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Welcome to As a Woman, fertility hormones and beyond. I'm your host, Dr. Natalie Crawford, and I am a board certified OBGYN and fertility physician,

and also co-founder of Fora Fertility in Austin, Texas. With the goal of educating and empowering women, each week on this podcast, I discuss health and fertility, and how they relate to your true self.

Become a part of the community of collaboration that amplifies others as a woman. I hope you enjoy the episode.

You are listening to As a Woman. This week we are talking about what you need to know before you get pregnant or before you try to get pregnant.

All about the preconception period on what you should know or have tested before you get pregnant.

Before we dive into this, I want to talk about this week's fertility in the news, and we are talking about Hillary Swank and her miracle pregnancy of twins.

First of all, big disclaimer. Celebrities OS nothing. There is absolutely no reason why we should be talking about somebody's pregnancy or their fertility journey.

That being said, many celebrities use the opportunity for education and to talk about what they went through to help break down barriers, and that's amazing.

However, it is completely fine and appropriate. That somebody wants to keep it to themselves. So Hillary Swank, miracle twin pregnancy, so happy for her.

But a few things. Number one, I'm not her doctor. Number two, the odds of getting pregnant at age 48 are extremely low. The odds of getting pregnant with twins, naturally, spontaneously, probably got one in a million at age 48.

Interestingly, getting pregnant with multiple twins does happen more as you have higher FSH levels or as you get older.

So people who actually do conceive at older ages are more likely to have twins and people who are younger when we talk about spontaneous pregnancies.

Now, is that the likely way she got pregnant? No. A good way to think about this is if you think about the daggers now, not to talk about the daggers or their family choices, but remember, they were on that 19 kids and counting show.

So here is somebody never used any type of birth control. Obviously, very, very fertile just gets pregnant all the time. Her last pregnancy that made it to a live birth was at age around 40 after that conceived one time and had a miscarriage at least that we know about.

So in somebody who had 19 births throughout her reproductive years, very fertile somebody who does not have infertility could not get pregnant with a live birth after age 41 and presumably was not preventing a pregnancy.

And if that is showing us what somebody who's very fertile is what happens naturally, that's a good testimony to understand what happens in nature, the odds of getting pregnant decrease significantly, especially as we get older, even if you're fertile.

So do we think that Hillary's wing got pregnant for the very first time ever, at least that we're aware of naturally with twins at 48 maybe totally it could happen.

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