Welcome back to the As a Woman podcast. I'm your host, Dr. Natalie Crawford. Joining me today is Emily Whitlock and we are doing one of your favorite episodes. This is a bonus fertility Q&A. You can submit your questions on Natalie Crawford MD.com and we are happy to answer them. Hey, Em, hi. What do you have for me? I have no idea what's on the card. Yeah, I've not let Natalie read these. So this should be interesting. Okay, first of all, I just want to say, I love this first one. They say, hello, Dr. Crawford, appreciate all of the insight. My wife actually encourages me to watch and listen to all of your videos and podcasts to understand her discussions on the topic. We love that. Any recommended tests for males to

take if we are being challenged with our last few attempts, age 36 plus, thanks in advance.

You know, in my perfect world, fertility would be a lot more proactive than it is right now.

I really think it's kind of crazy that we're going to tell you to try to get pregnant for an

entire year. Then if you don't have success, then we'll do fertility testing to potentially find out something that's wrong. One of the big factors that we see is male factor. We know that male factor can contribute to 50% of fertility cases, and I don't think there's any reason why we're not checking a semen analysis up front. This is not a hard test to do. I know it can be a little bit awkward. You can ask your OB. They can refer you to a fertility clinic. Many fertility clinics around you can just call them. They'll let you just schedule and come in. Or you can even look at online options so that you can do a mail order test. One of the ones that I recommend is fellow. But getting a semen analysis done first is going to be one thing that's going to be really advantageous. A semen analysis is telling us about how many sperm are made, how the sperm move, and the shape of

the sperm. So it's giving us a lot of information. Based on a seam analysis, we may then want to

follow it up with a more expanded hormone testing panel or diving into why certain things may be

abnormal if they are. Now, if you have issues causing you to

ask this question from the get-go, if we have low libido, difficulty with erection or ejaculation,

then I'd recommend scheduling an appointment with a urologist as well. They can also order the

semen analysis, but do more expanded hormone testing, and there may be more that's going on.

There may be a varicoseal.

If you have a dilated blood vessel in your testes or you notice one side of your scrotum is larger than the other. So there's a lot of different things when it comes to male fertility that we don't talk about. And we want to start thinking about do things seem normal to you, having noticed a change from your baseline and start that testing a lot earlier. We would say fertility is 50-50.

TeamSport.

Okay, the next one says, my name is Megan. Have you noticed a change from your baseline and start that testing a lot earlier? We would say fertility is 50-50.

Team sport.

Okay, the next one says, my name is Megan and I am 31 years old.

I got off the pill last month and my period came back two weeks after it normally comes.

It was coming every 28 days on the birth control pill.

Is that normal?

Also, will it becoming more normal going forward now that I'm done

with the withdrawal bleed as my doctor calls it? Megan, it's a good question. The truth is,

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