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High Tech Options, Including IVF

September 22, 2004 - Wednesday
2:43 PM to 3:43 PM (EST)
Guest Speakers: Geoffrey Sher, MD - Founder and Director of The Sher Institutes for Reproductive Medicine

Categories
Donor Egg • Fertility Drugs • IUI • IVF • PGD


Dr._Sher joined
Daniel_Becker Hi Doctor Sher!
Daniel_Becker We are almost ready to roll - just a few more minutes
Dr._Sher Hi, I'm in place and ready to go when you are.
Daniel_Becker OK - here it goes
Daniel_Becker Welcome to The American Fertility Association's online educational session. We are pleased to have Dr. Geoffrey Sher, (Sher Institues of Reproductive Medicine) joining us this evening. We will be discussing the topic "High Tech Options, Including IVF". Thanks for joing us this evening! Daniel Becker, Esq., Board Member to The American Fertility Association.
Daniel_Becker Congratulations to Dr. Sher - check out US News and World Reports, 9/27/04 issue!!!!!!!
Daniel_Becker Please feel free to post questions for Dr. Sher. Keep in mind that you may need to repost them as the room is quite busy. You may want to save your questions in a word docutment instead of having to retype them.
Dr._Sher Thank you for your kind words. I haven't read the article myself but patients have emailed me about it and I intend to get a copy tonight.
renee Are you a proponent of using donor eggs after several failed attempts at IVF?
hopeful Dr. Sher, (obviously) I've never used this site before, so please disregard last unfinished question. I am 43 1/2 yrs old. I've gone through approx. 6 inseminations from age 39-41 and no luck. Two years ago I did get pregnant but turned out to be a tubular pregnancy. Medicine was able to help so I still have my tubes and ovaries. I've started with another Dr. (Dr. #3) and am being told now egg donor invetro in the only way for my husband and I to go now. My own eggs (at my age) would only give us 5% chance and egg donor will give us 50% chance. We are in such a dilemna now we don't know who to get advice from. They say my husband is in fine health and so am I. I am so drained with emotions; I'
NYCRoadRunner How soon after IVF frozen transfer will the embryos implant and will know (not spotting) before pregnancy test?
Daniel_Becker Welcome to The American Fertility Association's online educational session. We are pleased to have Dr. Geoffrey Sher, (Sher Institues of Reproductive Medicine) joining us this evening. We will be discussing the topic "High Tech Options, Including IVF". Thanks for joing us this evening! Daniel Becker, Esq., Board Member to The American Fertility Association.
Dr._Sher Failed attempts alone are not an indication for DE. It's the reason why failure happened that needs to be evaluated. If it is the method of stimulation that is producing poor quality eggs, then that needs to be addressed. On the other hand, if the woman is over 43, being that age is the most important determinant of egg quality, then yes ovum donation becomes a first choice. But the decision is up to the couple. We recently had a woman of 46 give birth to twins with own eggs. Quite an achievement and not an indication to encourage such practice but it does prove a point.
Daniel_Becker Please feel free to post questions for Dr. Sher. Keep in mind that you may need to repost them as the room is quite busy. You may want to save your questions in a word docutment instead of having to retype them.
NYCRoadRunner How soon after IVF frozen transfer will the embryos implant and I will know (not by spotting) before having a pregnancy test?
Dr._Sher Hopeful - you need to inform your RE of your confusion. I wish you well.
NYCRoadRunner Or should I just be patient?
renee Dr. do you recommend the male have sperm tested to determine the dgree of potential for fertilizing egg. i think it is a fairly test.
Dr._Sher NYCRoad - After day 3 about 5 days later. With blast transfer (we virtually only do blast FETs), about 2-3 days later.
Daniel_Becker The American Fertility Association has free membership! Please go online and you will have access to all our publications at "No Barriers".
Heather How old is too old to have a baby?
NYCRoadRunner Will I know or feel different after implantation?
Daniel_Becker Welcome to The American Fertility Association's online educational session. We are pleased to have Dr. Geoffrey Sher, (Sher Institues of Reproductive Medicine) joining us this evening. We will be discussing the topic "High Tech Options, Including IVF". Thanks for joing us this evening! Daniel Becker, Esq., Board Member to The American Fertility Association.
