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E140
June 09, 2026
The Truth About Your Biological Clock: Egg Quality, AMH and Fertility with Dr. Natalie Crawford
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In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Natalie Crawford, a double board certified obstetrician, gynecologist, and reproductive endocrinologist, and author of the new book The Fertility Formula. Both physicians open by sharing their own fertility journeys, including pregnancy losses and dismissal from the medical system, before turning to the science that most women are never given access to.

Dr. Crawford challenges one of the most persistent myths in women's health: that the biological clock is about running out of eggs. It is not. It is about egg quality, and those are completely different problems with completely different solutions. She explains how inflammation damages the chromosomes and mitochondria inside eggs, how chronic inflammation can actually deplete the ovarian reserve by penetrating the ovarian vault, and why the standard message to women, hurry up or give up, is not supported by the science.

The conversation moves into a clear explanation of the reproductive health system, how the brain, ovaries, and uterus communicate, where chronic inflammation and insulin resistance create static interference in that system, and why the same biology that shapes fertility in your 30s directly shapes perimenopause, metabolic health, brain health, and bone density in your 40s and 50s. The fertility story and the menopause story, Dr. Crawford argues, are the same story.

Dr. Crawford also takes on the AMH test and why ACOG's recommendation against routine testing is, in her view, taking agency away from women by deciding in advance that they cannot handle the data. She explains what AMH actually measures, why a low result at 30 should change how a woman thinks about her family planning, her perimenopause timeline, and her long term bone and cardiovascular health, and why at $79 out of pocket, withholding it is indefensible. She also shares her own diagnosis of celiac disease and how it connected to unexplained pregnancy loss, osteopenia at 41, and years of dismissed symptoms.

The episode also covers what a healthy menstrual cycle actually looks like as a vital sign, how to track ovulation beyond what most apps are offering, what a short luteal phase or shortening cycles can signal before symptoms appear, why infertility is 50% a male factor issue, and what trimester zero, the three months before trying to conceive, could mean for egg and sperm quality.

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Chapters

00:00:00 – Introduction & Why Fertility Matters Beyond Pregnancy
00:02:02 – Mary Claire's PCOS, Miscarriages & Fertility Journey
00:03:01 – Why Fertility and Menopause Are Connected
00:06:10 – Dr. Natalie Crawford's Four Pregnancy Losses
00:09:00 – The Emotional Toll of Recurrent Miscarriage
00:12:00 – Discovering Celiac Disease After Years of "Unexplained" Infertility
00:17:10 – Why the "Fail First" Fertility Model Is Broken
00:18:40 – Infertility Rates Are Rising—Here's Why
00:20:00 – Why Couples Should Get Fertility Testing Earlier
00:25:00 – Inflammation's Hidden Impact on Fertility
00:27:00 – How Chronic Inflammation Damages Egg Quality
00:29:30 – Why Ovarian Health Affects Long-Term Health
00:31:00 – Fertility Is a Health Marker, Not Just a Baby-Making Issue
00:34:20 – The Truth About Male Factor Infertility
00:35:30 – How Marijuana Can Affect Sperm & Pregnancy Outcomes
00:37:00 – Trimester Zero: Preparing for Pregnancy Before Conception
00:43:00 – Debunking the Biological Clock Myth
00:44:00 – Egg Quality vs. Egg Quantity Explained
00:47:30 – Understanding AMH and Ovarian Reserve Testing
00:49:30 – Why Every Woman Should Know Her AMH
00:52:00 – Early Menopause, Bone Health & Preventive Care
00:56:00 – The Celiac Disease Diagnosis That Changed Everything
00:59:00 – Why Your Period Is a Vital Sign
01:00:00 – The Menstrual Cycle Explained in One Minute
01:02:00 – Why Fertility Apps Are Often Wrong
01:03:00 – What Your Cycle Length Reveals About Your Health

About the guest

Dr. Natalie Crawford

Natalie Crawford, MD is double board certified in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility and author of the bestselling book, The Fertility Formula. She is co-founder of Fora Fertility, a boutique fertility practice in Austin, Texas and CEO and co-founder of Learn at Pinnacle, a medical education network. Dr. Crawford completed her undergraduate at Auburn University obtaining a degree in Nutrition Science, Medical School at University of Texas Medical Branch, OBGYN Residency at University of Texas Southwestern, and REI Fellowship at University of North Carolina, concurrently obtaining a Master of Science in Clinical Research. Dr. Crawford is a digital health educator on social media @nataliecrawfordmd, YouTube “Natalie Crawford, MD,”  and hosts the podcast  “As a Woman” with over 7 million downloads.