How do I track my cycle?


When you are Trying to conceive (TTC), the first thing you need to think about is, how to track your cycle. Ask yourself: Do I get my period on a monthly basis, is it the pretty same time each month? And how long does my last? Does one month differ from the next?

So, Let’s track a Cycle: This is an example of a 28-Day cycle, so days can vary with individuals.

You can start by using a calendar and you are going to mark Day 1 of your cycle the first day of AF that you have a full flow and not spotting. So if you start seeing blood and it’s spotting but the next day you are flowing, count the day of flow as Day 1.

During your period, you are shed the thickened uterine lining and extra blood through the vagina. Your period can vary each month and it can be light, moderate or heavy depending on how much you bleed. It’s common for a period to last 3-5 days but others can last 2-7 days, which is normal.

After AF your body is getting ready for the next step, which is ovulating. For most women a 28-day cycle is common and this should occur on Day 14 or 15. Ovulation is when the egg is released from the ovary and goes down the fallopian tube where it waits for the sperm and this is where fertilization occurs.

Once fertilization occurs, the egg stays in the fallopian tube for 3 days before it moves down to the uterus for implantation. So this would be on Days 16-19 approximately. Implantation generally occurs 6-10 days after ovulation, or on Days 20-24 of cycle. The fertilized egg goes through its cell division and corpus luteum, which is left from the follicle that released the egg, produces progesterone at this time, which is preparing the lining of the uterus for implantation.

Once the embryo implants in the uterus this is when the pregnancy hormone HCG is produced. HCG can be detected in the blood about 11 days after conception and about 12-14 days by the urine HCG test. Generally HCG will double every 72 hours.

So let’s make it easy to see – Day 1 is January 1

January 1 – Day of full flow

January 1-7 Menstruation (Menstruation could be 3-5 or 2-7 days long)

January 14-15 Ovulation occurs

January 16- 19 Egg fertilized and is still in fallopian tube but starts it’s trip to the uterus

January 20- 24 Implantation occurs and HCG is starting to be produced

January 26 – HCG can be detected in the blood

January 27- 29 HCG can be detected in the urine

January 28- If not pregnant AF should be starting again around this date.

So this is what a typical 28- Day cycle looks like : we need to verify these dates using the Ovulation Predictor Kits (OPK’s) or some women can use their own bodies with symptoms. Some women don’t get symptoms so the kits will help. You really need to track 2-3 months to see your pattern and see if your body repeats this pattern each month.

Our nurses would tell the patients to start the OPK’s on Day 9 to start testing. I read on the box at the store the company wants you to start on Day 5. This may because some women have no idea when they are ovulating and they don’t want you to miss it. If you are not sure start on Day 5 but once you find out that it is after Day 9, start on Day 9, so you are not wasting test strips. It is best to test the same time everyday either morning or afternoon.

The test strip has what is called a control line or reference line. This line is important to see, so you know the test kit is working properly. Take a good look at this line note the color and intensity of the control line. This kit is measuring the hormone LH and this hormone is being produced during this part of your cycle, so you will start seeing a test line appearing, but it has to match up to the control line intensity or darker to be considered POSITIVE. We want to pick up when LH SPIKES, then this tells you will be ovulating in the next 36 hours. I have heard from patients the color blue and purple can be hard to read. It is very important to read it exactly when the instructions tell you…. by reading it after the time the color can change and give you wrong results.

So your fertile window is 5 days before ovulation and the day of ovulation. Sperm can stay alive in the cervical mucus for 5 days so there is a total of 6 days for your fertile window. So in the cycle I put together the fertile window would be Day 12 – Day 17.

I gave you this example because the numbers were easy to see…Cycles start anytime of the month that is why you have to write these things down on a calendar or on an App and it will help you keep track. Not every month is the same, they can vary slightly.

But definitely see your physician if you are not having your period, sooner than later.

Some women have shorter cycles, lasting only 23 days; some have much longer ones, lasting up to 35 days. If your cycle is shorter or longer this could indicate a hormonal problem, so it might be beneficial to consult your OB-GYN. I found this site that can help you predict your ovulation date for cycles that are not 28-day cycles. This might be able to guide you if you know how many days in your cycle.

If you are not having a period each month or have missed your period for a long time, you need to go to your OBGYN. They will be able to test your hormones and see what’s going on. You can’t get pregnant without your period.

Don’t be confused with the pregnancy test kit, we only produce the hormone HCG when we are pregnant, so if you get a faint line on a pregnancy test then you are most likely just pregnant and you should call your doctor to do a blood test.