Dr._Sher Renee - we do a DNA fragmentation index (DFI) by way of the SDIA test or SCSA, on all cases regardless of sperm count where the man has not initiated a viable 12 week pregnancy at least, before. Roughly 7% of men with normal sperm counts have occult DNA sperm problems.
Damon My wife recently started Follistim injection for IUI. After 6 days, our doc thinks she might develope Ovulation Hyperstimulation Syndrom, and aborted the IUI cycle. How long did we have to wait before she can start another IUI or IVF cycle?
Daniel_Becker Please feel free to post questions for Dr. Sher. Keep in mind that you may need to repost them as the room is quite busy. You may want to save your questions in a word docutment instead of having to retype them.
kf220 Type here
Dr._Sher heather - that is impossible to answer. We have treated women in their 50's with egg donation and provided that they are tested physically and biochemcially to have no predisposing factors to pregnancy problems, there is no reason justification for the RE to be judgemental. It is not our right to make decisions based on age, marital status or sexual orientation for that matter. It is the patient's right to make an informed choice in my opinion.
Dr._Sher Daman - one full resting menstrual cycle.
Daniel_Becker Heather - you must have got bumped - Dr. Sher answered your question - we will see if he can repost it
Daniel_Becker The American Fertility Association has a set of message boards, several which are moderated by a physician daily. Please feel free to stop by and ask questions there as well! Also, "Connections" will meet every week for an online educational session. Please check the schedule on our home page.
Damon Thanks, Dr. Sher. How many eggs are usually needed for an IVF cycle?
Dr._Sher Perhaps when the transcripts come out.
NYCRoadRunner Will I know or feeling anything after the implantation?
Dr._Sher damon - the optimal amount that you can make under an ideal protocol. We do many single embryo transfers and have had 100's of pregnancies especially when the embryo is soluble HLA-G (sHLA-G) positive 2 days after insemination.
renee We have went through IVF at Columbia and Cornell - this test was not recommended by them. I'm wondering why. Now, that we are considering donor egg - we thought iit would possibly reveal something else or hopefully everything is ok with him, just IVF not working -
Dr._Sher NYCRoad - no, not usually.
Daniel_Becker Welcome to The American Fertility Association's online educational session. We are pleased to have Dr. Geoffrey Sher, (Sher Institues of Reproductive Medicine) joining us this evening. We will be discussing the topic "High Tech Options, Including IVF". Thanks for joing us this evening! Daniel Becker, Esq., Board Member to The American Fertility Association.
Daniel_Becker Please feel free to post questions for Dr. Sher. Keep in mind that you may need to repost them as the room is quite busy. You may want to save your questions in a word docutment instead of having to retype them.
Beky What should done after a miscarriage
kf220 Dr. Sher. My husband and have done iui 4 times. He has had 7 and 10 million motile sperm each time. Do you think we'll need icsi? What are the chances of birth defects associated with icsi?
Dr._Sher renee - IVF is an art/science, not everyone agrees on the same approach. Just look at the immunology debacle. That should exemplify the point.
Yvonne_ Dr, in your experience, is IVF the best route after one IUI which resulted in cornueal ectopic preg, which ended @ 7-8 weeks via d/c? or should IUI be given another chance? thanks
Dr._Sher beky - after the miscarriage, the products of conception should be checked for karyotyping (chromosome makeup). Most miscarriages are due to chromosomal problems so that if there are none in the products it points to implantation failure usually and it is likely to recur. This means that treatment should be implemented to prevent another one.
Daniel_Becker Check out US News and World Reports, 9/27/04 issue to see Dr. Sher in PRINT!!!!
hopeful Dr. Sher, I've had approx 6 inseminations, no luck, 1 tubular pregnancy and now are trying a 3rd opinion. After all the basic testing, once again we are told we are in good shape but because I am 43 they recommend egg donor ivf. They give 50% chance. I'm drained and scared???
Daniel_Becker Please feel free to post questions for Dr. Sher. Keep in mind that you may need to repost them as the room is quite busy. You may want to save your questions in a word docutment instead of having to retype them.
Dr._Sher kf220- I would say so and I would also say that IUI in cases of moderate to severe male infertility that cannot be reversed by simple medical or surgical treatment on the man warrants ICSI. IUI will not improve the chances. The birth defects with ICSI relate to the cause (primarily male infertility and/or age of the woman) not the technique itself. We do 100% ICSI at our private practices throughout SIRM.
kf220 do you recommend doing genetic testing on the embryo if the male partner has 3 million sperm/cc and about 36 million total sperm count?
