How Women Can Improve Their Fertility & Hormone Health | Dr. Natalie Crawford

Summary of How Women Can Improve Their Fertility & Hormone Health | Dr. Natalie Crawford

by Scicomm Media

2h 36m•April 13, 2026
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Overview of How Women Can Improve Their Fertility & Hormone Health | Dr. Natalie Crawford

This Huberman Lab episode (host Andrew Huberman) features Dr. Natalie Crawford, a double-board-certified OB/GYN and reproductive endocrinologist. The discussion centers on fertility as a broad marker of health, practical steps women (and their partners) can take to improve reproductive and hormone health, what tests to get and why, how lifestyle/metabolic health affects egg and sperm quality, and both established and emerging medical interventions (egg freezing, IVF, HRT, GLP‑1s, supplements, etc.). Dr. Crawford emphasizes actionable recommendations—many inexpensive or free—that change outcomes and informed decision-making.

Key takeaways

  • Fertility is a health biomarker: infertility is associated with higher rates of metabolic syndrome, cardiovascular disease, cancer, stroke, and earlier mortality because it often signals chronic inflammation, insulin resistance, or autoimmune disease.
  • Everyone who may want kids someday should get an AMH (anti‑Müllerian hormone) test — it measures ovarian reserve (egg quantity), not egg quality. AMH is inexpensive (~$79 out‑of‑pocket) and widely available.
  • Egg quality declines with age due to chromosomal/mitotic spindle instability and mitochondrial deterioration; metabolic health and inflammation accelerate these processes.
  • Track ovulation, not just bleeding. Ovulation timing and luteal-phase length provide far more sensitive insight into hormonal health than cycle length alone.
  • Avoid certain exposures and behaviors when trying to conceive: cannabis (both partners), nicotine (all forms), frequent exposure to endocrine disruptors (phthalates, some fragrances, plastic-associated chemicals), and NSAIDs during the ovulatory window (they can block follicle rupture).
  • Egg stimulation/egg freezing/IVF do NOT “use up” your ovarian reserve. Stimulation recruits eggs that would otherwise die that month — it does not accelerate ovarian failure.
  • Hormone replacement therapy (HRT) is increasingly seen as beneficial and should be offered based on symptoms and needs rather than rigid cutoffs (e.g., 12 months without a period).
  • Many lifestyle interventions (sleep, muscle mass, diet, toxin reduction, stress management) materially affect fertility and are often under‑utilized.

Actionable recommendations (Do / Don’t / Take)

Do

  • Get an AMH test if you might want children in the future (order yourself if needed).
  • Learn to track ovulation (LH tests, basal body temperature, ovulation apps/devices, cycle charting) so you can:
    • Identify luteal phase defects or delayed ovulation earlier.
    • Time intercourse or treatments to the fertile window.
  • Aim for consistent, high-quality sleep (7–9 hours nightly). Poor sleep doubles infertility risk in some studies.
  • Build/maintain skeletal muscle to reduce insulin resistance.
  • Eat a fertility‑supportive diet: high fiber, whole foods, ample vegetables/fruits, quality protein, healthy fats (omega‑3s), minimize ultra‑processed foods and added/non‑nutritive sweeteners.
  • If trying to conceive soon: start or continue prenatal folate and consider CoQ10 and omega‑3s; ensure adequate vitamin D.
  • If male partner involved: consider semen testing early (CLIA-certified mail‑in kits available); supplements that may help sperm include L‑carnitine, zinc, selenium.
  • If you have known autoimmune disease, PCOS, or endometriosis, seek evaluation and treatment early — these conditions affect ovarian reserve and fertility.
  • Stop cannabis and nicotine for both partners when trying to conceive; avoid during pregnancy/breastfeeding.

Don’t

  • Rely solely on regular bleeding as proof of healthy ovulation.
  • Take NSAIDs (e.g., ibuprofen, naproxen) around the expected ovulation time — they can prevent follicle rupture.
  • Assume birth control causes infertility — it doesn’t cause long‑term infertility, but it can mask underlying disorders (e.g., PCOS); stop combined OCPs 3–6 months before trying to conceive to learn your cycles.
  • Fear egg retrieval/IVF as “using up” eggs — that’s a myth.
  • Overlook simple, inexpensive tests or lifestyle changes in favor of immediate advanced interventions.

Supplements (general, preconception)

  • Commonly recommended: prenatal (folate), CoQ10 (for mitochondrial/egg quality support), omega‑3 fatty acids, vitamin D.
  • Male supplements: L‑carnitine, zinc, selenium.
  • PCOS/endocrine-specific: inositol (improves insulin sensitivity), NAC used in some inflammation/endometriosis contexts.
  • Melatonin (1–3 mg) can be beneficial in certain contexts (egg quality/oxidative stress, IVF), but avoid very high OTC doses and use judiciously.
  • NR/NMN (NAD precursors) and other emerging agents: possible benefits in select inflammatory/unexplained infertility cases, but not universally recommended for everyone.

Tests & measurements to consider

  • AMH (anti‑Müllerian hormone): ovarian reserve (egg quantity). ~$79 out‑of‑pocket in many places. Recommended for anyone who may want kids.
  • Day‑3 FSH/estradiol, TSH, prolactin, metabolic panel (insulin/glucose), autoimmune screening where indicated.
  • Ovulation tracking: LH tests, basal body temperature, cycle tracking to measure follicular and luteal phase lengths.
  • Semen analysis (CLIA‑certified labs, mail‑in kits available).
  • Uterine/tubal evaluation (saline sonogram, HSG, or laparoscopy when indicated).
  • Recurrent pregnancy loss workup after two losses (not three): karyotype testing, uterine evaluation, thrombophilia/autoimmune testing, semen DNA fragmentation if indicated.
  • Consider egg/embryo genetic testing in IVF (PGT) when indicated.

