42h prior to ovulation or egg retrieval. Without prior optimal egg development (ovogenesis), egg maturation will be d

Ectopic (Tubal) Pregnancy and IVF

Approximately 1 out of every 100 embryos will implant and grow outside of the uterine cavity, almost always in a fallopian tube. This is defined as an ectopic pregnancy. Infrequently, an ectopic pregnancy attaches to an ovary...

The Fundamental Requirements For Achieving Optimal IVF Success

Given the considerable emotional, physical and financial investment associated with IVF treatment, it is essential that factors known to affect success be identified and regulated in advance of initiating treatment and to alw...

“Functional” Ovarian Cysts and IVF

An ovarian cyst is any collection of fluid, surrounded by a very thin wall, within an ovary. An ovarian follicle that is larger than 22mm is termed a functional follicular cyst. They are non-malignant (benign) and harmless an...

Varicocele and Male Infertility

What is a varicocele? The testicles are housed in the scrotum, a skin-covered sac that houses the two testicles as well as blood vessels that deliver blood to these glands, nerves, and lymphatics. An abnormality of the plexus...

Viagra as a Treatment to Thicken Uterine Lining

About seventeen years ago, after reporting on the benefit of vaginal Sildenafil (Viagra) for women who had implantation dysfunction due to thin endometrial linings, I was proud to announce the birth of the world's first "Viag...

Intralipid and IVIG Therapy in the Treatment of Immunologic Implantation Dysfunction

There is an ever growing realization, recognition, and acceptance of the fact that uterine immunologic dysfunction can lead to immunologic implantation dysfunction (IID) with "unexplained" infertility, IVF failure

Janet Jackson Delays Tour to Start Family: How Old is too Old for IVF?

More and more women are deciding, based upon personal preference and professional necessity, to postpone having a family to a later age. In fact, very recently Janet Jackson (49Y) was in the news stating that she was cancelli...

Pro's and Con's of "The Lupron Trigger"

Traditionally, IVF egg retrievals are timed for about 36 hours after a 10,000U hCG "trigger". The hCG hormone thereupon remains in the system for up to a week. When patients who overstimulate following ovarian stimulation exp...

How Does Bodyweight Affect Fertility and IVF Outcome?

The prevalence of obesity in Western societies is on the rise, which has a profound effect on the reproductive performance of women who are trying to have a baby. Recent evidence suggests that obesity in women of reproductive...

Premature Luteinization (“the premature LH surge): Why it Happens and how it can be Prevented

Premature luteinization ("premature LH surge") occurs when prior to the planned initiation of the hCG trigger, a progressive rise in LH, irreversibly compromises follicle and egg development and maturatio

Induction of Ovulation With Clomiphene Citrate: Mode of Action, Indications, Benefits, Limitation...

Clomiphene (Clomid, Serophene) is by far the most widely prescribed agent for the induction of human ovulation for women who do not ovulate, those with dysfunctional

Uterine Fibroids and Fertility

Fibroids or leiomyomas are non-malignant muscle tumors that grow in the uterine wall. They can be found in about one out of every five (1:5) women 30Y of age. Fibroids are far more prevalent in African Americans and women and...

Natural Killer Cell Activation (NKa) and Immunologic Implantation Dysfunction (IID) in IVF: The C...

 "Innovators are rarely received with joy, and established authorities launch into condemnation of newer truths; for at every crossroad to the future are a thousand self-appointed guardians

How Many Embryos Should be Transferred: A Critical Decision in IVF

The decision on how many embryos to transfer confronts most IVF physicians and their IVF patients. It is driven by a goal that both share in common, namely that of optimizing the chance of IVF treatment resulting in pregnancy...

Frozen Embryo Transfer (FET): A Rational Approach to Hormonal Preparation and How new Methodology...

Until about 15 years ago, we believed that the best and safest way to cryopreserve embryos was by using a slow freezing method. What we subsequently learned was that the slow freezing

Human Growth Hormone Administration in IVF: Does it Enhance Egg/Embryo Quality and Outcome?

The term "Biological Clock" is used to define the time line for  a woman's reproductive potential. It is affected primarily by two factors: Age:  Advancing age is inevitably accompanied by a progressive

Adenomyosis Related Infertility: A Therapeutic Challenge

Adenomyosis is a condition where endometrial glands develop outside the uterine lining (endometrium), within the muscular wall of the uterus (myometrium). A definitive clinical diagnosis of adenomyosis is difficult to make. T...

