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The menstrual cycle consists of two phases, the follicular phase and the luteal phase. The follicular phase varies in duration but is generally 10 to 18 days. The luteal phase is fixed at 12 to 14 days. During the follicular phase, estrogen levels increase and stimulate the growth of the uterine lining in preparation for potential pregnancy. Ovulation occurs when a mature follicle ruptures and releases an egg. If fertilization doesn't occur, the egg disintegrates and menstruation begins. The most fertile time to conceive is during the five-day period ending on the day of ovulation. Libido is higher during estrogen-dominant phases of the menstrual cycle.
Hormone-based birth control methods, such as combined oral contraceptives, do not change the release of eggs from the ovaries. However, prolonged use of birth control pills may temporarily lower the level of anti-Müllerian hormone (AMH), which is a marker of ovarian reserve. This reduction in AMH is reversible upon discontinuation of the pill. Birth control pills can actually improve fertility in individuals with underlying conditions such as endometriosis. They are commonly used in IVF cycles to synchronize the growth of eggs.
Cannabis and alcohol can potentially impact fertility and egg quality. While the effects of cannabis on egg quality are not extensively studied, some evidence suggests that THC in cannabis may have negative effects on reproductive health. Alcohol consumption, particularly heavy or chronic drinking, can also impair fertility and decrease egg quality. It is generally recommended to avoid or minimize cannabis and alcohol use when trying to conceive. Additionally, drugs of abuse like cocaine and methamphetamine can have detrimental effects on fertility and overall health.
Egg quality plays a crucial role in fertility, and factors like smoking and vaping can negatively affect egg quality. Cigarette smoke has been shown to decrease egg quantity and quality, increase the risk of miscarriage, and impact fetal health. Similarly, vaping, although different from smoking, has been associated with poor success rates in IVF cycles and can be detrimental to egg quality. While there may be individual variations in response, the general consensus is that smoking cigarettes or vaping nicotine is not beneficial for egg quality or chances of getting pregnant naturally.
The use of cannabis and alcohol can also impact fertility. Cannabis use has been linked to decreased sperm production, lower sperm motility, changes in sperm morphology, and increased DNA fragmentation, which can lead to a higher risk of miscarriage. Alcohol, when consumed in excess, can affect liver function, cause inflammation, and impact egg and sperm quality. Moderate alcohol consumption, one to two drinks per week, is generally considered acceptable, but it is recommended to avoid alcohol completely once pregnancy is confirmed.
When it comes to birth control, options like oral contraceptives (the pill) and intrauterine devices (IUDs) have both benefits and potential risks. The pill, specifically the combination pill containing estrogen and progesterone, provides effective contraception but can have side effects like vaginal dryness, decreased elasticity, and increased risk of yeast infections. Copper IUDs work by creating an environment toxic to sperm, preventing fertilization. Progesterone-based IUDs thin the uterine lining, making it harder for an embryo to implant. However, prolonged progesterone exposure can lead to absence of periods, which may take time to normalize after removing the IUD. Understanding individual circumstances and discussing options with a healthcare provider is important for making informed choices regarding birth control.
A healthy diet consisting of fruits, vegetables, whole grains, and healthy fats is beneficial for fertility. Supplements such as prenatal vitamins, vitamin D, omega-3 fatty acids, and CoQ10 can also support reproductive health.
In IVF, the sperm is washed and the eggs are collected and frozen. During the IVF procedure, the embryologist may decide to combine the sperm and eggs using a technique called intracytoplasmic sperm injection (ICSI), which involves selecting a single sperm and injecting it directly into the egg.
Engaging in healthy behaviors such as nutrition and supplements is important for both sperm and egg quality. Making these changes at least 90 days before attempting conception or starting fertility treatments can have a positive impact on fertility and reproductive health.
Fertility is influenced by various factors, including lifestyle choices such as smoking and exposure to toxins. Women with conditions like endometriosis may experience low ovarian reserve and go into early menopause. Early menopause has been associated with higher health risks, including dementia, osteoporosis, heart disease, and stroke. Hormone replacement therapy can help alleviate symptoms and improve quality of life during menopause.
Genetic testing of embryos during IVF can provide valuable information about their viability and help in selecting the best ones to transfer. This can increase the chances of a successful pregnancy and reduce the risk of failed transfers and miscarriages. Embryo banking allows freezing and storing of viable embryos for future use, which is especially beneficial for people who want to have multiple children or delay family building due to various circumstances.
