How Women Can Improve Their Fertility & Hormone Health | Dr. Natalie Crawford
Get an AMH (Anti-Müllerian Hormone) test if you want kids someday—even if you're not trying now. This blood test measures your egg count (not quality) and gives you critical data to plan your reproductive future. Knowing your ovarian reserve early lets you make informed decisions about timing, egg f
2h 36mKey Takeaway
Get an AMH (Anti-Müllerian Hormone) test if you want kids someday—even if you're not trying now. This blood test measures your egg count (not quality) and gives you critical data to plan your reproductive future. Knowing your ovarian reserve early lets you make informed decisions about timing, egg freezing, or treatments before you hit a crisis point. Don't wait until you've been trying for a year to get basic fertility data.
Episode Overview
Dr. Natalie Crawford, a double board-certified fertility specialist, discusses fertility as a vital health marker for all women, not just those trying to conceive. She covers the importance of early fertility testing (especially AMH), how inflammation and lifestyle affect ovarian function, why the current approach of waiting for 'failure' before testing is harmful, and the evolving role of hormone therapy in women's health and longevity.
Key Insights
Fertility is a Health Marker, Not Just About Pregnancy
Your fertility reflects overall hormonal, cellular, and metabolic health. Women with infertility have increased rates of metabolic syndrome, cancer, heart attack, stroke, and early mortality—not because infertility causes these directly, but because it's often the first warning sign of chronic inflammation or insulin resistance affecting long-term health.
The 'Failure First' Approach to Fertility Testing is Broken
Current medical guidelines force couples to try for 6-12 months before testing, yet 72% who will conceive do so in the first six months. This delays diagnosis of issues like blocked tubes, no sperm, or low ovarian reserve that could have been caught earlier. Proactive testing lets you make informed decisions before wasting precious time.
Age Impacts Fertility Probability Per Month Dramatically
At age 30, you have a 20% chance of pregnancy per month. By 35-36, that drops to 11-12%. At 38, it's 5% per month, and at 40+, it's 3%. These numbers aren't zero—many women do conceive later—but understanding these odds helps with realistic planning. Having had a child before keeps the rate around 18-20% until age 37.
Chronic Inflammation Shortens Ovarian Lifespan
Women who go into premature ovarian failure have more inflammatory markers and fibrosis in their ovaries. Conditions like autoimmune disease, untreated Hashimoto's, or endometriosis accelerate ovarian aging. Managing inflammation through diet, toxin avoidance, appropriate exercise, and treating underlying conditions can help extend fertility.
Microplastics Accumulate in Ovaries and Harm Fertility
Microplastics can accumulate in ovarian tissue, and endocrine-disrupting chemicals in plastics are associated with worse IVF outcomes, lower live birth rates, and longer time to pregnancy. While you can't avoid all toxins, small daily choices (glass over plastic bottles, whole foods over packaged) reduce your inflammatory burden.
Notable Quotes
"Everybody should get an AMH test. I think it's a very important marker. If you are listening to this and you want kids one day, ask your doctor for this test. It is not a test of egg quality... but it is a check of how many eggs you have. And that knowledge can be really impactful for how you view your future and your plan."
"If you have infertility, you have increased rates of metabolic syndrome, cancer, heart attack, stroke, and dying early. Those are extremely scary statistics... It's that for most people, it's one of the first warning signs that something is not right in their body and that there's higher levels of chronic inflammation or insulin resistance."
"I think it's a disservice to women to make them have no period ovarian failure for 12 months, no estrogen, feel terrible before we'll allow them to have hormone replacement therapy."
"One of the things I really hate the most right now about my field is that by definition infertility is a failure and we don't even recommend testing or screening or talk about a preventive approach at all until you have failed."
"You can't make decisions on data you don't know. I'm a big fan of knowing the data and then making the choice that's right for you and your circumstance versus taking population-based data and just applying it to every single person."
Action Items
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1
Get an AMH Test Now (Even If Not Trying to Conceive)
Request an Anti-Müllerian Hormone (AMH) blood test from your doctor to measure your ovarian reserve (egg count). This gives you baseline data to make informed decisions about timing pregnancy, freezing eggs, or pursuing treatments—don't wait until you've been trying and failing.
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2
Track Your Menstrual Cycle and Ovulation
Learn when you ovulate each month and monitor your cycle characteristics (length, regularity, symptoms). This knowledge helps you recognize red flags (irregular cycles, painful periods, spotting) that may indicate hormonal dysfunction or conditions like endometriosis or PCOS.
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3
Reduce Microplastic Exposure in Daily Choices
Switch from plastic water bottles to glass or stainless steel containers. Avoid ultra-processed foods in plastic packaging. These small daily decisions reduce your cumulative inflammatory burden and exposure to endocrine-disrupting chemicals that can harm ovarian function.
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4
Get Fertility Testing After 6 Months (Not 12) If Over 35
If you're 35+ and trying to conceive, seek evaluation after six months instead of waiting a full year. For anyone experiencing irregular cycles or concerning symptoms, consider proactive testing even earlier—at-home sperm tests and fertility workups can provide crucial information without delay.