Podcast Summary: The Neuro Experience | Why ‘Doing Everything Right’ Still Won’t Get You Pregnant (w/ Dr. Natalie Crawford)

Host: Louisa Nicola
Guest: Dr. Natalie Crawford, Fertility Physician
Date: December 9, 2025

Episode Overview

This episode delves into the realities and science of infertility, debunking the myth that "doing everything right" guarantees conception. Dr. Natalie Crawford—renowned reproductive endocrinologist and author—joins host Louisa Nicola to discuss the true determinants of female fertility, the elusive role of luck, and why focusing on cellular and metabolic health is key. Together, they unpack hot topics like chronic inflammation, egg and sperm quality, IVF technology, and practical, evidence-based fertility optimization.

Key Discussion Points & Insights

1. The "Luck" Narrative Versus Agency in Fertility

• Opening Perspective (00:00–02:33)
  • Louisa Nicola: Expresses frustration with the apparent randomness of fertility—some women conceiving easily despite poor predictors, others doing everything right but struggling.
    • "Fertility can feel like a cruel lottery...makes me question whether anything you do even matters." [00:00]
  • Dr. Crawford: Pushes back, reframing infertility as not pure chance but a complex interplay of health, age, and lifestyle, with chronic inflammation often at the core.
    • "Luck is something you have zero control over...when it comes to our fertility, for all of us, it is finite. Age is one piece, but not the whole puzzle." [02:33]

2. Fertility as a Health Barometer

• Infertility and Broader Health Risks (00:16–04:11)
  • Infertility is associated with increased risk for chronic diseases (stroke, heart attack, cancer, diabetes, earlier death)—not that infertility causes these, but that underlying cellular dysfunction and inflammation contribute to both.
    • "Women who have infertility...have a higher rate of chronic medical disease...It's a common causal factor." — Dr. Crawford [00:16]

3. Chronic Inflammation: The Hidden Hijacker

• Inflammatory Burden and Modern Life (04:12–07:02)
  • Chronic, low-grade inflammation from environmental exposures, diet, stress, or autoimmune disease is central to diminishing fertility, affecting both egg quantity (number) and quality (genetic & metabolic competence).
    • "This is truly how chronic inflammation...is hijacking our fertility." — Dr. Crawford [04:12]

4. Foundational Fertility Non-Negotiables

Dr. Crawford outlines five pillars:

• Sleep
• Stress Management
• Exercise
• Diet
• Minimizing Toxin Exposure
  • "We want to have an active plan to combat this inflammation...by focusing on sleep, stress, exercise, diet, and avoidance of toxins." — Dr. Crawford [04:12–04:53]

5. Clarifying AMH, Egg Quantity, and Quality

• Myths Around AMH Levels (07:02–11:44; 15:02–18:40)
  • AMH (Anti-Müllerian Hormone) reflects the quantity of eggs but not always the prognosis for fertility.
  • Both low and high AMH levels have nuanced impacts; underlying health and inflammation can affect both.
  • "It's very terrifying. So I can imagine how many women are led to believe that AMH is the sole number one thing." — Louisa [15:43]
  • "AMH is one piece of the puzzle...but it can influence multiple different aspects of trying to get pregnant." — Dr. Crawford [17:09]

6. Tracking the Menstrual Cycle: Self-Knowledge as Power

• Cycle Awareness is Under-Taught (18:54–20:14)
  • Most women only learn about ovulation and cycle tracking when trying to conceive or facing problems.
  • Early education and accurate tracking are vital, as subtle changes (like short luteal phase) may be first signs of dysfunction.
  • "We should learn what ovulation means...Yet this is not what current education is." — Dr. Crawford [19:04]

7. Hypothalamic Amenorrhea & Impact of Over- or Undernutrition

• Athletics, Weight, and New Diabetes Drugs (20:14–22:47)
  • Under-eating, over-exercise, stress, and certain medications (like GLP-1 agonists) disrupt the hypothalamus’s ability to trigger ovulation.
  • Recovery of normal cycles can take a long time after such stressors.
  • "Your body may not be functioning at its best. We want to have some fat reserves, not too little, not too much." — Dr. Crawford [22:50]

8. IVF Explained: Technology, Success, and Pitfalls

• How IVF Stimulates Egg Growth & Retrieval (24:02–27:15)
  • Synthetic FSH and LH given for two weeks to stimulate all ‘available’ eggs.
  • Eggs are retrieved, fertilized, grown to blastocyst, genetically tested, and then transferred (preferably frozen cycle).
  • "IVF is trying to get all the eggs that are outside the vault to grow." — Dr. Crawford [24:26]
  • Dramatic improvements in success: Modern embryo freezing yields 99% survival after thawing. [30:42]
• Why Frozen Is Better Than Fresh Transfer (32:00–33:05)
  • Fresh cycles can hinder implantation and raise risks due to hormone environment; freezing allows better timing.
  • "A frozen embryo transfer is almost always the way to go...allows me the opportunity to really synchronize that endometrial environment with the embryo." — Dr. Crawford [32:02]
• Risks: Ovarian Hyperstimulation Syndrome (OHSS) (33:05–34:53)
  • High estrogen can cause dangerous fluid shifts—now much rarer with improved protocols and frozen transfers.

