Fertility Q&A: Secondary Infertility, Birth Control Effects, Metabolic Health & More

Dr. Natalie Crawford, board-certified OB-GYN and REI, answers your fertility questions. I’ve been trying to conceive for a year for our third child. We’re both 35, live a very health-focused lifestyle, and I’ve done five rounds of letrozole without success along with extensive testing. What should the next step in evaluation or treatment look like? When using letrozole, does it make a meaningful difference if it’s taken on cycle days 3–7 versus 5–9, especially depending on whether you ovulate regularly? I have high cholesterol, pre-diabetes, and am about 50 pounds overweight, with two miscarriages in the past year. How do metabolic factors like these actually impact fertility and miscarriage risk, and what should be addressed first? I’ve been on birth control since my teens and currently have a hormonal IUD. Does long-term use affect future fertility, and how far in advance should I stop contraception if I want to plan for pregnancy? Pre-order Dr. Crawford's debut book, The Fertility Formula, now! Want your questions answered on the next episode? ⁠Ask them here! Learn more about your ad choices. Visit megaphone.fm/adchoices

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Fertility Q&A: Secondary Infertility, Birth Control Effects, Metabolic Health & More is an episode from As a Woman by Natalie Crawford.

This episode is 12:44 long.

This episode was published on Mar 29, 2026.

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