Daniel_Becker Welcome to The American Fertility Association's online educational session. We are pleased to have Dr. Geoffrey Sher, (Sher Institues of Reproductive Medicine) joining us this evening. We will be discussing the topic "High Tech Options, Including IVF". All questions are welcomed. Thanks for joing us this evening! Daniel Becker, Esq., Board Member to The American Fertility Association.
Dr._Sher yvonne - ectopic pregnancy is usually due to tubes damaged by inflammation i.e., PID which in 80% of the cases in this country is without a history of an acute attach. PID affects both tubes in all cases even if one is more severly affected and blocked while the other is open. The inside of the tube is permanently damaged that is why the risk of a 2nd ectopic is 30 times greater. Thus, a normal pregnancy is less likely after an ectopic and it is why IVF, especially in a woman over 35 running out of time, is often the best next step.
bpaul Type hereDr. Sher, How many mature follicles do you like to see before giving the HCG triggor shot?
Dr._Sher hopeful - you got good advice.
Daniel_Becker Please feel free to post questions for Dr. Sher. Keep in mind that you may need to repost them as the room is quite busy. You may want to save your questions in a word docutment instead of having to retype them.
Daniel_Becker Please be patient - I am sure that Dr. Sher will be right back!!!
Beky what should you do after one miscarriage?
renee Do you know why there is such a discrepancy between east coast and west coast donor egg policies. I met with a Dr. in Los Angeles who provides pictures of all donors. Also, the patient is able to read profiles and assist in the selection process. At columbia and cornell you hand in a form and then you might not here from them for a year until they have a donor.
Daniel_Becker The American Fertility Association has free membership! Please go online and you will have access to all our publications at "No Barriers".
Dr._Sher beky- I answered above, please refer to transcripts.
Julia Dr Sher I'm APA +ive & finally being treated for it after 2 IVF m/c now on my way to the 3rd with Fragmin & BA what is your opinion of Fragmin vs Heparin or Lovenox
Beky ok sorry I missed it
Daniel_Becker renee - I am not sure if it is a East v. West - it is more like IVF Center to IVF Center
bpaul Is it wise or necessary to see a board certified endocrinologist when researching a dr. for infertility? What qualifications should a dr. have to be doing IVF?
Jim Do you believe that sperm collection can be done at home and the sperm still be good?
Dr._Sher renee - it is not an east coast/west coast issue, it is the policies made by individual programs. In our practices throughout the US we provide pictures and even verbal interaction under a moderator. We have no waiting list and use one donor agency internally.
Daniel_Becker Jim - IMHO Yes but it must be brought in within a short window of time.
Jim how short?
Julia Dr SHer I'm APA +ive & finally being treated for it after 2 IVF m/c now on my to the 3rd IVF & implementing Fragmin & BA what is your opinion of using Fragmin vs Heparin or Lovenox?
Jim half a hour? one hour?
Daniel_Becker Jim - When I was in treatment - I was told within one hour
Daniel_Becker lease feel free to post questions for Dr. Sher. Keep in mind that you may need to repost them as the room is quite busy. You may want to save your questions in a word docutment instead of having to retype them.
adrean hello everyone
Daniel_Becker Welcome to The American Fertility Association's online educational session. We are pleased to have Dr. Geoffrey Sher, (Sher Institues of Reproductive Medicine) joining us this evening. We will be discussing the topic "High Tech Options, Including IVF". All questions are welcomed. Thanks for joing us this evening! Daniel Becker, Esq., Board Member to The American Fertility Association.
Heather hello
Daniel_Becker Please use the private button to chat among ourselves while the doctor is here. It becomes very confusing for the speaker to try to find the questions.
Dr._Sher bpaul-you need someone with experience and a track record and being board certified as statistics show doesn't necessarily mean good IVF. Patrick Steptoe, the founder of IVF, wasn't board certified. In fact, until 5 years ago it wasn't necessary to have any knowledge about ART to do the RE boards. So, does that mean that the RE's who qualified then shouldn't do IVF? No, I doubt it. Being an RE just shows that the doctor has some special training in infertility.
