Ask Our Doctors
Dear Patients,
I created this forum to welcome any questions you have on the topic of infertility, IVF, conception, testing, evaluation, or any related topics. I do my best to answer all questions in less than 24 hours. I know your question is important and, in many cases, I will answer within just a few hours. Thank you for taking the time to trust me with your concern.
– Geoffrey Sher, MD
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Dear Dr,
my husband and I have a 5year old daughter. we have been trying to get pregnant for the last 4 years but no success so far. we visited a fertility Dr and were subjected to hormonal profile test, HSG, semen analysis, heterescopy and everything was fine.
we did 4 rounds of stimulated ovulation and many eggs released but no pregnancy came
we did 2 rounds of ivf, no success
what should we do?
hola, buen día. Quería saber cuantos años tengo que tener para donar óvulos y cómo sería todo el proceso, tengo que pagar algo?
Hi,
My wife and I are doing IVF in Canada and going to transfer embryos to United States for surrogacy. Can I know the cost estimation of FET at your clinic? (including fees to receive embryos from other clinics, FDA screening kits for international parents etc)
Thanks!
Hello,
I compared the markers of different HLA genes between myself and my husband from our raw genetic data which was produced by 23andMe and I found the following:
1. HLA-A: 3/3 markers matched = 100%
2. HLA-B: 2/4 markers matched = 50%
3. HLA-C: 2/2 markers matched = 100%
4. HLA-G: 2/5 markers matched = 40%
5. HLA-DQA1: 7/17 markers matched = 41%
6. HLA-DQB1: 3/9 markers matched = 33%
7. HLA-DRB1: 3/5 markers matched = 60%
8. HLA-DRB5: 9/9 markers matched = 100%
Some APA testing done and was negative. No elevation in thyroid antibodies. Normal karyotype between me and my husband.
What treatments or methods of conception would be helpful for us given this information?
A bit of background:
We have a son from a medicated timed intercourse cycle after trying for 3.5 yrs after 4 failed medicated IUIs and one failed IVF cycle. I had an elevated PAPP-A during pregnancy and uterine artery blood flow was normal, however, son was small for gestational age (basically didn’t grow much after 35 weeks). Been trying for baby #2 since 2020. Since then I have done 5 medicated timed-intercourse cycles, 6 medicated IUIs, 7 blastocysts transferred (not PGT-A tested), all in all only resulting in 2 chemical pregnancies (1 from an IUI, 1 from an FET). Had chronic endometritis and undiagnosed endometriosis all during those blastocyst transfers. I also transferred 6 cleavage stage embryos where I used lovenox, intralipids, prednisone, and other meds but no pregnancy. Endometriosis diagnosed via laparoscopy in the Fall 2023 at age 41.
Thanks in advance for your advice.
Dear Dr. Sher,
Im 37 years old with long story of 15 natural chemical pregnancies and after one ovarian stimulation with my oen eggs but with no blastocysts in October 2023 I decided to go through frozen donor eggs from a bank abroad. The same results even with the donor eggs, no blastocysts in the end. Husband’s kariotype is normal. 2 last times the ICSI have been performed in the same lab. Do you thing it might be the error in the lab or my husband sperm might be also the problem?
Thank you so much for your reply
Hi Dr Sher, I am 40 years old and have suffered with a number of early pregnancy losses in the past year, all conceived naturally. I have a 3 year old son who was conceived easily with no issues during pregnancy or birth. I have read your info on IID and I’m hoping you can help me. I have had some bloodwork done in the UK and am borderline APA, with anticardiolipin results of 17.8 and 19.2. My plasma antithromb activity was 73. My clinic advised progesterone 3 days post LH surge, with aspirin and clexane after a positive pregnancy test. I did this with my last pregnancy but unfortunately a scan at what should have been 6 weeks gestation showed nothing in the uterus, but my lining was thick. I experienced a bleed soon after and have conceived again this next cycle and am now around 4 weeks 5 days.
I have only taken the progesterone and don’t plan to take aspirin as it was tough on my digestion and I have read your advice regarding aspirin for IID. I am unsure whether to begin the clexane as it didn’t help with my last pregnancy, would you recommend starting it now, or waiting until hcg levels have been tested to show the levels are rising as they should? I also have an ulstrasound scan planned for next week when I will be 5 weeks and 5 days, should I wait until after the scan to begin clexane? Getting past 5 weeks has been the biggest problem.
Is there any further tests I can do, either now during this pregnancy, or if it is not viable, should I have any other tests done before conceiving again? My clinic has suggested an endometrial receptivity test, with samples being sent to Chicago, would this be helpful?
I’m also curious on your thoughts about anti HY antibodies and RPL? As I have had a boy previously, could this be a factor?
Many thanks!
Hello Dr. Sher,
I am experiencing my 4th biochemical pregnancy in less than 2 years. I am 45 years old with 8 previous live births. My youngest son turned 2 years old in January. I recently acquired Day 3 labs and my AMH is .71 though I obviously have had no issues with spontaneous pregnancy. I have not evaluated my progesterone on Day 21 but I plan to do so the next cycle. Do you have recommendations or have you seen cases that are similar? I have regular 31 day cycles with normal luteal phases. I have normal BMI. I am not on any medications.