In this episode, my guest is Natalie Crawford, MD, a double board-certified physician specializing in obstetrics and gynecology, fertility and reproductive health and host of the “As a Woman” podcast. We discuss female hormones, nutrition, supplementation, reproductive health, and fertility, including how the timing and duration of puberty impact a woman’s long-term hormone cycles and menopause. We also discuss the pros and cons of various birth control methods and how hormonal vs. non-hormonal birth control each affects fertility. We cover the factors that impact egg and sperm quality and how to leverage timing for conception. We also discuss procedures to assess female fertility, including egg count and hormone testing, the process of egg freezing, in vitro fertilization (IVF) and other reproductive options. This episode represents fairly comprehensive coverage of female hormones and reproductive health, highlighting important tests and screening, behavioral, nutritional, supplement and prescription-based tools that women of any age can use to improve their fertility, hormone function and overall health.
For show notes, including referenced articles and additional resources, please visit hubermanlab.com.
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(00:00:00) Dr. Natalie Crawford
(00:01:52) Sponsors: LMNT & Waking Up
(00:04:59) Female Puberty & Growth Characteristics, Height
(00:13:27) Eggs & Ovulation, Harvesting Eggs, In Vitro Fertilization (IVF)
(00:17:31) Endocrine Disruptors, Fetal Development
(00:21:39) Lavender, Tea Tree & Evening Primrose Oils, Scents, Diapers
(00:25:13) Breast Milk vs. Formula & Fertility
(00:26:04) Menstruation Cycle & Hormones, Timing
(00:33:47) Sponsor: AG1
(00:35:59) Estrogen, Progesterone & Menstrual Cycle
(00:38:08) Hormonal Birth Control & Ovarian Reserve, AMH Testing, Fertility
(00:42:42) Spermatogenesis & Testosterone; Heat: Ovaries vs Testes
(00:46:11) Period & Pregnancy, Conception Window
(00:48:56) Estrogen, Libido & Ovulation; Mittelschmerz
(00:51:33) Tool: Intercourse Timing & Conception; Artificial Insemination, IVF
(00:55:03) Egg/Sperm Quality, Cigarettes, Vaping, Cannabis & Alcohol
(01:03:29) Intrauterine Device (IUD), Depo-Provera & Fertility
(01:10:00) Birth Control Risks & Benefits, Cancers, Polycystic Ovarian Syndrome (PCOS)
(01:19:39) Blood Clotting & Birth Control Pill; Health Screening
(01:24:50) Tool: AMH Testing, Ovarian Reserve, Antral Follicle Count Ultrasound
(01:29:55) IVF, In Vitro Maturation (IVM); Early Ovarian Reserve Screening
(01:35:40) Tools: Egg Freezing, IVF; Age & Egg Quality
(01:43:37) Egg Freezing & IVF Procedures, Maternal Age, Success Rates
(01:51:30) Tool: Sperm Freezing & Paternal Age, Vasectomy
(01:55:01) Hormones, Egg Freezing & IVF
(02:00:42) Three-Parent IVF, Mitochondrial DNA
(02:05:21) IVF Embryo Storage & Donation; Donor Education & Consent
(02:14:29) Autism, Developmental Disorders, IVF Babies, Age
(02:20:36) Tools: Sleep, Nutrition & Fertility; Dietary Fat
(02:27:32) Protein, Meat, Tofu, Fish; Sugar, Artificial Sweeteners; Weight & Miscarriage
(02:37:38) Tools: Supplements; Prenatal Vitamins, Omega 3s, Vitamin D, Coenzyme Q10
(02:42:26) L-Carnitine & Male Fertility; PCOS & Myo-inositol; Metformin
(02:47:11) Egg Retrieval, Ovarian Hyperstimulation Syndrome, Minimal Stimulation
(02:57:56) INVOcell
(03:03:12) Egg Freezing, Intracytoplasmic Sperm Injection (ICSI), Sperm Fragmentation
(03:11:45) Genetic Testing, IVF Transfer & Success Rate, Embryo Banking
(03:15:10) Menopause
(03:19:47) Hormone Replacement Therapy & Menopause
(03:22:25) Early-signs of Menopause
(03:25:18) Zero-Cost Support, Spotify & Apple Reviews, Sponsors, YouTube Feedback, Momentous, Social Media, Neural Network Newsletter
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