Julia Dr Sher Im APA +ive & finally after 2 IVF m/c I'm being treated for it by implementing Fragmin & BA I'm ready to begin 3rd IVF what is your opinion in using Fragmin vs Heparin or Lovenox?
Heather Dr. Sher do you think that everyone deserves a chance to try with their own eggs? Some doctors won't even let you try. I think that is because of the success rates that are published. What do you think?
walkerbaby Today after U/S - cycle day 3 - I was denied Clomid for IUI b/c one follicle is too large, i.e., ovulation cyst is too big. Doc said try again after next cycle - if follicle size reduces, then go ahead w/ chlomid protocol. What are my options for infertility treatment if the follice stays too big for several months? (Aside from BC pills)
Dr._Sher julia - we prefer using regular heparin or lovenox. The former preferably. Aspirin has no effect on implantation failure. Embarrassingly, I was the first to recommend aspirin for this purpose and have had to recant.
kf220 do you think it is necessary to do genetic testing if the male partner has 3 million sperm per ml and about 36 million total?
adrean Dr. Sher I am 23 and reciently found out I was not ovulating. My doctor is going to put me on birth control to regulate everything and when my husband and I want to try to have a baby we will need to go on clomid. I have already had 2 children and am wondering what the success rate of clomid is?
Daniel_Becker Please feel free to post questions for Dr. Sher. Keep in mind that you may need to repost them as the room is quite busy. You may want to save your questions in a word docutment instead of having to retype them.
Julia Dr sher any reason why you prefer Heparin or Lovenox over Fragmin? is it less effective?
Dr._Sher heather- if you are prejudging simply on the basis on trying to achieve the best IVF success rates then you will take that attitude. I don't believe anyone has the right to make those judgments based purely on self interest. The patient should have the final say.
bpaul Dr. Sher, typically at what follice size would you triggor an IVF patient? I know this is a general question but how big is too big?
Heather So even if I have a high fsh you would let me try with my own eggs before insisting on donor egg?
Dr._Sher andrea- you need to be evaluated to see whether clomid is appropriate, it doesn't work on everyone. For example, if you have an elevated FSH (unlikely but possible) or if your periods are more than 5 weeks apart or if there is male factor or endometriosis, clomid is not likely to be a good choice. There is no such thing as "one size fits all".
bpaul What cell division do you look for on day 3 for a better chance of pregnancy? I've heard really only 7 and 8 cells make it. Would you agree?
Daniel_Becker The American Fertility Association has a set of message boards, several which are moderated by a physician daily. Please feel free to stop by and ask questions there as well! Also, "Connections" will meet every week for an online educational session. Please check the schedule on our home page.
Dr._Sher julia- a recent publication has supported this view which I have held for a long time. WE have been using heparin for more than 10 years and it seems to work best. Lovenox is ok, but I still prefer regular heparin with all of its problems of having to administer twice daily, local brusing, etc.
Dr._Sher bpaul- when at least 2 follicles are 18-22 mm and half of the remainder are over 15 mm.
adrean Dr. Sher can my regular ob/gyn give me the complete evaluation to determine if clomid is the right choice?
Yvonne_ Dr, if one is limited with the number of attempts for IVF, would you recommend also proceeding with ICSI and PGD, just to be sure the one chance is pretty viable? I just turned 35 yesterday, and hubby feels we need to maximize our odds. Except for the iui ending in the ectopic, everything else was pretty easily dealt with. Thanks!
Daniel_Becker bpaul - I would not say that to my oldest son - his pre-embryo was less than 6 cells and was highly fragmented
bpaul Thanks Dan. That is so nice to hear!
Dr._Sher heather-absolutely, yes. Remember, age is the main determinant of egg quality. FSH merely points to the likelihood of getting access to eggs (ovarian reserve). This of course depends on whether or not an indivudalized stimulation is used. I would avoid microflare protocols and even late antagonist (antagon/cetrotide) protocols. We have been using a protocol called "agonist/antagonist conversion protocol" with estrogen priming and have had great success. Email me at gsher@sherinstitute.com and I will send you information about this exciting protocol especially for poor responders.
kf220 You say icsi is not associated with birth defects but the partner with the fertility problem is. How low is too low? Is there a way to prevent birth defects by doing some tests on the male partner or on the embryos before implantation?