IVF- A Moral And Ethical Dilemma: Disposing of Left-Over Human Embryos

Human life can be defined as any living entity that contains viable human DNA. There are two issues. The first is when does life begin and the second is when is it endowed with "personhood. Pro-choicers believe that the trans...

IVF: How do you decide how many embryos to transfer?

The majority of IVF patients intuitively recognize that the more embryos transferred the greater will be the chance of their getting pregnant. However in their preoccupation with conceiving as quickly as possible they often t...

CASE STUDY: Prolonged Clomiphene Citrate Therapy can in Some cases reverse Male Factor Infertili...

About 2 years ago, I consulted with a couple who presented with many years of infertility due exclusively to severe male factor (sperm count= 1.0 million/ml;

Anti Mullerian Hormone (AMH) Measurement to Assess Ovarian Reserve and Design the Optimal Protoco...

Anti-Müllerian hormone also known as AMH is a protein that, is encoded by the AMH gene located on chromosome 19p13.3,. There is an important interactio

Fragile X Syndrome: Which IVF Candidates Should be Tested and How Should Results be Interpreted?

Fragile X syndrome occurs in individuals who carry the gene, FMR1 on an X-chromosome. This condition is inherited as a dominant X-linked disorder. With a dominant disorder, the condition results when t

Molar Pregnancy: What is it and How Should it be Treated?

Molar pregnancy or hydatidiform mole — is a benign tumor that occurs in the uterus. It starts when an egg is fertilized, but instead developing into a normal, conceptus + placental tissue, the placenta tissue develops into a ...

Confronting the real cost of IVF Treatment

There are about 1.0 million infertile couples in the United States, for whom IVF offers the only rational opportunity to have a baby. About 10% of these women (100,000) undergo approximately 150,000 fresh IVF cycles annually....

Surrogacy: For some, like Tyra Banks, the only road “from Infertility to Family”

Surrogacy involves conception and the subsequent birthing of a baby by one woman (the surrogate) for another individual or couple. There are two primary types of surrogacy – Traditional (Classical) and Gestational (IV

Evaluation of IVF Outcome does not readily lend itself to “Evidence-Based Scientific Scrutiny”

The dictionary defines "evidence based medicine" as follows: "The practice of medicine in which the physician finds, assesses, and implements methods of diagnosis and treatment on the basis of the best a

Cost of IVF Treatment

When considering IVF, cost is a major consideration. Patients tend to compare the cost of treatment at one center with that of another. While it is understandable for cost per IVF procedure to be considered, the focus should ...

The “Biological Clock” and How it Should Influence the Selection and Design of Ovarian Stimulat...

It is inevitable reality that all women will at some point or another, experience a progressive decline in their reproductive potential. This occurs as their ovarian egg populat

PGT IN IVF: Some embryos that test PGT- chromosomally abnormal can self- correct in the uterus: ...

Human embryo development occurs through a process that encompasses reprogramming, sequential cleavage divisions and

Micro-IVF: Often Preferable to Ovarian Stimulation with or Without IUI

Micro-IVF differs from "conventional IVF" in that when performed on younger women (36Y) who have normal ovarian reserve (AMH=2.0ng/ml and basal FSH= 9.0MIU/ml) it requires less effort/time/human resources to conduc

IVF for Same Sex Couples

Gay, lesbian, or transgender individuals experience the same fears as any individual in the world. One of these is trepidation that they might not be able to have children. In the United States of America, same-sex marriage h...

IVF for Women Who Have Previously Conceived (Secondary Infertility)

While Primary infertility refers to the inability of a woman who has never been pregnant in the past, to conceive, Secondary Infertility is defined as an inability to conceive more than 1 year after having conceived in the pa...

IVF Outcome: How Age, Ovarian Reserve and the Protocol Used for Controlled Ovarian Stimulation (C...

It is the egg's numerical chromosomal integrity (ploidy) that is the most influential in influencing its subsequent ability post-fertilization, to propagate a "competent" embryo

Immunologic Implantation Dysfunction: Importance of Meticulous Evaluation and Strategic Managemen...

Greetings Dr. Sher! Just wanted to first thank you for all that you do for women and infertility and I'm truly amazed and grateful at how you are so willingly to share your knowledge

Sperm DNA Damage- Tests and Interpretation

The Sperm Chromatin Structure Assay (SCSA): A Measure of the Potential of Sperm to Help Propagate a Viable Pregnancy In about 40% of infertility cases, male factor is the sole cause. In approximately another 40% it is solely...

