At 39, I was told I was in early menopause and would never have another child.
I was devastated.
And every fertility treatment before that diagnosis felt like grieving all over again. The injections. The waiting. The negative pregnancy test, over and over, while I was doing everything right.
With the grace of God and a healing path that took me around the world, I conceived naturally at 41. The little girl you've watched grow up at barrel races and rodeos is off to college now.
So when I tell you your diagnosis is not your destiny, I mean it from the deepest place in me.
That's why I wanted you to meet Dr. Dorette Noorhasan. She's a board-certified reproductive endocrinologist and fertility specialist, and she has sat on both sides of the exam table. Five egg retrievals. A surrogate. And one beautiful little boy.
Here's what she shared with me on The Girlfriend Doctor Show, from the labs to ask for in your 30s to the question I've quietly carried for almost two decades.
In this article
- Five egg retrievals, one baby. Dr. Dorette's story
- Do fertility drugs cause early menopause?
- Male factor is half the picture
- How IVF has changed, and what PGT-A testing does
- The labs to ask for in your 30s
- Why your results are a Polaroid, not a crystal ball
- Lifestyle, supplements, and egg quality
- Ovarian longevity is whole-body longevity
- Where fertility science is headed
- Frequently asked questions
Five egg retrievals, one baby. Dr. Dorette's story
Dorette grew up in an immigrant family, born in South America, and she put education and career first. In medical school she learned she was born with a congenital heart defect, which meant she would one day need a gestational surrogate to carry a pregnancy.
She finished medical school, residency, and fellowship. Then, around 35, it hit her.
"I went through all this schooling and I forgot to have children."
Her first egg retrieval brought back four eggs. A healthy retrieval is closer to eight to ten. At 37, still single, she chose to become a single mother by choice with donor sperm and a surrogate. Two embryo transfers. Two negative pregnancy tests.
The second negative came on a Friday. On Saturday, she went to a Halloween party to get her mind off it and met the man who became her husband.
His testing showed his sperm needed support too. After a varicocele repair and medication, they did a third retrieval. Every embryo tested abnormal. They took a six-month break, then did a fourth retrieval, adding in the eggs she'd frozen years earlier. Every embryo tested abnormal again.
She was ready to adopt. Her husband asked for one more try, reminding her that her mother had six children and had her youngest brother late.
The fifth retrieval gave them one embryo. A good one. Their surrogate carried it, and today Dorette is a mom.
My only regret is I didn't do another five egg retrievals to give my son a sibling.
Do fertility drugs cause early menopause?
This is the question I've carried for years. I took the highest dose fertility medications before my own early menopause, and I've always wondered whether they played a role.
Dr. Noorhasan, speaking as both a fertility doctor and a woman who has done five cycles, says no.
Here's why. At the start of every cycle, your ovaries recruit a small group of follicles. Follicles are tiny fluid-filled sacs, each holding an egg. Say you start the month with ten. Normally, only one ovulates, and the other nine are lost for good.
Fertility medications simply give more of those ten a chance to mature. Usually seven or eight grow. They use what your body had already set aside for that month, so they don't draw down your future supply or move menopause earlier.
The same holds for egg donors. And your cycle typically picks right back up, with a period about 14 days after retrieval.
Male factor is half the picture
For centuries, a couple's infertility was blamed on the woman. Dr. Noorhasan sees something very different in her practice.
When she finds a true cause, it's roughly 50 percent female factor and 50 percent male factor. That doesn't even count unexplained infertility.
One common male factor is a varicocele, a cluster of enlarged veins around the testicles. Think varicose veins in the legs, but in a spot that needs to stay cool. Sperm develop best at a lower temperature, which is why testicles sit outside the body. Warm blood pooling in those veins can affect sperm development.
So if you're going through testing with a partner, make sure he gets tested too. Fun fact, about 40 percent of the listeners on Dr. Dorette's own podcast are men.
How IVF has changed, and what PGT-A testing does
The first IVF baby was born in 1978, when success rates were modest. In the 1990s came ICSI, intracytoplasmic sperm injection, where a single sperm is placed directly into an egg. That opened the door for men with low sperm counts to father a biological child.
In the last decade, PGT-A has changed the picture again. That stands for preimplantation genetic testing for aneuploidy, a screen of the embryo's chromosomes for issues like Down syndrome and other common causes of failed implantation or miscarriage. Dr. Noorhasan didn't have it for her first transfers and still doesn't know why they failed. Today she recommends it to all her patients.
Freezing technology improved too. Vitrification, a fast-freeze method, made frozen embryo transfers the standard. That gives a woman's body time to reset after retrieval and makes single-embryo transfer possible.
In Dr. Noorhasan's experience, most IVF clinics average around 50 to 60 percent pregnancy success, and strong responders can reach as high as 80 percent.
The labs to ask for in your 30s
Whether or not babies are in your future, I want you to know your numbers. These are the core ovarian reserve tests, done early in your cycle, along with where Dr. Noorhasan likes to see them.
I also look at the bigger picture. Hemoglobin A1C (your three-month blood sugar average), inflammatory markers, vitamin D, thyroid with thyroid antibodies, and adrenal markers.