Dr Sher answers a question on Human Growth Hormone for Fertility…..

Hi Dr Sher, A question from my group..What are you thought on HGH for fertility?Reply:
A woman’s reproductive potential is very much influenced affected by her “biological clock” which comprises two components:
1. Age: Advancing age is inevitably accompanied by a progressive reduction in the number of eggs in the ovaries (“ovarian reserve”). As a diminution in ovarian reserve (DOR) ultimately passes a theoretical “threshold” the woman becomes progressively more resistant to stimulation with fertility drugs. This is accompanied by a fall in blood AMH levels and a rise in basal blood FSH. After several years of progressive DOR, the ovarian reserve is ultimately depleted, and ovulation as well as cyclical menstruation ceases (menopause).
2. “Egg Competency” The second component of the biological clock is an inevitable age-related decline in egg competency (the ability of an egg, upon fertilization, to propagate a healthy embryo) . The most important manifestation of this age-related occurrence is an inevitable and rapid increase in the percentage of eggs that have numerical chromosome irregularities (aneuploidy). By way of example, at age 30Y, about one out of every two human eggs will be aneuploid while at 45Y more than nine out of ten are so afflicted. Aneuploid eggs cannot propagate healthy babies. Most will not even fertilize and those that do, will usually be lost as early miscarriages or go on to produce a birth defect such as Down syndrome.
It is important to understand is that e the two components of the biological clock (i.e. ovarian reserve and age) represent variables which while they are often interrelated and inter-dependent can often exist independently. By way of example, some older women in their mid-forties have excellent ovarian reserve while some young women in their thirties have DOR. Yet while they produce fewer eggs, the potential competency of the eggs they produce is largely tied to their age. However, the ovarian hormonal environment brought about by DOR and the protocol used for ovarian stimulation, is readily affected by the protocol used for ovarian stimulation. Selection of the wrong stimulation protocol can adversely influence egg competency. Conversely, an individualized and optimal protocol for ovarian stimulation by favorably regulating the ovarian hormonal environment, can improve the potential for optimal follicle and egg development thereby minimizing the risk of egg aneuploidy. The problem is that it becomes progressively more difficult to optimally regulate the intra-ovarian hormonal environment in older women, and in those with DOR, and it is here that the use of human growth hormone can play a valuable role.
Several researchers have shown that the administration of human growth hormone (HGH), as an adjunct to ovarian stimulation, enhances follicle response in older women and those with DOR and so can help optimize egg quality. It is thought that HGH hormone by increasing the production of insulin-like growth factor 1 (IGF-1), improves follicle development, estrogen hormone production and egg maturation. Two basic mechanisms have been proposed: 1) improving the response to gonadotropin therapy by up-regulating the FSH receptors on the granulosa cells that form the inner lining of follicles and, 2) through a direct enhancing effect of HGH on the egg’s mitochondrial activity. While human eggs do have HGH receptors, those retrieved from older women show decreased expression of such receptors (as well as a reduction in the number of functional mitochondria) as compared with those derived from younger women. In fact, it has recently been shown that older women treated with HGH showed a marked increase in functional mitochondria in their eggs along with improved egg quality.
My own experience in selectively prescribing HGH as an adjuvant to women with DOR, older women and those with unexplained egg quality deficits, is that if used in combination with individualized protocols of ovarian stimulation it does indeed enhance egg quality and ovarian response, culminating in improved IVF outcome.
I hope this helps!

Spanky asks Dr Geoffrey Sher on Let’s Talk Infertility !

I’m very excited..I posted many of your questions to Dr Geoffrey Sher, Here are his Bio

Awards & Accomplishments

– 30+ years experience with In Vitro Fertilization
– Founder of the first private IVF Clinic in the US
– Influential in the births of more than 18,000 babies
– Trained under Patrick Steptoe and Robert Edwards, the “Fathers of IVF”
– Internationally renowned authority on immunologic causes of infertility
– Pioneer of many “firsts” in the field of IVF
He is located in Las Vegas NV…

So Fridays will be ” Answers from Dr Sher” I want to do this for a long time , so I need questions from all of you……

So Let’s Talk Infertility:     1st question?

Spanky Glasses

Spanky asks:
Dr Sher
Why after a loss- Does it take so long to get cycle back and why is it so different than before. AF (Aunt Flo)longer and O (Ovulation) is much later?