Ovarian Endometriomas: Sclerotherapy provides a Safe, Convenient, and highly effective Non-Surgic...

Women, who have advanced endometriosis, often have endometriotic ovarian cysts, known as endometriomas. These cysts contain decomposed menstrual blood that looks like melted chocolate…he

Measuring and interpreting Blood hCG to Assess Pregnancy Viability Following ART Treatments

I know of no medical announcement associated with the degree of emotional anticipation and anguish as that associated with a pending diagnosis/confirmation of pregnancy following infertility treatment. In f

Infertility Caused by Pelvic Tuberculosis: An Easily Missed Diagnosis

Tuberculosis is caused by a bacterium known as mycobacterium tuberculosis. It is primarily an infectious process that involves the lungs it is capable of spreading elsewhere (extra-pulmonary TB) It can spread to the woman's r...

Autism and Reproduction

Autism Spectrum Disorder (ASD) encompasses a range of conditions that most commonly affect males and are characterized by lifelong neurodevelopmental derangements manifesting as deficiencies in social interaction, verbal and ...

IVF Failure and Implantation Dysfunction: The Role of Endometrial Thickness, Uterine Pasthology a...

The considerable emotional, physical and financial burden associated with infertility treatment in general and with IVF in specific, demand that factors known to affect outcome b

Ovarian Stimulation For Women with Diminished Ovarian Reserve (DOR) and in Older Women undergoing...

Two main factors determine the quality of a woman's eggs at ovulation or egg retrieval.  First is her age and second is the protocol used for ovarian stimulation. With the possible the exception o

Fertility Drugs for IVF: How safe are They and do They Cause Cancer?

Are unsuspecting infertile women at increased risk through the drugs and treatment they administered with fertility treatment? When it comes to fertility drugs (e.g. gonadotropins such as Follistim, Gonal F, Puregon, Bravel...

IVF following previous Tubal ligation is a Better Option than Surgical Reversal

There is a relatively high success rates following tubal re-connection (reanastomosisis) in cases of previous tubal ligation (a birth rate of +/- 50% within 3 years of a successful surgery). However, IVF performed in a

COMMERCIAL EGG BANKING FOR FERTILITY PRESERVATION (FP) AND A REPOSITORY FOR DONOR EGGS

For more than a thirty years, attempts by medical scientists to freeze and bank (cryobank) a woman's eggs have yielded limited success. In fact, to date, since the birth of the 1st "frozen egg baby" in the mid 1

The Role of Gender Selection: The Pros and Cons

Couples have for centuries sought to influence the gender of their offspring. More than seven centuries ago the ancient Chinese developed a birth calendar said to be able to predict gender on the basis of when conception occu...

The BCP: Does Launching a Cycle of Controlled Ovarian Stimulation (COS) Coming off the BCP Compro...

One often hears the expressed opinion that the BCP suppresses response to ovarian stimulation. This is not the case, provided that the BCP is overlapped with administration of an agonist

Intrauterine Insemination (IUI): Who needs it and who does not; Pros and Cons

"As physicians we really need to seriously rethink the basis upon which we recommend  IUI!" -GS Intrauterine insemination (IUI), the injection of sperm into the uterus by means of a catheter directed through the cervix,

Unexplained IVF Failure

When confronted with "unexplained" IVF failures where morphologically good embryos were transferred, the question arises as to whether the problem is due to inherent egg/embryo "incompetence" (which usually equates with an ir...

Egg Freezing: Fertility Preservation (FP) & Commercial Donor Egg Banks

The bottom line is that because of the traumatic effect of freezing on egg viability and "competency" the statistical chance of each frozen/ thawed egg ultimately resulting in a baby is only at best 6-8%. So, while success ra...

Advantages of Combining Preimplantation Genetic Sampling (PGS) with Tests for Immunologic Implant...

Whenever IVF fails to resolve reproductive failure, the explanation is almost invariably either:  a) embryo "incompetence" (usually …although not always due to the embryo being

IVF: The Economic Realities

Patrick Steptoe and Robert Edwards were responsible for the birth of the world's 1st IVF baby, Louise Brown, in 1978. Since then about 4 million babies have been born worldwide, and the number is growing fast. The introductio...