If your numbers point to a lower egg reserve and you want to keep the door open, Dr. Noorhasan says to seriously consider freezing eggs sooner rather than later. Talk through your results with your own doctor, because ranges vary by lab and by age.
Why your results are a Polaroid, not a crystal ball
Dr. Noorhasan uses a picture I love. Fertility testing is like an old Polaroid. It shows you exactly where you are in that moment.
You'll likely be in a similar place over the next three to six months. But the snapshot can't tell you where you'll be in two years, or when menopause will arrive. Some women hold steady for decades. Others see a steeper decline. That's genetics, and it's why she says if you can freeze your eggs, freeze your eggs.
Lifestyle, supplements, and egg quality
Age and genetics are two things you can't change. Lifestyle is the one you can.
"The healthier you are, the healthier all your cells in your body are going to be, including your egg and sperm cells," Dr. Noorhasan told me.
She shared that smoking can add two to four years to ovarian age. With her patients, she focuses on non-processed, Mediterranean-style eating, plenty of lean protein, fewer refined carbs, and cutting back on caffeine and alcohol.
There's a reason this matters so much. The ovaries, testes, and heart are among the most mitochondria-rich tissues in the body. Mitochondria are the tiny power plants inside your cells. Support them, and you support far more than fertility.
Here are the nutrients Dr. Dorette and I talked through on the show.
Vitamin C, a water-soluble antioxidant
Vitamin D, ideally dosed after testing your level
Methylated B complex, the activated forms, with extra attention to B12 for women eating vegan
Myo-inositol, which Dr. Noorhasan uses with some of her patients
NAD, a molecule your mitochondria rely on for energy. Dr. Dorette still takes it today
CoQ10, for mitochondrial support. She recommends it widely and still takes it
L-carnitine and omega-3s, two of my longtime favorites for both partners
Creatine, for lean muscle as you age, fertility or not
Electrolytes and hydration, the foundation under all of it
Please talk with your doctor before starting any supplement, especially if you're trying to conceive, pregnant, or breastfeeding.
Ovarian longevity is whole-body longevity
Here's what I want every woman reading this to hear. Your ovaries aren't only about babies.
Ovarian longevity is a marker of overall longevity. The research world is paying attention too, with longevity scientists now studying how preserving ovarian function connects to brain health.
So whether you're planning a family, finished building one, or never wanted one, supporting your hormones is supporting your future self.
My own daily foundation includes Mighty Maca® Plus, the superfood drink I formulated with certified organic Peruvian maca and more than 30 ingredients to support steady energy and mental clarity. And because vitality includes feeling good in your own skin, I use Julva®, the DHEA cream I formulated for daily comfort and moisture down there ;)
A note from me, Girlfriend. Mighty Maca Plus is not recommended during pregnancy or breastfeeding. If you're actively trying to conceive, check with your doctor before adding any new product.
Where fertility science is headed
For women with diminished ovarian reserve, meaning a lower egg supply than expected for age, Dr. Noorhasan says growth hormone is now commonly added to IVF cycles.
PRP, platelet-rich plasma, is used more often than before, though not widely. Your own blood is spun down to concentrate the platelets, the healing cells, and injected into the ovaries or uterus. The hope is to support egg numbers and quality, or help a thin uterine lining. She reserves it for harder cases.
And in research labs, scientists are learning to turn a skin cell into a stem cell that could one day become an egg. It's still in its very early stages.
Exciting as all of this is, none of it replaces the foundation. Labs, lifestyle, and good guidance come first.
Frequently asked questions
Do fertility drugs cause early menopause?
According to reproductive endocrinologist Dr. Dorette Noorhasan, no. Fertility medications help mature eggs that your body already recruited for that cycle and would otherwise lose, so they don't deplete your egg supply or bring menopause earlier.
What is a good AMH level for fertility?
Dr. Noorhasan likes to see an AMH of 1.5 or higher. AMH naturally falls with age and lab ranges vary, so review your number with your own doctor alongside FSH and an antral follicle count.
What age should you freeze your eggs?
If you plan to delay pregnancy, the earlier the better, ideally in your 20s or early 30s. Egg quantity and quality begin declining in the early 30s, and 35 is considered advanced reproductive age.
How much infertility is caused by male factor?
When a cause is identified, Dr. Noorhasan sees about a 50/50 split between female and male factors. Testing both partners early saves time.
What is PGT-A testing in IVF?
PGT-A, preimplantation genetic testing for aneuploidy, screens embryos for chromosomal issues that commonly lead to failed implantation or miscarriage, so the healthiest embryo can be chosen for transfer.
Can lifestyle improve egg quality?
Lifestyle can't change age or genetics, but Dr. Noorhasan sees improvements in ovarian and sperm function when patients eat whole foods, avoid smoking, limit alcohol and caffeine, and support mitochondrial health.
Listen to the full episode
There's so much more in the full conversation, including the moment Dorette almost walked away, and how her patients convinced her to write her story.
Listen Now: Apple Podcast | YouTube | Spotify
Connect with Dr. Dorette Noorhasan
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And remember, Girlfriend. Your best years are not behind you. They are waiting for you.
This content is for educational purposes only and is not medical advice. Please talk with your healthcare provider about your individual situation.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
