Fertility Q&A: OHSS, Short Luteal Phase, Pregnancy Timing & More

Dr. Natalie Crawford, board-certified OB-GYN and REI, answers your fertility questions.

1. I’m preparing for IVF and have heard about ovarian hyperstimulation syndrome (OHSS). What steps can be taken during treatment to reduce the risk of developing OHSS?
   

2. My cycles are about 28–30 days, but I tend to ovulate around day 19 or 20 and my luteal phase is only about nine days. My progesterone level was just above 3, though the rest of my labs look normal. I’ve had two miscarriages in the past and previously used progesterone after ovulation. If I’m trying to optimize my cycle before a future pregnancy, what tests, questions, or treatments should I discuss with my OB?
   

3. After someone stops breastfeeding, how long does it usually take for prolactin levels to return to normal?
   

4. If someone wants multiple children, what is the recommended minimum amount of time to wait between pregnancies for maternal and reproductive health?
   

5. I’m 37 with diminished ovarian reserve and a history of thin uterine lining. My first FET failed, and I only have one embryo left. I’ve had ReceptivaDX, TRIO testing, and hysteroscopy, all normal, but I’m feeling stuck at a high-volume clinic where care feels very protocol-driven. What would you recommend as the next steps in this situation?

   
   

6. What is your perspective on using calcium ionophore to help activate eggs after retrieval during IVF?

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