Daniel_Becker kf220 - PGD is the test on a pre-embryo to help determine if it is normal or abnormal
adrean is he gone for good? My first time.
Daniel_Becker Welcome to The American Fertility Association's online educational session. We are pleased to have Dr. Geoffrey Sher, (Sher Institues of Reproductive Medicine) joining us this evening. We will be discussing the topic "High Tech Options, Including IVF". All questions are welcomed. Thanks for joing us this evening! Daniel Becker, Esq., Board Member to The American Fertility Association.
kf220 is it recommended for male factor?
Daniel_Becker adrean - I am sure he will be right back
hopeful We were told today, that with egg donor there is a chance there won't be any eggs left to freeze for a 2nd chance incase it doesn't work the first time?
adrean I just reciently found out I am Infertile and wanting to find all any info I can.
Daniel_Becker It is recomended if first you can afford it - second if there is some history of genetic issues that concern you
bpaul Approximately how much does an egg donor cost?
Daniel_Becker bpaul - it depends on lots of factors - you should check out the message boards to get a better idea
adrean has everyone successfully produced a baby?
Daniel_Becker Hopeful - sorry to hear that -we were never lucky enough to have anything frozen
kf220 thanks.
renee Do you know if Dr. Sher's office accepts GHI or Oxford insurance? I know some dr.'s do.
Daniel_Becker First - IVF-ICSI-TESE - second IUI - Donor
bpaul Yes Adrean,. We did on IVF #2 and I was 36. We got pregnant on IVF #3 at 37 but MC at 8 weeks. So hang in there!
Daniel_Becker Welcome back DOC!!!!!!!!!!!!!!!!!!!!!!
Daniel_Becker Please feel free to post questions for Dr. Sher. Keep in mind that you may need to repost them as the room is quite busy. You may want to save your questions in a word docutment instead of having to retype them.
adrean dr. sher can my regular ob/gyn preform the evaluation to determine if clomid is the right choice for me?
Dr._Sher kf220-unfortunately this is the new frontier. We should all function at a level of armed neutrality when it comes to accepting new methods and it is good to have a high index of suspicion but the answers are not there as of yet.
Daniel_Becker The American Fertility Association has a set of message boards, several which are moderated by a physician daily. Please feel free to stop by and ask questions there as well! Also, "Connections" will meet every week for an online educational session. Please check the schedule on our home page.
hopeful I'm not sure I understood your response on you were never lucky enough to have anything frozen. Is it common to purchase 16 eggs from a donor and not have any good ones left to be frozen incase the 1st try doesn't work?
Noreen dr. sher - what is the rate of success typically 25-30% with IVF
Daniel_Becker Hopeful - we did not use an egg donnor but we did 7 IVF ICSI Cycles and we never had left over usable pre-embryos for freezing
Dr._Sher hopeful- We never touched on this issue. But yes, it is possible to have 16 eggs, translating to about 10 embryos, transfer the best ones fresh and have none that make it to blast for freezing. Only 40% of 7-9 cell good quality embryos make it to blast. Those that don't are highly unlikely to do so in the uterus. This is not an absolute but highly likely to be factual.
Daniel_Becker Welcome to The American Fertility Association's online educational session. We are pleased to have Dr. Geoffrey Sher, (Sher Institues of Reproductive Medicine) joining us this evening. We will be discussing the topic "High Tech Options, Including IVF". All questions are welcomed. Thanks for joing us this evening! Daniel Becker, Esq., Board Member to The American Fertility Association.
renee Dr. - back to the DFI index. If I was to undergo IVF with donor egg, would the SCSA scan be very important to do, prior to using egg donor?
Julia Dr SHer I WAS KICKED OFF PREVIOUSLY WHY DO YOU PREFER HEPARIN OR LOVENOX VS FRAGIM TO TREAT APA?
walkerbaby How likely is is that follice too large for Chlomid/IUI will reduce in size over the next cycle?
Dr._Sher renee - yes, it applies equally if your husband has poor quality sperm or has never initiated a viable pregnancy.
Daniel_Becker The American Fertility Association has free membership! Please go online and you will have access to all our publications at "No Barriers".
Dr._Sher See transcripts for heparin.
