# Confused following telephone consult with Dr Sher - what do you think?



## suitcase of dreams (Oct 7, 2007)

Hi girls,

Well, so many people recommended Dr Sher that I thought I'd give it a go...had to keep re-scheduling due to me being away, but finally had the call this evening

I was kind of expecting him to tell me to just keep on doing what I'm doing with the immune treatment and that sooner or later I'd get lucky

Instead, he tells me that there is no reason why I can't use my own eggs, that the PGD is misleading and egg quality can vary significantly from cycle to cycle, that I should be on a completely different stimulation protocol, that I need HLA and DQ Alpha tests done and then I need the sperm donor also tested for HLA and DQ Alpha to make sure we are compatible
He also said I should be on gestone at least 6 days before ET, and intrallipids at least 4 days before - whereas on my last cycle I was only on gestone for 3 days before transfer and had the intrallipids 2 days before....so all that money at LWC wasted as he believes it would never have worked without starting the gestone/intrallipids sooner

Anyway, needless to say I have been totally thrown by this suggestion that I could be successful with my own eggs. And I'm also wondering about this whole HLA/DQ Alpha thing - can't see any way I can get the Reprofit sperm donor tested, so does that render my April cycle in Brno pointless too? Have paid a deposit so would be a financial loss to cancel, but if there's a risk the sperm donor isn't compatible, is it silly to go ahead?

So what do I do? Carry on with Reprofit, make sure I'm on the gestone and intrallipids in time, and just hope the sperm donor is compatible? Or stop, review, consider using my own eggs? Chances of going to Vegas are pretty slim though, especially for an OE cycle - I don't even have enough holiday to do that after my Nepal trip

Ho hum, rather wish I hadn't had the consultation now. Any wise words from you knowledgeable single girlies on what to do next?

Off to make myself a creamy hot chocolate and to have a bit of a think about all this....
Suitcase
x


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## blueytoo (Oct 5, 2003)

Hi Suity

Dr Sher also recommended that I have the sperm donor tested for HLA and DQ matches to make sure there is no match. However, as far as I know you can only have this done in the USA, nowhere here in the UK will do it and as far as I know the Czech Republic won't have the facilities to do it either as the bloods can only be tested in the USA. He did give me the exact percentage chance that the sperm donor would be a match and I did write it down but can't remember it off the top of my head!

He also pointed out that my immune drugs had been given at the wrong point in my cycles here and that was why they had no chance of working. You won't find a single doctor here that agrees with that except maybe Dr G (Lister/Care/Argc stick to the same closer to EC/ET protocol) but Dr Sher's success rates with immunes complete blow all of those clinics (including Dr G) out of the water.

Based on that, I decided that until I can afford to go to Las Vegas (one cycle there is about the same as 2.5-3 cycles OEIVF at Reprofit once you add in the drugs and immune drugs, flights, hotel etc - Reprofit comes out at close to £5k for me once everything is added up) that I would do OEIVF at Reprofit using Dr Sher's stim protocol etc and his immune protocol and lack of down reg that he suggested for me. So basically, doing everything he said except getting the HLA and DQ Alpha tests which wouldn't be possible anyway.

TBH I'm not at all surprised he said that to you about trying again with your own eggs as I knew that he has said that egg quality varies hugely cycle to cycle and PGD is no indication of the true situation.

Could you consider doing his full protocol but going to Reprofit on an OEIVF cycle?

I think he really is the top expert in immunes & more difficult cases etc and his success rates speak for themselves. If he believes an OEIVF would work for you then I'd be strongly inclined to believe that. Personally I wouldn't risk following any other immune protocol than his, I've even adjusted my steroids dose down from the typical UK dose for NKC to his recommended dose for this cycle.

Just my thoughts!  

Claire xx


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## midnightaction (May 20, 2003)

I am following Dr Sher's protocol and immunes but am going through Reprofit to do it. Stepan has been very accommodating of the particular protocol and the drugs that I need. I would love to be able to cycle with Dr S in Vegas but I just can not afford it and doubt that I would ever be able to.

I was all ready to go for a DE cycle this March and it was all booked up with Stepan, but Dr Sher has convinced me that I really shouldn't give up on my eggs, as like he has told you egg quality can be different cycle to cycle. He has also convinced me that PGD is not really a good indication of embryo quality and that CGH is a much better tool to identify competent embryos and gives pretty high success rates. I believe Care in the UK are the only ones currently doing CGH, but I am sure I read somewhere that the Lister might be starting it as well.

