Ask Dr. Sher – Open Forum

22 Nov

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This is a forum where I welcome any questions you have on the topic of infertility, IVF, conception, testing, evaluation, or any other related topic.

I try to answer all questions in less than 24 hours. In many cases, I will answer within just a few hours.

– Geoffrey Sher, MD

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14,446 Comments

  • Nisha S says:

    Hi Dr Sher,

    I am 29 years old and my husband is 32, we are both otherwise healthy. We tried naturally to conceive for 3-4 months however due to late ovulation (around day 20 of cycle) and luteal phase spotting (starting around DPO 6), we were referred to a Fertility Specialist. HSG showed open right tube and question of distal blockage on left tube. AMH 4.4. FSH/LH/TSH were all normal. We did 4 cycles of clomid 100mg along with 2 IUIs, none of which were successful. IVF was then recommended. I underwent the antagonist protocol and had 32 mature oocytes retrieved. Of those we did ICSI on 25 and no ICSI on 7. We had a total of 15 embryos reach blast stage and then sent for PGD. 9 of these embryos were normal. I have now had 2 PGD tested embryos implanted on seperate FETs with good lining and no other issues. Both of these did not work with beta HCG<5. Given the two failures, I asked for a repeat HSG to rule out hydros-it again showed open right tube and concern for blocked left tube, no hydro. A thrombophilia panel showed a mildly positive Lupus Anticoagulant screening thus I was referred to a Rheumatologist. On repeat testing, the LAC was normal and thyroglobulin antibodies, b2 glycoprotein antibodies, and anti cardiolipin antibodies were all negative. I did however have a positive ANA (was not given the titer) with specific anti-centromere antibodies. I was told that this likely does not mean anything as I am completely asymtompatic from a Rheumatologic perspective. I am planning to undergo hysteroscopy this cycle and then an ERA prior to another transfer.

    Do you recommend any other testing at this point?
    Have you seen patients wtih a positive ANA and specifically anti-centromere antibodies conceive successfully?
    Should I be on heparin and steroids for the next transfer? If so, for how long.

    Thank you!
    Nisha

    • Geoffrey Sher says:

      My website has changed. The new site is at http://www.sherIVF.com where I host and populate new and updated blog articles . The blog can also be accessed directly by going to http://goo.gl/4hvjoP. I currently respond to posts on this new site

      To find and follow updated and new blog articles and to post questions or comments, please use this new venue. I promise to respond promptly.

      NOTIFICATIONS:

      1. About my Intended Retirement by mid-2018:
      After 35 years in the field of Assisted Reproduction (AR), the time has finally come for me to plan on retiring from full-time clinical medicine within a year. If you are interested in my medical services prior to my retirement, I urge you to contact my concierge, Julie Dahan ASAP to set up a Skype or an in-person consultation with me. You can also contact Julie by phone or via email at: 702-533-2691 or Julied@sherivf.com You can also apply online at http://www.SherIVF.com.

      2. The 4th edition of my newest book ,
      “In Vitro Fertilization, the ART of Making Babies” is now available as a down-load through http://www.Amazon.com or from most bookstores and public libraries.

  • han says:

    Hi Dr. Sher

    I had 4 IVf cycle and 7 total transfer last FET feb was successful but had a missed miscarriage, the baby stop growing at 9 weeks. I just want to ask if there is still chance for me to get pregnant? I still have 5 Frozen ones and I am 37 yrs old. Will it be alright to try to get pregnant asap of will i have to wait for 3 cycles before trying? What are my odds? I am really down at the moment as I thought after 5 yrs of trying it works but then it did not. Thank you

    • Geoffrey Sher says:

      My website has changed. The new site is at http://www.sherIVF.com where I host and populate new and updated blog articles . The blog can also be accessed directly by going to http://goo.gl/4hvjoP. I currently respond to posts on this new site

      To find and follow updated and new blog articles and to post questions or comments, please use this new venue. I promise to respond promptly.

      NOTIFICATIONS:

      1. About my Intended Retirement by mid-2018:
      After 35 years in the field of Assisted Reproduction (AR), the time has finally come for me to plan on retiring from full-time clinical medicine within a year. If you are interested in my medical services prior to my retirement, I urge you to contact my concierge, Julie Dahan ASAP to set up a Skype or an in-person consultation with me. You can also contact Julie by phone or via email at: 702-533-2691 or Julied@sherivf.com You can also apply online at http://www.SherIVF.com.

      2. The 4th edition of my newest book ,
      “In Vitro Fertilization, the ART of Making Babies” is now available as a down-load through http://www.Amazon.com or from most bookstores and public libraries.