9. Egg and Sperm Quality: A True Team Sport

• Egg Health and Sperm Health Both Matter (35:05–38:54)
  • Egg quality governs early embryo development; sperm DNA integrity kicks in after day 3.
  • Sperm is remarkably responsive: lifestyle changes can improve sperm quality in ~3 months.
    • "Sperm are unlike eggs...in three months time a man's going to have totally new sperm." — Dr. Crawford [37:01]
  • Saunas, hot tubs, and high temperatures damage sperm—not eggs.
  • "For ideal sperm development, they need to be at a lower body temperature...So yes, putting your testicles into an abnormally hot environment is damaging for sperm production." — Dr. Crawford [39:14]

10. Limitations and Misapplications of Technology

• Not All Add-ons Help—They Can Harm (45:15–47:53)
  • Some tests (like the endometrial receptivity analysis) were over-applied and ultimately decreased implantation rates; more is not always better.
  • "Not everything is neutral...sometimes things can be harmful." — Dr. Crawford [47:02]
• Thorough Evaluation Before Embryo Transfer is Underutilized (47:53–49:38)
  • Evaluating tubes and uterus for blockages or inflammation (hydrosalpinx, polyps) can make a 50% difference in outcomes, yet not all clinics do this.

11. Dr. Crawford’s “Fertility Non-Negotiables”

What Every Woman Should Know/Do (Any Age): [49:38–62:19]

1. Get your AMH checked (if you ever want kids)
   • Early info = more choices (freeze eggs, rethink timing, etc.)
2. Track your cycle (not just period, but ovulation and luteal phase length)
   • Most apps are inaccurate; use physical cues or hormone testing.
     • "It only actually predicts ovulation correctly in 21% of women." — Dr. Crawford [51:02]
3. Prioritize sleep
   • Less than 6 hours/night = reduced fertility and poor IVF outcomes (in men & women)
   • "Sleep is the first thing...crucial to your inflammatory state, to your body’s health." — Dr. Crawford [53:59]
4. Manage stress (and blood sugar/insulin resistance)
   • Chronic stress feeds inflammation and insulin resistance—major reproductive disruptors.
   • "We’re constantly undergoing this process...Our cortisol is constantly activated." — Dr. Crawford [56:40]
   • Tips: Build muscular strength (exercise), use movement to combat stress spikes, schedule restorative practices (yoga, walking, meditation).
5. Adopt an anti-inflammatory diet
   • Ultra-processed foods drive inflammation; fiber, whole foods, and good-quality animal/plant protein support gut health (and thus hormone balance).
   • "Food is probably one of the top sources where inflammation is getting into our body." — Dr. Crawford [57:14]
6. Limit toxin exposure
   • Environmental toxins (plastics, chemicals, pollution, beauty/household products) disrupt hormones and harm fertility.
   • Use air/water filters, avoid microwaving plastics, check product safety via Environmental Working Group.
   • "My messaging is never to be afraid, but to really be mindful because these are things we choose." — Dr. Crawford [58:31]
7. Never ignore symptoms
   • Heavy bleeding, cycle changes, pain, or irregular periods should trigger a medical evaluation now—not only when you want to conceive.

Memorable Quote:
“Having infertility can be one of the first actual signs [of poor metabolic/cellular health]. It’s a red flag for your body.” — Dr. Crawford [59:55]

12. Perspective, Choice, and Hope

• Even with low odds, successful pregnancy is possible; don’t let statistics rob you of agency.
  • "It only takes one...Odds are interesting, but when it comes to holding a baby in your arms, it’s truly 0% or 100%." — Dr. Crawford [40:57]
• Technology is powerful, but preparation and understanding your body—and your partner’s health—are key.

Notable Quotes & Highlights (by Timestamp)

• Luck vs. Agency:
  "Luck is something you have zero control over...That's planning and preparing and making active decisions." — Dr. Crawford [02:33]
• Fertility is Health:
  "Infertility is a red flag your cellular health is not functioning appropriately." — Dr. Crawford [03:10]
• Inflammation as Common Denominator:
  "Almost everything that now I'm believing is coming back to inflammation." — Louisa [04:57]
• Egg Quality and Inflammation:
  "Inflammation breaks down proteins...more genetically abnormal eggs." — Dr. Crawford [10:41]
• Misapplied Technology:
  "Not everything is neutral...sometimes things can be harmful." — Dr. Crawford [47:02]
• Education Gap:
  "We should learn what ovulation means...Yet this is not what current education is." — Dr. Crawford [19:04]
• Sperm and Lifestyle:
  "Sperm...in three months time a man's going to have totally new sperm." — Dr. Crawford [37:01]
• Tracking Advice:
  "Most women use apps...predicting ovulation correctly in 21% of women." — Dr. Crawford [51:02]

Key Timestamps for Important Segments

• Fertility as a Sign of Health: [00:16–03:10]
• Chronic Inflammation & Its Impacts: [04:12–07:02]
• AMH, Egg Quality, Cycle Tracking: [07:02–18:40]
• Exercise, Stress, Weight, Amenorrhea: [20:14–22:47]
• IVF Process Explained: [24:02–27:15]
• Frozen vs Fresh Transfer, OHSS Risk: [32:00–34:53]
• Egg & Sperm Quality, Men’s Lifestyle: [35:05–39:55]
• Fertility Optimization Non-Negotiables: [49:38–62:19]

Conclusion

Dr. Natalie Crawford cuts through the myths and anxieties plaguing fertility discourse, offering a potent combination of empathy, science, and proactive advice. The episode empowers listeners—regardless of age or current family plans—to learn about, monitor, and influence their reproductive and overall health. From practical cycle tracking to the latest in IVF, Dr. Crawford’s message is both reassuring and action-oriented: “If I’d only known this information sooner, I would have made different decisions.”

Preorder Dr. Crawford’s upcoming book: The Fertility Formula (April 14, 2026)