Julia DR Sher where can i find transcripts for Heparin
Noreen what is the typical success rate on ivf
Dr._Sher walkerbaby- it depends on why you had one so dominant. It may have to do with your underlying ovarian reserve. If that is low then clomid is not the right treatment. You would probably be better off with gonadotropin injections in the right hands.
Daniel_Becker Julia - check The AFA site to see the Transcript of this chat in a few days
Dr._Sher julia - in the transcripts of this chat.
Yvonne_ Dr, with limited IVF attempts, probably one, would you recommend ICSI and PGD? our first IUI was rather normal, until ectopic. We dont have unlimited funds for treatment, nor any group coverage, so we are rather limited with chances for treatment. Thanks
bpaul Dr. Sher, what is the difference between a lupron protocol and antagon? Do you have a preference?
Daniel_Becker The American Fertility Association has free membership! Please go online and you will have access to all our publications at "No Barriers".
Dr._Sher noreen- the national average for women under 39 yrs is about 30% but the success rates can vary from single digits to up to 60% with own eggs and even higher with donor eggs in certain centers of excellence. Again, it depends upon age, ovarian reserve, and implantation potential.
Julia Should Fragmin treat my APA issue?
Julia or will Fragmin not help?
renee How long has the SCSA test been around?
bpaul What is the SCSA test?
Dr._Sher bpaul-that's a long answer, feel free to email me at gsher@sherinstitute.com and I will send you detailed information per return.
Julia Will Fragmin treat my APA issue or will it not help? I paid $3000 for this medication
Julia & it is our 3rd & last IVF/ICSI cycle
walkerbaby Dr. Sher - What does "low ovarian reserve" mean? Thx.
bpaul HOw many mature follicles are the minimum you would like to see for an IVF cycle?
Dr._Sher renee-SCSA is a test that evaluates the DNA integrity of sperm. The fragmentation index of DNA if it is above 30% is a sign that the likelihood of successful implantation will be lower. The embryos may look good and even initially attach but the pregnancy is less likely by a factor of 2 or 3 to reach viability. There is treatment available with antioxidants and vitamins that can fix the problem in about 60-70% of cases where the DFI is raised, sometimes surgery for obliteration of a varicocele will work when medical treatment fails. If nothing solves the problem and the DFI is very elevated, donor sperm may be required. The SDIA measures the same end point as the SCSA. We do the former.
Julia Dr Sher will Fragmin treat my APA issue I have spent alot of $ on this medication & it's our 3rd & final IVF/ICSI cycle
Dr._Sher julia-please discuss this with your RE. NOthing is absolute. I'm not suggesting it won't do the job, but in my opinion, regular heparin and secondly lovenox is better. He/She may disagree.
Julia thk you
Daniel_Becker Check out US News and World Reports, 9/27/04 issue to see Dr. Sher in PRINT!!!!
bpaul Dr. sher, We have severe MF and have done 3 IVF cycyles. 2 pregnancies but only one successful with a baby boy. We have extremely low fertilization rates even with ICSI? Do you think it woul d be helpful for us to do SCSA testing? My husband has already had varicocele surgery. do you think are chances are better b/c we have already had a successful IVF?
Dr._Sher walkerbaby-that the woman over time has depleted so many of the eggs in her ovarian repository that every month far fewer are available for recruitment and rescuing with fertility drugs. Usually on day 3 the FSH is >9, the Inhibin B is < 45 and the antral follicle count by ultrasound is < 8. Also, there will be a history of poor response to injectable fertility drugs in the past.
Daniel_Becker Don't panic - I am sure that Dr. Sher will be right back
walkerbaby Dr. Sher - Thank. I'm almost 34 & first attempt. What are my best alternatives? Donor eggs?
walkerbaby Daniel - can I print a transcript of tonight's chat?
Julia good question alkerbaby
Daniel_Becker walkerbaby - yes but I am not sure when the transcript will be ready - check in a day or two.
Julia i was thinking the same
bpaul Can severe sperm fragementing result in a trisomy m/c? We m/c at 8 weeks and were told it was a trisomy after genetic testing. Can a severe male factor be the cause of this?
Julia Daniel Becker where do we call for those
Daniel_Becker The American Fertility Association has free membership! Please go online and you will have access to all our publications at "No Barriers". The American Fertility Association has a set of message boards, several which are moderated by a physician daily. Please feel free to stop by and ask questions there as well! Also, "Connections" will meet every week for an online educational session. Please check the schedule on our home page.
