Fertility Doctor Reveals the Biggest Mistakes Couples Make Before Trying to Conceive

Summary

Dr. Natalie Crawford explains that fertility is a shared health issue—not solely a woman’s responsibility. She says male factors are involved in about half of infertility cases and that preparing for pregnancy can also be a way to pay attention to broader health.

Key Fertility and Self-Care Strategies

• Treat fertility as a team effort. Both partners’ health and fertility matter. Crawford recommends evaluating both rather than assuming the woman is the only one who needs testing or lifestyle changes.
• Consider semen testing early. Couples do not necessarily need to wait a year of trying before getting useful information. A semen analysis can be arranged through a reproductive clinic or urologist; the interview also mentions mail-in testing.
• Be cautious with testosterone treatment. Taking testosterone can suppress the hormones that signal sperm production, sometimes for months or potentially longer. Men who hope to have children should discuss their fertility goals with a clinician and avoid taking testosterone without appropriate medical oversight.
• Notice possible signs of a male fertility or hormone issue. Low energy, weight gain, low libido, and difficulty with erections or ejaculation are reasons to seek medical evaluation, particularly in younger men.
• Use a “zero trimester” approach. The three months before trying to conceive are presented as a time for both partners to focus on health. Crawford says this may support egg and sperm quality, though it cannot guarantee pregnancy or a particular outcome.
  • For men: Avoid smoking, cannabis, excess alcohol, and overheating the testicles. Focus on nutritious food and reducing toxin exposure.
  • For both partners: Prioritize practical habits that support overall health, such as sleep, exercise, and a nutrient-rich diet.

Crawford’s Five Fertility “Non-Negotiables”

• Sleep: Aim for roughly 7–8.5 hours and keep a consistent sleep/wake schedule. Crawford links inadequate or irregular sleep with less favorable fertility-related outcomes.
• Build muscle: Add resistance training—Crawford suggests women aim for strength training about three times per week—alongside other activity. She frames muscle-building as helpful for metabolic and hormonal health.
• Manage stress: Rather than expecting to eliminate stress, set aside at least 20 minutes a day for a calming activity. Examples include journaling, walking, meditation, yoga, acupuncture, therapy, or talking with a friend.
• Eat more plant foods and fiber: Include fruits, vegetables, and fiber-rich whole foods regularly; Crawford suggests at least three servings of fruit and vegetables a day. She also recommends sources of unsaturated fats, such as olive oil, avocado, nuts, and seeds, and discusses replacing some animal protein with plant protein.
• Reduce avoidable toxin exposure: Where practical, limit food contact with plastics and consider alternatives to items such as nonstick cookware. Crawford discusses endocrine-disrupting chemicals and microplastics while acknowledging that not every exposure can be controlled.

Prenatal Vitamins and Fertility Information

• When choosing a prenatal vitamin, Crawford highlights 400 micrograms of folic acid, choline, and omega-3s (including DHA/EPA) as nutrients to check for. She also discusses vitamin D and iron, noting that needs vary and iron may be added later in pregnancy.
• Choose a supplement based on its ingredients and suitability—not just influencer recommendations or branding. Crawford notes that a vitamin that causes unpleasant side effects may be hard to take consistently.
• Crawford supports learning about fertility and health data before making major decisions. She discusses AMH testing as one source of information about ovarian reserve, but stresses that AMH can fluctuate and is not a guarantee or a standalone measure of whether someone can become pregnant.
• IVF and egg freezing work with the eggs available; they do not create more eggs or guarantee a future baby. Crawford presents egg freezing as a way to preserve options, not as a certainty.

IVF, Egg Freezing, and Planning

The interview gives approximate costs discussed by the speakers: about $100 for a semen analysis, $300–$400 for sperm freezing, and roughly $10,000–$15,000 for one egg-freezing cycle, with total costs potentially around $15,000 or more. These are examples from the conversation, not universal prices.

Before choosing a clinic, Crawford recommends asking:

• What is included in the quoted price, and what costs extra?
• Are medications billed separately, and what is the estimated range?
• What are the annual embryo or egg storage fees, and what happens if samples are moved elsewhere?
• How are samples labeled, stored, and protected from handling errors?
• Who can answer financial questions, and would a second opinion be useful?

Couples considering embryo freezing should discuss in advance what they want to happen to embryos if they separate or one partner dies. Crawford says these decisions should be addressed before treatment, even though there is no single right answer.

Presenters and Sources

• Dr. Natalie Crawford — reproductive specialist, author of The Fertility Formula, and guest.
• Maggie Sellers Reum — host and interviewer.
• Other sources or services mentioned: Crawford’s book The Fertility Formula; Fellow, described in the interview as a mail-in semen-testing service; and the U.S. Environmental Protection Agency (EPA), mentioned in connection with environmental-chemical research.