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

I open with a simple ask: get an AMH test if kids might be in your future. It does not grade egg quality; it estimates how many eggs you have, which can reshape planning.

Welcome to the Huberman Lab, where we share science and practical tools. Today I’m joined by Dr. Natalie Crawford to lay out what women can do—at any age—to improve fertility and hormone health, and I want to congratulate her on her new book, The Fertility Formula.

Thank you. Writing it was a marathon, but my goal was clear: make the science usable so women can act on it.

Why treat fertility as a health lens even for those unsure about having children?

Fertility reflects hormonal, cellular, and metabolic health, so problems there often flag broader issues like inflammation and insulin resistance. Infertility itself does not cause disease, but it frequently serves as the first alarm.

If someone is perimenopausal or past childbearing, do cycles still teach us anything, and should strict rules delay hormone therapy?

If you’re cycling, you can still get pregnant and your cycle remains a vital readout of hormone function. Menopause marks ovarian failure, and we’re finally moving toward starting hormone therapy based on symptoms and protection benefits, not a rigid twelve‑month no‑period rule.

In men, many doctors now optimize within the normal range; I’m glad to hear women can pursue relief and function without waiting for a hard cutoff.

Exactly—long lifespans now outlast our reproductive hormones, yet estrogen and progesterone protect heart, brain, and bone. Know your normal, track it, and advocate early; perimenopause can stretch five to ten years.

Do you start women on estrogen by default, and can we extend ovarian lifespan at all?

Most feel best when estrogen is restored, often with progesterone; some do well on progesterone alone, and testosterone is rarely first‑line. While we cannot add eggs, lowering chronic inflammation and treating autoimmune and gynecologic disease may preserve function longer.

How worried should we be about plastics and microplastics?

You can’t dodge every exposure, but microplastics can accumulate in ovaries and endocrine disruptors link to worse outcomes. Make daily choices that reduce overall inflammatory load rather than chasing an all‑or‑nothing cleanse.

Does a prior pregnancy make conceiving later meaningfully easier?

Age still drives monthly pregnancy chances, but prior live birth with the same partner keeps fecundability near twenty percent until the late thirties before it drops. Secondary infertility is real, so do not wait longer than six months to get evaluated, sooner if older.

Men can now test semen at home; are those results useful?

Simple plus‑minus tests exist, but mail‑in CLIA‑certified kits deliver the full parameters we use clinically and help bypass early gatekeeping.

If someone has had a loss or termination, does that change future fertility?

Getting pregnant shows key systems can work, and most losses stem from random chromosomal issues. After two losses you deserve evaluation—labs, semen analysis with DNA fragmentation, and uterine and tubal imaging—so you are not asked to fail again.

We clearly need to move away from “fail‑first” definitions toward proactive screening.

Agreed; many will test normal, but a sizable minority have fixable problems, and even the “unexplained” group benefits from specialized care. Public storytelling is finally shaking off the stigma and pushing the field forward.

For women banking on family history or “there’s still time,” what should urgency and testing look like?

Eggs leave a finite vault monthly, guided by FSH and LH; with age, mitochondria and chromosome cohesion falter, so quality declines even as quantity falls. We approximate quantity with AMH, an imperfect but practical blood test I recommend broadly to inform timing, uncover contributors like autoimmune disease, and guide choices like trying sooner, using donor sperm, or freezing eggs or embryos.

Why the resistance to AMH when it is actionable and low cost?

Some worry it causes stress and does not predict monthly chances, but it changes treatment yield, flags earlier menopause, and often uncovers treatable drivers. You can order it through common labs for about seventy‑nine dollars; doctors should not be gatekeepers to your data.

Patients can handle nuanced results; we should empower informed choice, much like modern genetic counseling.

Exactly; we even test embryos for single‑gene disorders without revealing a parent’s status if they choose, which preserves autonomy while preventing disease transmission.

Does an egg‑freezing or IVF cycle drain the reserve faster?

No—stimulation recruits the eggs already set to die that month; we cannot tap the vault. IVF simply matures more from that cohort using the same hormone your brain makes.

Should insurance cover egg freezing given the downstream savings, and what blocks it?

Freezing is an investment that extends options, but policy resistance often hinges on embryo personhood ethics despite IVF enabling millions of births. We tailor care to beliefs—freeze eggs only, create fewer embryos, or bank embryos—and coverage remains patchy even for cancer patients.

Some tech firms pay for freezing; employees I know were grateful and kept their eggs after leaving.

Company coverage boosts utilization, retention, and satisfaction, and it bridges the financial gap when people are young enough for the best returns.

Does hormonal birth control harm fertility after stopping?

Across methods there is no higher infertility at twelve months, but the pill can mask conditions like PCOS, so stop about six months before trying to learn your ovulation. Remove a progesterone IUD at least six months ahead to rebuild the lining, and avoid a single Depo shot if you plan to conceive within two years.

Do terminations reduce chances of pregnancy later on?

Not in general; any intrauterine procedure carries a small scarring risk, higher with infection or heavy bleeding, so a persistently lighter period merits a saline sonogram.

What best supports egg quality at any age—what to do, avoid, and take?

Manage chronic inflammation without shutting down the acute response needed for ovulation and implantation; avoid NSAIDs except during bleeding because they can block follicle rupture. Focus on sleep, stress, muscle, food, and toxin reduction, and use the sixty‑day “trimester zero” to shape outcomes.

If sleep is solid, should someone still add melatonin?

Usually no; consider one to three milligrams at bedtime if there is clear inflammation, unexplained infertility, or prior poor egg quality, and avoid high‑dose over‑the‑counter products.

Cold plunges and curcumin—helpful or risky while trying to conceive?

