If you’ve ever left a doctor’s appointment feeling confused, dismissed, or underwhelmed by the information you were given about your fertility, you’re not alone. Fertility challenges are rising, and many women spend years trying to understand what their bodies have been telling them before they get clear answers.
In this conversation, Dr. Sasha Hakman and I talk about why fertility challenges are rising, the commonly missed signs of endometriosis and PCOS, what age really means for fertility, how to think about egg freezing without fear or pressure, and which wellness trends are worth your time. It’s a conversation about getting informed, asking better questions, and taking an active role in your reproductive health.
Key takeaways
01 Age matters for both partners, but it isn’t the whole story. Female age is the strongest predictor of fertility, but male age plays a role too, and genetics and endocrine-disrupting chemicals are part of why infertility is rising.
02 Endometriosis and PCOS are often missed. Endo can show up as bladder or bowel symptoms during your period, unexplained infertility, or a poor IVF response, even with a clear ultrasound. PCOS isn’t a painful condition, so pain or low egg reserve alongside a PCOS diagnosis is worth questioning.
03 Fertility declines gradually, not overnight at 35. Most women can still conceive at 35, and the steeper change tends to come around 37 to 38. Understanding your options earlier gives you more of them.
04 When it comes to supplements, less is more. A quality prenatal with folic acid is the foundation, and anything else should be based on your needs, third-party tested, and cleared with your doctor.
05 Small, consistent changes count. Skip plastic for food and drinks, cook with stainless steel or cast iron, filter your water, and cut synthetic fragrance. It doesn’t have to be perfect to be meaningful.
Conversations like this, every Thursday
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My favorite moments
There’s so much about this episode that I loved and resonated with, but I especially appreciated Dr. Sasha’s perspective on egg freezing. When I froze my eggs and talked about it openly, so many of you sent me messages asking whether you should do it too. It’s such a personal choice, and I loved that Dr. Sasha framed it not as admitting defeat, but as taking charge of your own life and getting clear on what you want.
I also loved our rapid-fire round on wellness trends. In a world where it feels like we’re told to take every supplement and try every protocol, it was refreshing to hear a doctor say you don’t have to do it all. Her final piece of advice stayed with me most: educate yourself, so you can take control of the parts of your reproductive health that are within your control.
About the guest
Dr. Sasha Hakman is a double board-certified OB-GYN and reproductive endocrinologist based in Los Angeles. Her approach combines the latest evidence-based medicine with a deep understanding of how lifestyle and environment, including nutrition, sleep, stress, and everyday chemical exposures, can shape reproductive health.
Dr. Sasha also brings her own experience as a patient. After years of irregular cycles, she believed she had PCOS, until expanded genetic testing revealed a different diagnosis: non-classical congenital adrenal hyperplasia. Having gone through IVF herself, she is passionate about helping women recognize the red flags, ask better questions, and advocate for the care they need.
Find her on Instagram and at sashahakmanmd.com.
Pause here
What questions have you been holding back from asking about your fertility or your health?
Maybe it’s a symptom you’ve been told is “normal,” a lab result no one fully explained, or a decision about egg freezing or IVF that keeps getting pushed to “someday.” You don’t need all the answers today. But you can start by writing down what you’ve noticed, learning a little more about how your body works, and finding a doctor who will listen and give you real options.
And if you’re feeling overwhelmed by everything you’re “supposed” to be doing, what is one small change that feels doable this week?
This conversation is for education and inspiration, not medical advice. Please talk with your own doctor about what’s right for your body and your fertility.
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