Fertility Q&A: Secondary Infertility, Birth Control Effects, Metabolic Health & More
From As a Woman by Natalie Crawford, MD
March 29, 2026 · 13 min
About this episode
Dr. Natalie Crawford answers listener questions about fertility challenges and related health issues.
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! https://www.nataliecrawfordmd.com/book Want your questions answered on the next episode? Ask them here! https://www.nataliecrawfordmd.com/qa-submissions Learn more about your ad…
People in this episode
Host: Natalie Crawford
Topics covered
- fertility
- secondary infertility
- birth control
- metabolic health
- miscarriage
- letrozole
Keywords
- fertility
- secondary infertility
- letrozole
- birth control
- metabolic health
- miscarriage
- cholesterol
- pre-diabetes
Mentioned in this episode
Organizations: nataliecrawfordmd.com
Products: The Fertility Formula
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