When you’re stuck in the trenches of infertility, your RE basically becomes your bestie. Am I right? You stalk them to get follicle updates, you know the type of car they drive (LOL, but seriously) and they’re a shoulder to cry on when times are tough. It’s pretty much the most important relationship in your life next to your semi-serious romance with The Bachelor on Monday nights. (Oh yeah and the hubs too!) Your Doc knows everything about you (seriously like ev-ery-thing) but what do you really know about them? Meet Dr. Natalie Crawford. She’s one of the newest RE’s in the industry, making babies in Austin, Texas since 2016, but this Doc is going places! Dr. C is quite possibly the coolest Doc we know, I mean have you seen her Instagram page? She’s as smart as she is gorgeous and as down to earth as she is passionate about her job! Dr. C even struggled with infertility herself so she totally GETS IT! This is definitely the type of Doc you want on your baby making squad and we’re pretty much obsessed! So we sat down with Dr. C to find out what’s new in IF treatments and how to know when it’s time to see a specialist and how to optimize our chances for success!
What The Fertility: Why did you decide to become an Infertility Physician?
Dr. Crawford: I loved women’s health and was drawn to the complexity of the endocrine system and the technology with infertility care. In addition, I love knowing a patient’s story – and becoming a part of their life. To me, this relationship with patients is part of why I became a physician.
WTF: Any steps you recommend taking before couples start trying to conceive and before they seek medical advice?
Dr. C: I think optimizing your health before you get pregnant is always important, as this is the last time to just focus on you. Lose weight that may be nagging – work on improving dietary habits. I encourage my patients to drink plenty of water, no soda, limit sugar, whole grain breads over white breads, and a mostly plant based diet (limiting meat and focusing on lean meats). I also recommend 30 minutes of exercise five times a week. Women need to take a daily prenatal vitamin with at least 400 mcg folic acid and 600 IU vitamin D3. Stop smoking (both partners). Other recommended preconception evaluations include: knowing your blood type, proving immunity to rubella and varicella (chicken pox), thyroid screening, and genetic carrier screening. Your OB/GYN or a fertility doctor should be able to talk to you about all of these before you get pregnant.
WTF: When is it time to see a Reproductive Endocrinologist?
Dr. C: In general, if you have no known issues with fertility, it is recommended to see a specialist after 12 months of unprotected intercourse if you are under 35 years old, and six months if you are over 35 years. However, in some situations it is best to see an REI early. For example, if you have: irregular periods, difficulty having intercourse, a male partner who has used testosterone or other steroids, known history of gonorrhea/chlamydia, prior ectopic pregnancy, or multiple pregnancy losses then an earlier evaluation is needed. I also always say that it is never too early. If you are concerned about your fertility, you will only feel better after talking to a specialist and understanding where you stand. The truth is, many couples with no risk factors have difficulty conceiving. Being proactive is never a bad thing.
WTF: What are the first steps one should take after an infertility diagnosis?
Dr. C: I think the most important first step is to talk to your partner and make sure you are both on the same page about how you want to proceed. Is the goal to become pregnant the fastest? To do the least invasive treatment? How many children (in an ideal world) do you envision for your family. Having clear “goals” will help your physician navigate you through the most appropriate treatment.
WTF: What is the most important question to ask at your first appointment with a RE?
Dr. C: I think the most important question to ask is “why?” Why are we doing that test? Why do you recommend that treatment? As a patient, make sure you understand the process, the next steps, and why things are being done. I think it is important to trust your infertility physician – and often, trust comes with understanding.
WTF: Any new and noteworthy developments in treating infertility?
Dr. C: I think the most interesting technology includes the 2 different types of preimplantation genetic testing can be done with IVF.
PGS – Preimplantation genetic screening: this is where embryos after IVF are biopsied before being transferred into the uterus and are screened for random genetic abnormalities which are more common with aging (like Trisomy 21, or Downs syndrome)
PGD – Preimplantation genetic diagnosis: this is where embryos after IVF are biopsied before being transferred into the uterus and are screened for specific single gene disorders which the parents are carriers for (like cystic fibrosis).
WTF: How did becoming a mother change how you deal with your patients?
Dr. C: I struggled with infertility myself, and I know how difficult the process can be. I was afraid that being pregnant would make it hard for my patients with infertility to relate to me. However, I have been fortunate to have the most gracious, supporting, and encouraging patients. The grace exhibited by those suffering with infertility while I was pregnant was inspiring. I love my kids endlessly and I love (love love) being a mom. Becoming a mother has been the greatest gift, and I leave home each day to try and help others experience this same joy. I understand how hard it can be for those dealing with infertility – and I try to make sure my patients know that I understand their struggle. For me, being a mom makes this job even more satisfying, because I know the true gift my patients are getting when we are able to help them grow their family.
You can find out more about Dr. Crawford and her practice here and don’t forget to check out her Instagram @nataliecrawfordmd!