Skip cold plunges then, as they may mute needed inflammatory signaling; cook with turmeric but avoid high‑dose curcumin supplements unless prescribed for a specific condition.

What about NAD, NMN, and NR versus CoQ10 and other basics?

NAD‑pathway supplements show promise in animals for unexplained infertility, but I do not recommend them broadly; prioritize CoQ10, omega‑3s, vitamin D, and a prenatal during trimester zero, then stop CoQ10 once pregnant. For sperm, consider L‑carnitine plus zinc and selenium.

Quick gut check on supplements: in your world, is there real consensus on things like CoQ10 or L‑carnitine, or is it still split between old school and new school?

The culture has shifted a lot, and beyond IVF technique we now talk about inputs you can control. In better trials we see meaningful gains with CoQ10, vitamin D, and omega‑3s, plus targeted support like inositol for PCOS and NAC for inflammatory conditions, but lifestyle is the base and supplements are add‑ons; I also encourage people to treat themselves like a careful n‑of‑one.

Red and infrared light used to be laughed off, yet now they help skin and even dry macular degeneration; how is light therapy viewed for fertility, and is it systemic or aimed at the ovaries?

Because inflammation disrupts brain‑ovary signaling and egg quality, systemic red light that lowers whole‑body inflammation seems to help ovulation, and exploratory work is testing closer targeting to the ovaries; data are early, but the signal leans positive.

I’d love to see embryos cultured under mitochondria‑friendly light; is that even doable in the lab?

It’s feasible with incubators, and it’s a great question; fun side note, my daughter’s chicken‑egg project found blue light hatched best while red did worse for chicks, which is a reminder that biology loves to surprise us.

Sunlight already gives us red and infrared and supports circadian health, so no one needs to buy a panel to start. On the do‑nots, cannabis use in pregnancy is common; does that worry you?

It’s one of the most concerning exposures I see, as it lowers sperm counts and testosterone, raises DNA fragmentation, and is linked to higher miscarriage, while in women it’s tied to fewer retrieved eggs, lower fertilization, and more loss; THC crosses the placenta and edibles tend to deliver the most.

That message needs to land, especially with men; a brief pause is a small price for a healthier baby. What about oral nicotine—does it harm egg quality or chances of pregnancy?

Nicotine disrupts ovulation and hormone signaling, and smoking in particular reduces egg number and quality and brings menopause earlier; pouches likely impair eggs and clearly drag down sperm, so it has no place when trying to conceive.

The wins here are practical and stacked: better sleep, real stress management, building muscle to reverse insulin resistance, more fiber and fewer ultra‑processed foods, and dropping behavioral toxins will lower inflammation and make you feel tangibly better.

You’ve seen a lot—any clinical hunch you want studied next?

GLP‑1 medicines look promising beyond weight loss for inflamed states like endometriosis or unexplained IVF underperformance, and in select cases I’ll use a low dose for a few months, stop, then cycle; some benefits seem independent of fat loss, especially in lean patients where dosing must avoid pushing weight too low.

Access and dosing matter, since brand‑name versions can be pricey even though lower doses from compounders may be more affordable.

We already use thoughtful add‑ons when basics are optimized, like short‑course growth hormone during stimulation, which in certain repeat cycles has improved egg maturity and embryo development; what I resist is the reflex to “just do IVF” while ignoring sleep, diet, alcohol, and other heavy hitters.

Separate from stem cells, where do you stand on PRP for fertility?

Intrauterine PRP is minimally invasive and the most encouraging for recurrent implantation failure, while ovarian PRP is invasive, expensive, and still experimental, so I reserve it for rare end‑of‑line scenarios.

Years back we heard older paternal age might raise autism risk; any update?

After fifty we see higher rates of autism, specific new dominant mutations, and some mental health conditions, yet the absolute risks remain low; if possible, bank younger sperm and double down on the ninety days of lifestyle cleanup before trying or cycling.

Quick PSA on lab work: NSAIDs are a thing to avoid when trying to conceive, and I’ve heard biotin can mess with hormone tests; can it?

High‑dose biotin from hair and nail supplements can skew assays for estradiol, progesterone, hCG, TSH, and testosterone, so pause anything above roughly three hundred micrograms before labs or IVF monitoring.

Let’s revisit endocrine disruptors, which people love to politicize.

Large cohorts now link higher exposure to slower time to pregnancy and worse IVF metrics, so control the repeat exposures at home: skip fragrance and choose fragrance‑free over unscented, be cautious with lavender, tea tree, and evening primrose oils, and remember thermal receipts are a major BPA source for workers; do not stress about the occasional Uber air freshener.

People do want knowledge; they just need clear priorities, like the cannabis warning for men and AMH checks for women.

Give people data and agency; after my own long road and a later celiac diagnosis, learning to listen to subtle inflammation cues changed my outcomes, and even with IVF I can only work with the eggs and sperm you bring.

On food, I like short runs of cleaner, simple meals to isolate triggers; it helped me uncover a histamine issue I never would have found otherwise.

I recommend a brief elimination with lots of produce and fiber, then reintroduce and notice changes, while following fertility staples like whole grains over refined carbs, fewer ultra‑processed foods and fake sweeteners, more plant protein alongside high‑quality meats, moderation with red meat for those who flare with it, and plenty of healthy fats and omega‑3s to support hormone production, especially progesterone.

Do these same habits help through perimenopause and menopause?

Yes, the anti‑inflammatory playbook serves you across the lifespan, and it matters even more as estrogen wanes and baseline inflammation climbs.

Dr. Natalie Crawford, thank you for another master class; her book The Fertility Formula is terrific, and I’m grateful for how you teach while pushing the science forward.

Thank you for inviting me and for giving this topic real space.

Thanks to all of you for listening today, and thanks again for your interest in science.