Fertility Q&A: IVF Success Rates, Transfer Protocols, Autoimmune Infertility, and More

As a Woman

Natalie Crawford

Medicine, Health & Fitness

4.8 • 1.1K Ratings

🗓️ 22 March 2026

⏱️ 15 minutes

🔗️ Recording | iTunes | RSS

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Summary

Dr. Natalie Crawford, board-certified OB-GYN and REI, answers your fertility questions. I’m almost 35 and currently going through IVF. I have PCOS and insulin resistance and have had four early miscarriages despite normal testing and blood work. I’ve also had two laparoscopic surgeries for cysts, one showing mild endometriosis, and a uterine biopsy that showed no inflammation. Given this history, how successful might IVF be for us? What transfer protocol do you recommend after Lupron and letrozole suppression for positive ReceptivaDX results—modified natural or medicated—and what factors guide that decision? Can autoimmune conditions contribute to secondary infertility? I have a four-year-old but have since experienced five miscarriages and have diminished ovarian reserve. After four cycles I’ve only had one embryo tested and it was aneuploid, and my doctor says autoimmune testing may be the next step if endometriosis testing is negative. In a 28-day cycle, is it concerning if a positive LH surge happens around days 15–16? And when tracking cycles, do you count day one as the first day you see bleeding even if it starts midday, or the following day? I’m 35 and planning for pregnancy. What are the most important first steps I should take now to set myself up for success? 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 choices. Visit megaphone.fm/adchoices

Transcript

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0:00.0	Welcome back to the As a Woman podcast. I'm your host, Dr. Natalie Crawford, and this is one of your
0:08.6	favorite episodes. This is fertility Q&A, questions that you have submitted. And joining me today
0:14.1	is Emily Whitluck, who has a whole list of questions that I don't know what they are.
0:18.5	Hi. Hi, let's do it. Okay, perfect. Starting off with TAMP, she says, I am almost 35 years old. I am a female and my husband is 32. My husband and I are currently going through IVF. I am healthy with PCOS and insulin resistance. I have had four early miscarriages with all normal tests and blood work, laparoscopic surgeries for cysts, one revealed mild
0:39.1	endo. She also had a uterine biopty that shows no inflammation. She said, how successful do you
0:44.5	think IVF will be for us? It's hard to quantify the individual success, but I think there's a few
0:48.9	things that are showing us that hopefully IVF will overcome the problems that we are having.
0:53.6	The general statistic is that for a single genetically normal embry problems that we are having. The general statistic
0:54.5	is that for a single genetically normal embryo, we would expect a 65% chance of live birth.
1:00.1	If we have two transfers, so two embryos, not in the same month, but in consecutive months,
1:04.6	you would have cumulatively an 85% chance of success. And if we have three genetically normal embryos,
1:09.9	we'd have a 95% chance of success. So that means only 5% of people are not going to have success. And if we have three genetically normal embryos, we'd have a 95% chance of success.
1:12.3	So that means only 5% of people are not going to have success if they end up with at least three
1:17.8	genetically normal embryos from IVF. Now, be it that we have our age and we've got PCOS,
1:25.1	we should, if we have an average cycle for somebody in this scenario, fall into the
1:29.6	position of having at least three genetically normal embryos. So that means one round of IVF should
1:34.4	put us in a really great position where we should have at least a 95% chance of getting to a live
1:38.6	birth. A lot of the factors that make it really hard to conceive or can contribute to
1:43.4	increase miscarriage risk
1:44.9	when you have mild endometriosis or it's the inflammation, the insulin resistance from PCOS.
1:50.7	A lot of these impact early embryo growth and development, chronic inflammation in the body,
1:55.6	and we're controlling for those by taking the eggs out of the body, fertilizing them in a lab,
	...

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