Dr. Geoffrey Sher – August 4, 2016 reply

After a pregnancy the central control over hormonal cyclicity can take a while (usually up to 2 months to reinstate.)
Geoff Sher

Sperm Tales made it to the Huffington Post

#AGEMATTERS35 : Why Don’t Doctors Tell Patients That Age Matters ?

07/12/2016 07:33 am 07:33:26

The clock is ticking away….When Do I Have My Baby, Now or Later?
 After listening to a news story from Australia about how fertility specialists are not telling over 40-year-old patients the real chances of having a child, I was disturbed to find out that added-on procedures to an IVF are being performed with absolutely no studies being tested to show that they work. For example embryo glue, which is a product that can be used to help the embryo stick to the uterus, is being used. Does it work? Are patients being charged for false hope?

There are some Medicare rebates for IVF procedures in Australia but there is still cost to the patients. So many couples are having over six IVF procedures and still not pregnant. One specialist mentioned a patient went through over 37 IVFs before having a child. Fertility treatments not only cause stress with the cost of IVF but also there’s emotional stress to couples ― depression, guilt, blame ― the list goes on and on. The show, “The Baby Business,” said that a woman at the age of 43 has less than 3% chance of having a live birth. True this was from Australia but the statistics are not far off in other countries. It’s standard knowledge that a women trying to conceive in her 40’s has an extremely low chance of having a live birth with her own eggs. When specialists are asked the main cause of infertility, the answer is “AGE.” Fertility for women starts dropping very quickly at the age of 35. (#AGEMATTERS35)

Society and lifestyles have changed for women but the number of eggs they are born with haven’t changed and as time goes on the quality and number drop.Women go off to college, find work in their careers, travel, etc., but often times delay the time for having children. Unfortunately, many women don’t stop to think about the real meaning of “the clock is ticking,” which is that the perfect time to conceive is between the ages of 18 – 29. Remember: the older the eggs, the harder it is to get pregnant.

The desire to have one’s own biological children can be strong and compelling, the effects of infertility for individuals and couples who are unable to conceive can be devastating. Treatments of infertility can be medically invasive and may cause discomfort or be associated with health problems for women, men and the resulting children.

The CDC has developed the National Public Health Action Plan for the Detection, Prevention and Management of Infertility. Given the goal of public health to reduce disease, premature death, injury and disability through prevention and health promotion, preventing infertility and results associated with its treatment are important concerns.

The plan is to promote healthier behaviors that can maintain fertility. It is also to help educate, promote prevention and early detection and treatment of medical conditions that threaten fertility, reduce exposure to environmental, occupational, and infectious agents that can threaten fertility.(1)


Women need to think of the big picture…….


A large part is to educate our young women when to have their family. I am not saying to run out, find Mr. Right and get pregnant, but keep this all in your mind. In my book, Sperm Tales: An Informative Guide Through the Challenges of Infertility. In chapter one, When Do I Have My Baby, Now or Later? it reviews an article in Newsweek 2001, about different women who pondered when they wanted to start their families, most of which chose to put it off for several years.

Some were at the height of their careers, others were traveling or going to graduate school. They had no social life and felt that this wasn’t the right time to have children. One woman who was in medical school knew she was pushing the biological time clock. Even so, she felt that the advancement in technology would help her conceive by the time she was ready.

Another woman found her “Mr. Right” at the age of 42 and decided then she wanted to start her family, thinking if movie stars can get pregnant at 40, why can’t I? (Movie stars don’t tell you, there is a good chance they are using donor eggs.) Over the next few years this woman and her husband tried to conceive naturally with no success. They went to a fertility specialist and in time, were able to conceive, but then miscarried. She was devastated. She could not have imagined she would have such a problem conceiving. She asked herself, “What did I do? Did I wait too long to start trying?” To make matters worse, she had spent over $3,000 for the first month of injectable medications.(2)


The general misunderstandings and misguided assumptions about the process are often made worse by the hesitancy of some doctors to mention the topic of age to their younger patients. The above-mentioned Newsweek article highlights that many physicians choose not bring up fertility plans to women under 35 unless the patient herself initiates it. The reasons for this include the idea that some doctors assume that women are aware of the issues related to their fertility or they fear that if it’s brought up might cause them distress or encourage them to make a premature decision to have a child before they are ready. As it is, when a woman visits her OBGYN for the first time the physician usually will ask if the patient is sexually active and if she is using birth control.

In a recent poll, 52% of women over the age of 35 would have made different decisions with better fertility education in their younger years. The new norm is 20% of women having their first baby at 35-45 years of age which has no guarantees and that also includes infertility treatments and higher risks.

