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

1. Get AMH Test Early

Ask your doctor for an AMH test, or order it yourself, even if not actively trying to conceive, as it provides crucial information about your ovarian reserve and potential reproductive timeline for only about $79. This knowledge empowers proactive decisions about your fertility future.

2. Track Ovulation, Not Just Cycles

Learn to track your ovulation, not just your menstrual cycle, as it provides a more sensitive health marker by revealing the length of your luteal and follicular phases, which can detect early ovulation disorders. This allows for earlier investigation and intervention if abnormalities are present.

3. Avoid NSAIDs When Ovulating

Refrain from taking NSAIDs (Advil, ibuprofen, Aleve) during the time of ovulation if trying to conceive, as these medications can prevent the follicle from rupturing and releasing the egg. They are safe to use only during your period for cramping.

4. Prioritize Quality Sleep

Aim for 7-9 hours of consistent, quality sleep, especially during the luteal phase, as adequate sleep lowers inflammatory markers, supports proper hormonal release (FSH and LH), and is directly linked to better egg and sperm quality and higher pregnancy rates.

5. Stop Cannabis Use

Eliminate all cannabis use for both partners when trying to conceive, as it is hugely detrimental to sperm quality (increasing DNA fragmentation and lowering counts) and for women, it can decrease egg retrieval yields, fertilization rates, and increase miscarriage rates. This is a highly movable factor for improving fertility outcomes.

6. Discontinue Nicotine Use

Avoid all forms of nicotine use (smoking, oral pouches) if trying to conceive, as it is correlated with negative impacts on ovulation, hormone response, and can tank sperm counts. Smoking specifically decreases egg count and quality, leading to earlier menopause.

7. Remove Hormonal IUDs Early

If using a progesterone IUD, have it removed at least six months before you plan to get pregnant to allow the endometrial lining time to rebuild and regrow. This improves endometrial receptivity and increases the odds of conception.

8. Avoid Depo-Provera Shot

Do not use the Depo-Provera shot if you plan to get pregnant within the next two years, as a single dose can prevent ovulation for up to 18 months. This form of contraception has a prolonged effect on fertility.

9. Be Wary of Scented Products

Opt for “fragrance-free” products over “unscented” ones, especially for daily use in your home or on your body, to minimize exposure to phthalates and other endocrine-disrupting chemicals. “Unscented” products may contain masking agents that are still endocrine disruptors.

10. Limit Thermal Paper Exposure

Minimize direct contact with thermal paper receipts, especially if you handle them frequently for work, as they are a top source of BPA exposure, an endocrine disruptor. Consider wearing gloves if your job involves constant handling.

11. Consider CoQ10 and Omega-3s

Supplement with CoQ10 and omega-3 fatty acids during “trimester zero” (the 60 days before trying to conceive) to support mitochondrial health and egg quality, as these have robust human data for improving reproductive outcomes without risk of harm. Stop CoQ10 during pregnancy due to lack of data.

12. Build Skeletal Muscle

Engage in activities that build skeletal muscle, as it is one of the most effective mechanisms for reversing insulin resistance and improving overall hormonal health. This contributes positively to fertility and long-term health.

13. Eat Anti-Inflammatory Diet

Adopt a diet rich in fruits, vegetables, and fiber, and reduce ultra-processed foods and artificial sugars to lower chronic inflammation and insulin resistance. This dietary pattern supports a healthy gut microbiome, hormone balance, and can improve fertility outcomes.

14. Experiment with Elimination Diet

If struggling with inflammatory symptoms or unexplained fertility issues, consider a temporary, restrictive clean eating pattern (e.g., cutting gluten, dairy, reducing red meat) and then reintroduce foods to identify specific triggers that negatively impact your body. This helps you learn to listen to your body’s responses.

15. Ensure Healthy Fat Intake

Consume healthy fats from sources like nuts, olive oil, fish, algae, chia seeds, and flax, as cholesterol is essential for producing steroid hormones like progesterone, which is crucial for implantation during pregnancy. Insufficient healthy fats can impair progesterone production.

16. Stop Biotin Before Hormone Tests

Discontinue high-dose biotin supplementation (300 micrograms or more) for at least seven days before any hormone or steroid hormone lab assays (estradiol, progesterone, HCG, TSH, testosterone) as it can bind to the lab test and produce inaccurate results.

17. Consider Hormone Augmentation

If experiencing symptoms of hormonal imbalance, especially during perimenopause or menopause, explore hormone augmentation therapy with a doctor to optimize hormone levels within the normal range, rather than waiting for strict “failure” criteria. This can be cardioprotective, bone-protective, and may reduce Alzheimer’s risk.

18. Address Autoimmune/Inflammatory Conditions

If you have a low AMH, investigate underlying causes like autoimmune diseases or chronic inflammatory disorders, as treating these conditions (e.g., thyroid replacement for Hashimoto’s) can slow down the rate of egg loss and improve fertility outcomes.

19. Consider Melatonin for Egg Quality

If experiencing unexplained infertility or “bad egg quality,” a low dose of melatonin (1-3 milligrams, 30 minutes before bed) might be advantageous due to its anti-inflammatory properties and its natural increase during ovulation to counter oxidative stress. Avoid higher doses commonly found in supplements.

20. Avoid Cold Plunges When Conceiving

It is generally recommended to avoid cold plunges when trying to get pregnant, as they are potent inhibitors of acute inflammation, which is a necessary process for ovulation to occur.