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As a Woman

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

As a Woman

Natalie Crawford

Medicine, Health & Fitness

4.81.1K Ratings

🗓️ 20 April 2026

⏱️ 15 minutes

🧾️ Download transcript

Summary

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? Order Dr. Crawford's debut book, The Fertility Formula, out 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 choices. Visit megaphone.fm/adchoices

Transcript

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0:00.0

Hi and welcome back to the As a Woman podcast. I'm your host, Dr. Natalie Crawford. And today's one of your

0:08.3

favorite episodes. This is Fertility Q&A. And I'm joined by Emily Whitlock. Thank you. And hi.

0:14.0

Let's do it. As always, I did not let Natalie rate these questions. So we're just going on a web today.

0:18.4

Okay. The first one is from Iona.

0:22.5

Hi, I hope I'm saying that right.

0:23.5

She says, hi, Natalie.

0:26.9

Thank you for your content and research on the topic of fertility and IVF.

0:33.0

I would appreciate your opinion on the supplementation of DHEA for women with low ovarian reserve and advanced age.

0:36.6

How do you interpret the current scientific position on this topic?

0:41.4

This is a good question and a good example of how more is not always more when it comes to supplements. DHEA is an adrenal androgen and it can be really important, especially in

0:47.9

postmenopause when your ovaries aren't making hormones anymore. And in that transitional period

0:52.7

in perimenopause or low ovarian reserve, it does

0:55.1

become more important to be a precursor to making your important sex hormones. So what I find is that

1:02.2

so many people go and they Google supplements to be on for IVF and they go and put themselves on

1:06.5

DHEA. And we actually see really mixed results when you're on it with the exception if you do have

1:11.6

very low ovarian reserve and you're getting older that is the patient group we do find some benefit

1:16.9

from especially when it comes to IVF outcomes so the recommended dose is 75 milligrams a day you

1:22.0

don't want to be over that it can cause some side effects it does increase androgen so

1:26.4

oily skin and hair is going to be the

1:28.7

number one top complaint in addition to an increase in acne. So very fun. Lovely. Lovely side effects there.

1:35.8

But it's fewer patients that might need to be on it than the majority. So there's some supplements

1:39.6

that I recommend super liberally like Kocutan, which has got great benefits when it comes to fertility

...

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