Women are very proactive in situations once they have all the major elements to see the big picture, and education is key. My book Sperm Tales: An Informative Guide Through the Challenges of Infertility  is an attempt to help patients start an Infertility program on time and to heighten the chance for success, and also to educate young people to keep a clear head about this harsh reality as they plan their lives, families and careers.



In closing, I think it is so important for OBGYN’s to bring up the conversation of fertility or like Resolve said at National Infertility Awareness Week (NIAW) this past April 2016 ― “#Start Asking!”


1 National Public Health Action Plan for the Detection, Prevention and Management of infertility, CDC, June 2014

2 Claudia Kalb, “The Truth about Fertility,” Newsweek August 13, 2001.


Lynn M. Collins was trained in the Infertility field at Brigham and Women’s Hospital in Boston, MA and later set up and worked for more than 10 years at an Infertility Lab and Sperm Bank in Massachusetts. Collins draws on her experience as a laboratory supervisor for a leading national sperm bank and manager for a multi-million dollar infertility laboratory. She is the author of Sperm Tales: An Informative Guide Through the Challenges of Infertility, website:   Lynn lives in New Hampshire with her husband Kevin,black lab Shamus and cat Trapper John.

Edited by Skye Wentworth, Book Publicist, website:



June is Men’s Health Month

Men, Infertility, Depression

We hear a lot about how infertility affects women’s emotional well being and less about how it affects men. It’s important that we pay some special attention to how men’s lives are impacted by the disease, especially when, according to the Centers for Disease Control, suicide is the 7th leading cause of death for all men in the United States and there are 4 times as many deaths to suicide for males than females. Read more on the link……

Author Event: Infertility and Yoga !

spermtales6final copy   Infertility and Yoga !

Merrimac Public Library , Merrimac Ma.

Thursday , June 23, 2016 7 pm- 8 pm

86 W. Main St. , Merrimac, MA

Lynn Collins will be teaming up with Paula Wilson, Registered Yoga Instructor

Lynn will read from her book Sperm tales – An Informative guide through the challenges of Infertility. The CDC says 1 in 8 couples are infertile. Lynn will read selections from her book and be on hand to answer questions and sign copies of the book.

Paula Wilson has been a Registered Yoga Teacher since 2004 and has taught Yoga to people of all ages and abilities, including adults, seniors, children, pregnant women and even special needs students

Paula struggled with infertility for 5 years before having 2 beautiful children.  She feels Yoga helped her on her long journey to having children.  She taught and practiced throughout both of her pregnancies,  which helped with stress, anxiety,  and even labor and delivery. Yoga also kept her flexible and in great shape as well.
For free classes:
Anyone who attends the event can take 1st Yoga class free at the Merrimac library with Paula Wilson, Registered Yoga Teacher from May – August and the can enter a raffle to win 3 additional FREE Yoga classes with her (to be used by 12/31/16). Please visit her website at for details on her classes.

There will also be a free drawing for a copy of Sperm Tales. With each signed book you will receive a tip sheet “10 Fertility Tips: How to make pregnancy possible ”

There will be light refreshments served……Hope to see you there


Did you know 52 % of women over the age of 35 would have made different decisions about their fertility, if they educated better when they were younger. Doctors don’t bring up the conversation unless they are asked. Your most fertile years are between 18 – 29 years of age, starting to decline at age 30.

The new norm is 35- 45 years of age where women are having children and during this time there is higher risks factors with pregnancies, higher number of miscarriages, and  lower egg count and quality. Women were unaware of that their fertility drops between the ages of 30 an 45 .

Pubic Health Priority

I am working with the CDC  to help bring awareness on the importance of educating women that age does matter when it comes to a woman’s fertility. The (WHO) World Health Organization and the (ASRM) American Society for Reproductive Medicine has defines infertility as a disease. One out of 8 couples are infertile, and to add to this environmental , chemical and occupational exposures now and earlier in life could affect fertility outcome. These exposures can also affect pregnancy outcomes ( multiple births, premature deliveries ) and increase likely hood of adult onset diseases  such as ovarian , prostate, testicular cancers, metabolic syndrome and (PCOS) polycystic ovary syndrome.

