One of the privileges of practicing obstetrics and gynecology for decades has been witnessing how reproductive medicine continually evolves. IVF, once considered extraordinary, is now routine. Yet even with all our advances, one question remains central: how can we support healthy pregnancies while minimizing unnecessary medical intervention? A recent clinical trial suggests we may be […]

I often tell patients that lifestyle isn’t just a backdrop to fertility — it is part of the biology we need to understand if we want conception to unfold smoothly. Physical activity is one of those powerful lifestyle factors: it affects metabolism, hormones, body composition, blood flow, and even psychological well-being. But when you look

When Maine Senate candidate Graham Platner and his wife publicly announced they would pause his campaign and travel to Norway for IVF because of cost barriers in the United States, it captured headlines for its political implications. But as a physician who has spent more than three decades walking alongside people trying to build families,

When women struggle to get pregnant, we often think first about hormones, ovulation, or blocked tubes. But for many women with PCOS or endometriosis, the real problem is something deeper: chronic inflammation and an overactive immune system. This is where a small, unexpected medication called low-dose naltrexone (LDN) is starting to make a difference. LDN

When we think about infertility and environmental exposures, we often imagine large epidemiologic studies or animal models linking chemicals like phthalates and BPA to reduced reproductive outcomes. While those remain vitally important, a groundbreaking new tool is stepping onto the stage — and it has the potential to reshape how we study chemical impacts on

Recently, The Economist published an article titled “Don’t Panic About the Fertility Crash.” As someone who has spent more than three decades caring for women and couples navigating fertility, both naturally and with medical assistance, I agree with one crucial premise: panic is not helpful. But neither is complacency. The fertility decline we are witnessing

Last week, I shared how the uterus is not passive — it is responsive, intelligent, and constantly communicating with the rest of the reproductive system. This week, I want to widen the lens once more — because the uterus does not work in isolation. It exists within an ecosystem. And part of that ecosystem is

There is a quiet but profound shift happening in how we understand fertility. For many years, the focus was almost entirely on hormones — estrogen, progesterone, FSH, LH — and while these remain important, we are now seeing that reproductive health is just as profoundly influenced by the microbiome: the bacterial ecosystems that live in

The hidden male-fertility cost of environmental exposures As an OBGYN who has spent decades guiding couples on optimizing fertility, I’ve often emphasized women’s lifestyle, nutrition, timing, and so on. But one dimension we must not overlook is the environmental context — and increasingly, that includes the air we breathe. A new study by Lindell et

The Hidden Chemistry of Fertility We often think of fertility as something internal — a matter of hormones, egg quality, and ovarian reserve. But what if the environment around us is part of that inner story? Every day, we are exposed to substances that mimic, block, or distort our body’s natural hormones. These endocrine-disrupting chemicals