Dr Sher has convinced me also that the protocols I have followed in the past have been completely wrong for me as they have given me premature LH surges half way through my cycle which has caused poor egg quality. This cycle I am doing the Agonist/Antagonist conversion protocol which keeps your LH really low throughout the whole cycle, that combined with a much higher stimms dose, I am hoping will give me a much better response.

I have discussed the HLA/DQ issue with Dr S and he has told me that in my situation it is not really necessary to have this test unless I feel like I really need it. Because I am using Donor Sperm he has said that this match is not quite so important because if there is a match you can just change the donor. I think he may have told you something a little different so it may be worth considering having this test, but it isn't something I am gonna consider, if this cycle doesn't work then I will just change the donor and hope that makes a difference.

I have been told that intralipids have to be between 7-10 before ET and any time before or after that won't have the desired effect.

Anyway I am rambling, and I think ultimately your the only one who can decide what feels right for you and if it is worth trying OEIVF again or not, I can only say that Dr S has given me hope that my eggies might still work and to give them one last try. If this cycle fails then I will more than likely move on to DE, but I will feel that for me I have tried everything that I possibly can.

PM if you wanna know anymore about the protocol I am doing etc

Take care hun 

Sarah xxx


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## Violet66 (Dec 28, 2007)

I wouldn't know what to advise (helpful eh?) 

I will say that in the short time I've been doing this I have discovered that every single doctor and clinic seem to have their own methods that they are convinced are right - which the next clinic will rubbish completely. 

If following his protocol at a cheaper clinic is affordable then (in your shoes) I would probably look at that because, as you say, he does have the most amazing success stats.


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## suitcase of dreams (Oct 7, 2007)

Thanks all

midnight - I completely agree with Dr Sher that you should give it another go with your own eggs and with his stimming protocol and immunes etc, after all you are a mere 30 yrs old   

I, however, will be 40 this time next week, and I think I have to be very realistic about my chances with my own eggs. I tend to agree that the cycle when I had PGD may not necessarily indicate that I have no good eggs left at all (despite all of them being severely chromosomally abnormal that time round) but at the same time, I think the overall stats for 40+ years are 1 in 6 eggs being normal. And that feels like pretty low odds to me, especially combined with my immune issues...and after 2.5yrs, so many failed cyles and the miscarriage, I just want a healthy baby, and I want one NOW   

So I've pretty much decided to stick with DE to maximise my chances of getting good eggs. I've given it so much thought and am comfortable with DE now, and it really seems like that would give me the best chance for success. 

I am def going to make sure I get the immune protocol as 'perfect' as I can for the upcoming cycle though. That said, I don't think I'm going to do anything about the HLA/DQ tests since that would mean importing from a US sperm bank and faffing around getting the donor tested as well as getting my own tests done etc. I may read up on it a bit more and see what the chances are of me and a donor chosen at random being a 'bad match' - and perhaps if I am not successful in April, I will pursue that option for subsequent cycles.
So now I just need to work out what is the perfect immune protocol for me, shall double check that with Dr S when I have the follow up call

It's all so hard isn't it? Here's hoping that this is our time  
Suitcase
x


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## Felix42 (Oct 14, 2007)

Suity, sorry to hear about your confusing consult. I would agree with you that its probably best to stick with DE but to add in some of the elements of Dr Sher's protocol. At least with DE, you are maximising the Egg quality aspect both in terms of a BFP and an ongoing healthy pregnancy and then you can maximise the 'environment' for those eggs by working on the immune aspect. Also I guess chopping & changing at this stage might be a bit too unsettling. Wishing you so much  for your upcoming treatment!

Love & hugs, Felix xx


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## Malini (Jan 23, 2009)

Hi,

I don't know if this is helpful but I thought I would let you know I am here if you want to discuss being treated by Dr Sher and cycling in LV with SIRM.  My signature sums up my story and I understand that significantly I am younger and have autoimmune issues but not alloimmune ones, so very fortunate for that and I appreciate it.

It is true that every clinic and doctor has their own approach and finding fans of Dr Sher in the medical world is a lot like looking for hen's teeth.  I am now very biased.

While I cycled with him and beforehand, I haunted the forums www.ivfconnections.com and www.haveababy.com to see whether he really could make a difference to me and I watched a mixture of stories, turnarounds and disappointments.  I wish there were easy answers but please feel free to ask me anything on here or by PM and I will answer as best as I can.

Wishing you ALL well and your dreams,
Malini xx

/links


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