Common myths busted

  • Myth: Egg freezing/IVF “uses up” your eggs. Fact: stimulation recruits eggs that would otherwise have been lost that month; it does not deplete your ovarian reserve.
  • Myth: AMH predicts whether you can get pregnant. Fact: AMH measures egg quantity, not egg quality or immediate fertility; it’s still crucial for timeline planning and treatment expectations.
  • Myth: Birth control permanently reduces fertility. Fact: No population-level increase in infertility after contraception; however, it can mask conditions like PCOS and Depo‑Provera can suppress ovulation longer than desired.
  • Myth: Pregnancy termination causes infertility. Fact: Routine early terminations do not increase infertility risk unless complicated by infection or severe bleeding leading to intrauterine scarring.

Important statistics & fertility probabilities

  • Fecundability (probability of pregnancy per month): age 30 ≈ 20%/month; age 35–36 ≈ 11–12%/month; age 38 ≈ 5%/month; age 40+ ≈ 3%/month.
  • 72% of couples conceive within the first 6 months of trying; only ~13% conceive in the next 6 months.
  • Men’s sperm are most susceptible during the ~90 days before conception; eggs are particularly susceptible in the ~60 days before conception (“trimester zero”).
  • Cannabis and nicotine substantially impair sperm count/quality and increase miscarriage rates; female cannabis use is associated with fewer eggs at retrieval and lower fertilization rates.

Emerging/advanced treatments & experimental approaches

  • Egg freezing: effective for preserving fertility potential; best outcomes when done younger. Coverage is limited; some employers offer benefits.
  • IVF/PGT: powerful, but not guaranteed; attrition rates through freeze/thaw, fertilization and culture mean not every egg becomes a transferable embryo.
  • GLP‑1 receptor agonists (e.g., semaglutide): promising for PCOS/insulin resistance and possibly endometriosis‑related inflammation; still evolving evidence.
  • PRP (platelet‑rich plasma): intrauterine PRP shows some promise for recurrent implantation failure; ovarian PRP is more experimental and invasive.
  • Red‑light/infrared therapy: biologically plausible mitochondrial benefits; data inconclusive. Some clinics explore abdominal or intravaginal application; more research needed.
  • Human growth hormone and other “add‑ons”: used in some poor‑response IVF cases; some supportive clinical data but not universally standard.
  • Stem cells for fertility: currently not an approved/established therapy in the U.S.; caution advised.

Practical FAQs (short answers)

  • Should I get an AMH if I’m not trying now? Yes, if you may want children someday — it informs timelines and options (egg freeze, earlier attempts).
  • How long after stopping birth control to get pregnant? Most resume ovulation quickly, but stop combined OCPs 3–6 months before trying to learn cycles and detect underlying issues; Depo‑Provera can suppress ovulation much longer.
  • Do I need to test my partner? Yes — semen analysis early can avoid months of delay if there is a male factor.
  • Can supplements/changes improve “egg quality”? Lifestyle improvements (sleep, diet, insulin control, reduced inflammation) and some supplements (CoQ10, omega‑3s) can support mitochondrial function and possibly egg/sperm outcomes; age remains the main determinant.
  • Are endocrine disruptors a real concern? Yes — cumulative exposure (plastics, phthalates, scented products, some chemicals) correlates with worse reproductive outcomes; reduce routine/frequent sources (use fragrance‑free, limit plastic contact, avoid thermal‑paper handling if frequent).

Notable quotes / clinician perspectives

  • “Fertility is a sign that you have good hormonal health, good cellular, good metabolic health… infertility is often one of the first warning signs that something is not right in the body.” — Dr. Natalie Crawford
  • “Everybody who wants to have children or understand her reproductive timeline should get an AMH checked.” — Dr. Crawford
  • “Doing IVF or egg freezing is not going to decrease your ovarian reserve… we are simply maturing more eggs that month instead of letting them die.” — Dr. Crawford
  • “Trimester zero: the 60 days before pregnancy for eggs (and ~90 days for sperm) — choices in this window matter a lot.” — Dr. Crawford

Practical next steps / resources

  • Get basic labs if you may want kids: AMH, thyroid, fasting glucose/insulin if indicated, and learn ovulation tracking.
  • If trying ≥35 or trying >6 months (or 12 months if <35) without pregnancy, pursue fertility evaluation earlier.
  • If you or your partner use cannabis or nicotine — stop now when planning conception.
  • Consider starting prenatal folate, vitamin D, omega‑3s and CoQ10 if planning pregnancy in the near term.
  • Read Dr. Natalie Crawford’s book: The Fertility Formula — Take Control of Your Reproductive Future for deeper, structured guidance.
  • For men: consider a CLIA‑certified semen analysis via mail‑in kit or clinic.

This summary condenses the clinical, lifestyle, and practical guidance from Dr. Crawford’s conversation with Andrew Huberman. It highlights tests to order, behaviors to change or avoid, and interventions that are established versus experimental — all intended to help listeners make informed, proactive reproductive-health decisions.