Dr._Sher WOW, this is the 3rd time we were kicked off the server.
Daniel_Becker Well, we are very glad that you have comeback
Dr._Sher I'm all ears.
Julia Dr Sher now Im scared Fragmin won't treat my APA
hopeful Regarding donor eggs - Is it common not to have any eggs left to freeze incase this egg donor ivf doesn't work the first time?
Julia I really respect yr opinion
Daniel_Becker Now would be a good time to repeat some questions because we only have a few more minutes
Julia & know you're usually right baout things
Yvonne_ dr, do you recommend PGD and ICSI with IVF, everything else pretty normal, age 35, only the one iui w/ ectopic. thanks!
Dr._Sher hopeful - I believe I responded to this above, you will find it in the transcript.
bpaul Dr. do you think severe MF should have sperm genetic testing? We have horrible ferilization rates with ICSI. Out of 3 IVF's 2 pregnancies. One= healthy baby boy and 1 trisomy mc at 8 weeks. Can the sperm be the issue? or is it unlikely seeing as we have already had one baby?
hopeful Are there any organizations that help financially. This egg donor ivf is $20,000
Dr._Sher yvonne- I responded to the lack of benefit in using PGD to select embryos for transfer. See the transcript.
Yvonne_ are clinical trials helpful for IVF costs? are they worth it? has anyone done them?
Yvonne_ sorry, did not see it!
Daniel_Becker Welcome to The American Fertility Association's online educational session. We are pleased to have Dr. Geoffrey Sher, (Sher Institues of Reproductive Medicine) joining us this evening. We will be discussing the topic "High Tech Options, Including IVF". All questions are welcomed. Thanks for joing us this evening! Daniel Becker, Esq., Board Member to The American Fertility Association. The American Fertility Association has free membership! Please go online and you will have access to all our publications at "No Barriers". The American Fertility Association has a set of message boards, several which are moderated by a physician daily. Please feel free to stop by and ask questions there as we
Julia DR Sher now Im scared Fragmin won't treat my APA & it is our 3rd cycle I really respect your opinion I'm a little concerned
walkerbaby Dr. Sher - re low ovarian reserve. WOW! At 33 & my first attempt, would donor eggs be my nect best option?
Dr._Sher yvonne-trials are always ongoing and they usually are backed with a grant. You need to assess each one individually and understand what you are getting into. Remember, this is not about doing IVF, but rather about having a baby.
jaggrotke Is there a maxium dose for FSH medicines when doing an IVF cycle? I've had one doctor tell me that he wants to administer a total of 6-8 amps a day (half in the am and half the other half in the pm), and another doctor who feels that, given my high FSH levels after 10 days of 3-4 amps a day, that more than 4 amps a day would not make a difference. What are your thoughts?
Dr._Sher walkerbaby-at 33 it is worth trying with your own eggs using an indivudalized FSH dominant long protocol with estrogen priming because age is the major determinant of egg quality, not FSH. Thus, unless you are immenently premenopausal, I would say it is worth trying with your own eggs at 33.
bpaul At what point would you recommend sperm genetic/fragmenting testing?
Dr._Sher jagg-there is no absolute highest level and it is not the length of time of stimulation that matters but rather the initial dosage in the first few days of stim that will determine the number of follicles rescued. Email me and I'll send you more info.
Dr._Sher bpaul - before starting an IVF cycle so you could do something about it if it comes up abnormal.
Daniel_Becker One Last Question?
Dr._Sher Yes, fine.
Daniel_Becker Well, unfortunetly it is that time. Let's all give Dr. Sher a "Cyber-Hand" for doing such an excellent job this evening. On behalf of The American Fertility Association we thank you for taking the time to share this important information with us.
Yvonne_ thank!
Yvonne_ s
bpaul Thanks so much!
renee thank u
jaggrotke thanks
Julia thx now im scared Fragmin wont treat my APA I wish I was prescribed Heparin
Dr._Sher It is absolutely a pleasure to support AFA in such noble endeavors. You truly have a great organization and I appreciate being able to play a small part in your noble agenda.
Julia sigh
renee very informative
Daniel_Becker Good Night all and remember to check out our Web site for other exciting educational sessions!
kf220 thank you!
Daniel_Becker Good Nite ALL - Hope all your dreams come true!
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