Dr. Natalie Crawford, board-certified OB-GYN and REI, answers your fertility questions.

What is your current interpretation of the scientific evidence on DHEA supplementation for women with low ovarian reserve and advanced maternal age who are preparing for IVF?
Can you use retinol skincare products while trying to conceive, or should they be avoided during TTC?
For someone in their early 30s who has been trying to conceive for over two years with no positive pregnancy tests and has completed multiple IUIs without success, what would you recommend as next steps or further evaluation?
What does it mean if someone notices type 4 cervical mucus occurring twice in a cycle, including again right before their period?
For a male partner taking finasteride for several years, is there evidence that it affects sperm quality or fertility outcomes, and should it be stopped when trying to conceive?
In lean PCOS, what additional steps can be taken before trying to conceive to help regulate ovulation and hormone balance, especially when cycles are irregular and progesterone is being used to induce a bleed?
How do varicoceles impact fertility outcomes even when a standard semen analysis appears normal, and what should patients understand about “normal” lab results versus actual sperm quality?
Is there anything that can be done to prevent varicoceles, and what causes them to develop in the first place?
When a semen analysis is reported as normal, how should patients and clinicians interpret that result, and what deeper factors might still need to be considered?

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Fertility Q&A: DHEA, TTC Skincare, Lean PCOS, Semen Analysis and more