Dr. Mary Claire Haver

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Let's talk about the biological clock because the data is really different than what most women have been told or not told.

You say that fertility is often capped 10 years before menopause because of egg quality.

But what does that mean?

I was taught that.

I was advanced maternal age.

Yeah.

And to be clear, ACOG is American College of OB-GYN, and they do not recommend doing AMH testing outside of, are you a candidate for IVF, right?

Correct.

You know, and I'm thinking of the downstream effects of osteoporosis and cardiovascular disease and all the things we know that POI puts you at risk for.

I treat the downstream of all of this.

And I see the epidemic of frailty and osteoporosis we have in this country and dementia.

A thousand percent.

It's crazy.

So for women who have had a child in their late 30s, early 40s, and I stopped doing obstetrics in 2018, I was still delivering babies, but just in a hospital setting.

Now that we have this, you know, older cohort of women having children, we're rolling right from postpartum into perimenopause.

Yes.

And how are you counseling those patients?

One of the statistics that shocked me and I didn't realize until I read this recently was how much bone we actually lose during pregnancy and postpartum from the hypoestrogenic state.

Well, in postpartum, really.