Infertility can serve as a marker of past, present and future health and provide a window of opportunity to improve care for affected reproductive aged women and men . Infertility can have a pubic health implications that go beyond just simply the ability to have children.*1

Please check out the National Public Health Action Plan for the Detection, Prevention and Management of Infertility

*1- CDC-National Public Health Action Plan for the Detection, Prevention and Management of Infertility


Author Event: Plaistow Public Library May 12, 2016


Plaistow Poster Option2

Author Lynn M. Collins to Hold Book Event at Plaistow Public Library

Author Lynn M. Collins will read from her new book, Sperm Tales: An Informative Guide Through the Challenges of Infertility at the Plaistow Public Library, May 12, 2016 at 6:30 p.m. 85 Main St, Plaistow, NH 03865

According to the American Society of Reproductive Medicine, infertility affects about 6.1 people in the United States, which is about ten percent of the reproductive age population. Collins’ unique fertility guide, Sperm Tales: An Informative Guide Through the Challenges of Infertility, provides clear answers to questions of all women of childbearing age, and helps them gain a better understanding of fertility and the potential roadblocks they may confront if they wait too long.

This easy-to-read guide explains how infertility affects both men and women, while covering the latest treatments. For instance, How to Choose a Fertility Center, The Initial Consult, Causes of Female/Male Infertility, Procedures for an IUI, In Vitro Fertilization, Same Sex Couples, Sperm Banking, Egg Donors and much more. Sperm Tales also provides a list of acronyms, a glossary of terms and humorous asides from an imaginary friendly sperm named Spanky.

Collins draws on her experience as a laboratory supervisor for a leading national sperm bank and manager for a multi-million dollar infertility laboratory. Written with compassion, humor, as well as clear step-by-step information about the numerous challenges — medical and otherwise — Sperm Tales walks you through the journey of infertility treatment.

Lynn M. Collins was trained in the Infertility field at Brigham and Women’s Hospital in Boston, MA. She later set up and worked for more than 10 years at an Infertility Lab and Sperm Bank in Danvers, MA. She lives in Newton, New Hampshire with her husband, Kevin, black lab Shamus and cat Trapper John.

For more information about the book and the author, visit

The author will read a selection from Sperm Tales and be on hand to answer questions and sign copies of the book. With each signed book, you will receive a tip sheet, “10 Fertility Tips: How to Make Pregnancy Possible.” The event is free and open to the public. Light refreshments will be served.


Skye Wentworth, Book Publicist


NIAW- National Infertility Awareness Week

Help spread Awareness and Start Asking !

Let’s Talk Infertility …… Have any questions please ask me

Let’s end this taboo around Infertility

Infertility is a medical problem defined as the failure of a couple to conceive a child after one year of unprotected sexual intercourse, or the inability to carry a pregnancy to live birth. According to the American Society for Reproductive Medicine (ASRM), infertility affects about 6.1 million people in the United States, which is about 10 percent of the reproductive age population.

Spanky says : ‪#‎StartAsking‬ Age Matters – Did you know 1 out of 8 couples are infertile ? and basic fertility education is not taught in schools and is not part of the normal conversation during doctor visits….
52 % of women over the age of 35 would have made different decisions with better fertility education in their younger years.
35 is the magical number when your fertility drops dramatically…..#StartAsking

Let’s Talk Infertility

Spanky wants to discuss Let’s Talk Infertility: Secondary Infertility

Secondary infertility is defines as the inability to become pregnant or carry a pregnancy to term, following the birth of one or more biological children. The birth of the first child did not need ART assisted reproductive technologies or fertility medications.

Infertility is a medical problem, 30 % of infertility is due to the female, and 30 % to the male and the other 30 % is a combination of both partners. Infertility is defined as a disease after the inability to conceive after 12 months of unprotected intercourse, or the ability to carry a pregnancy to birth.

When you have your first child with no problem you are caught off guard by having trouble with the next child. Secondary infertility can have similar causes like primary infertility. A men’s sperm can be impaired, ovulation disorders, fallopian tubes, complications to prior pregnancy and changes in your partners or yourself risk factors such as weight, age and use of medications.

You should see a specialist if you are under 35 if you have tried for at least one year and if over 35 after trying for a 6-month period. Be in control and talk to your OBGYN. Secondary infertility is very common.

It is so hard on the couple that you felt you had no issues having your first child, why is this happening with the next?   There is such a stigma with second infertility and people feel like you have one you should be happy and fortunate because there are some that haven’t conceived. It’s different than with primary infertility.

Emotions can run so high with infertility; there are so many feelings you and your partner are going through. You have to keep communications open between the two of you. It doesn’t take long before infertility becomes the ruling force over your life. Anyone who has experienced infertility for a period of time can tell the experience changes you. Look into a support group or an infertility counselor; it can be a big help through this roadblock. So if you feel you may have secondary infertility get to a specialist soon or talk to your OBGYN.

communication is important......
communication is important……