Thank you,
Faith
Tenho 2 fib fallidas protocolo estimulación 200 de pergoviris 450/900. 1a 6 ovulos ningún normal después de biopsia. Segunda 3 ningún balocisto
De esta vez la 3a me adicionaron letrozol en los primeros dias de estimulación ovarica.
Que mas puedo hacer ya que me está acabando el tiempo que protocolo me aconsejarían tengo 43 años recién cumplidos
Hi Dr Sher,
Could you please try and answer what could be causing my issue and possible solution. I am 38 (husband 40) and we are married for 13 years; trying for a child since 10 years. I never had trouble conceiving but it always ends up either as a biochemical or ectopic. 2014 first natural pregnancy was a ruptured right ectopic which, led to trauma and subsequent rosacea ( I still have). Left tube was patent on HSG during 2015. After two failed IUI , I conceived naturally during 2017 that ended up in a biochemical with max beta HCG at 200. I went on to have 3 natural pregnancies during 2018 that were all biochemical (max 1400 HCG). Post a hysteroscopy that showed normal study, I then tried IVF with IVIG infusion in 2019 with two PGS inconclusive embryos (clear 10 cell division is what I was told so probably day 3 embryo) that had max HCG 6 and turned negative. Had another ectopic (this time left tube) mid 2019 that was treated with methotrexate. Underwent receptive DX early 2020 that had maximal BCL6 expression & beta integren, the adhesion molecule was 0; I was told it was a clear case of endometriosis and was suggested 8 week estrogen suppression through depot lupron post egg retrieval. During 2021/22, I followed the steps,egg retrieval (got 2 PGS euploid) and two depot lupron monthly shots four weeks apart. On 54th day post suppression, started estrogen priming with letrozole and the subsequent transfer was another biochemical (HCG 26). In summary, I only had repeated biochemical or ectopic. Lost all hope of being able to bear a child. Came across your podcast on the egg whisperer show and am writing to you. Awaiting your reply.
Hi Dr Sher, many thanks for your advice and information. Today is my official pregnancy test day, 16 days after egg collection and I am thankfully testing positive. My clinic have now advised I stop taking the aspirin and do not start the inhixa, but rather wait and test again on Monday, 19days post egg collection, and if it’s still positive to soeak to the recurrent miscarriage consultant for advice. This doctor is the one who said I was borderline APA and prescribed the inhixa to take after a positive pregnancy test so I’m very confused.
My Anticardiolipin results were 23.9 in October and 12.0 in January.
Can you please advise if I should stop the aspirin and wait a few days or go ahead with the Inhixa? Would there be an increased risk of miscarriage in stopping the aspirin? Or should I do as my clinic have advised and stop everythig except progesterone and wait until Monday?
Many thanks for any info or advice
Nat
Hi Dr Sher, I’m hoping you can help me, I’ve been reading your info on IID and the use of baby aspirin and clexane, and think it could apply to me. I’m 30 years old and have recently conceived after ICSI with donor sperm. I’ve previously suffered recurrent chemical pregnancy loss with donor insemination using a different donor. I have been told i was ‘borderline’ APA syndrome and was 1 point over the range limit and so have been prescribed Inhixa and advised to begin injections 2 weeks after my embryo transfer, which is tomorrow. I have got clear positive home pregnancy tests from 2 weeks after egg collection but I have been taking aspirin since egg retrival and have experienced spotting, which is likely to be from a cervical erosion, and nose bleeds. I have also been advised to continue progesterone pessaries until 16 weeks gestation.
Do you think the aspirin could have contributed to the nose bleeds and spotting? And should I go ahead and start the clexane/inhixa on the proposed date? I’m concerned that as I’m borderline APA it may not be necessary, could taking the inhixa cause harm? I would appreciate any advice.
Many thanks, Nat
Hello doctor doing iui this cycle
On cycle day 3 my lining came back at 4.0….did ultrasound again on day 7 it was 4.1…on day 8 it was 4.6 they gave me Menopur injection on day 8 and it came came 5.1 on day 9 they gave me again Menopur for thickening my follicles on day 9 are already mature 20mm..any suggestions
Hi Dr. Sher. I was about to start IVF and I was told I only have 5 follicles this cycle and that IVF will most likely fail. I was advised to do blood work again for AmH, FSH, TSH, vitamin D, CBC, estradiol and do ultrasound next cycle again. I’m 39. Healthy. AMH below 1 ( 9 months ago). FSH 24 ( 9 months ago) and follicle count 8 ( 9 months ago). Are my chances really low as the doctor says? Should I still try ? Thank you
Hello,
I have multiple ovarian Endometriomas. I was wondering if you offer sclerotherapy? How far are you booking out? I already have diminished ovarian reserve. Would having this done hurt my reserve more?
I was sexually active march 4th and had unprotected sex… no seman got inside of me.i tested myself on the 18 got a negative and than got my embryo transfer on the 18 tested myself on the 19,20,21
Got a negative tests and than got a faint positive 4 days after transfer on the 22nd is this pregnancy from me or from the embryo transfer. I also had an ultrasound on my belly while they did the embryo transfer of that matters
i want to know if i qualify to be donor im 33 where i have to go and how much you pay for it?
Hi . I try ivf I don’t get pregnant 🙁 I want baby but I can’t pay a lot money I don’t have 🙁 I need help plz