The Fertility Expert: Egg Freezing, Perimenopause & GLP-1s Explained
Dr. Jamie Grifo, Director of Reproductive Endocrinology and Infertility at NYU Langone Fertility Center, has been at the forefront of reproductive medicine for four decades, helping shape modern IVF and launching NYU's egg freezing program in 1999. Recently, he sat down with Tamsen Fadal on The Tamsen Show to address questions around what's actually happening to women’s fertility, and when.
Watch here: The Fertility Expert: Egg Freezing, Perimenopause & GLP-1s Explained
The Odds at 40 Are Lower Than Most Women Think
Many women assume their chances of conceiving in their early 40s remain reasonably strong. The reality is more sobering: at age 40, the chance of pregnancy in any given month is closer to 2–3%, not the 20% often assumed based on fertility rates at younger ages. Understanding this gap between perception and biology is often the first step toward making informed, timely decisions.
Fertility Decline Starts Earlier Than Expected
Egg quantity and quality doesn't begin declining in a woman’s late 30s—it starts well before most women are thinking about family planning at all. This is exactly why proactive conversations about fertility, ideally in a woman’s 20s and early 30s, matter so much.
Three Tests Every Woman Should Understand
Dr. Grifo highlights three key markers used to assess ovarian reserve and function:
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FSH (Follicle-Stimulating Hormone): Reflects how hard the body is working to stimulate the ovaries.
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Estradiol: Provides context for interpreting FSH results accurately.
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AMH (Anti-Müllerian Hormone): Offers a snapshot of ovarian reserve and is one of the most commonly used markers today.
Importantly, a low AMH result doesn't mean pregnancy is impossible—it's a piece of the puzzle, not a diagnosis or a verdict. Interpreting these numbers in context, with a specialist, is essential.
Egg Freezing vs. Embryo Freezing
Choosing between freezing eggs or embryos is deeply personal and depends on relationship status, timeline, and future plans. Both are valid paths toward preserving fertility options, and the right choice varies from patient to patient.
Infertility Isn't Just a "Women's Issue"
Roughly 40% of infertility cases involve a male factor, yet women frequently carry the emotional and diagnostic burden alone. A full fertility workup should always include both partners.
Endometriosis and PCOS/PMOS: Two Common but Misunderstood Conditions
Both endometriosis and PCOS, now known as PMOS, can significantly affect fertility, but they do so in very different ways—one through inflammation and anatomical changes, the other through hormonal and ovulatory irregularities. Understanding which condition is at play shapes the entire treatment approach.
Postpartum vs. Perimenopause: Symptoms That Overlap
Fatigue, mood changes, and irregular cycles can show up in both postpartum recovery and perimenopause, leading to confusion about what's actually happening in the body. Getting the right diagnosis requires looking at the full clinical picture, not just symptoms in isolation.
GLP-1 Medications and "Ozempic Babies"
An emerging and increasingly discussed trend: GLP-1 medications, prescribed for weight management, appear in some cases to improve fertility outcomes—leading to a wave of so-called "Ozempic babies." While research is still developing, it's a space worth watching closely.
The Emotional Difference Between Freezing Early and IVF Later
Perhaps the most striking insight from the conversation is the emotional contrast between women who freeze their eggs proactively and those who pursue IVF later, often under more pressure and uncertainty. Time, in fertility, is not just a biological factor—it's an emotional one too.
Dr. Grifo's conversation with Tamsen Fadal is a reminder that fertility knowledge shouldn't be reserved for when a woman is already trying to conceive. The earlier these conversations happen, the more options remain on the table.
Watch the full episode of The Tamsen Show featuring Dr. Jamie Grifo to hear the conversation in full: The Fertility Expert: Egg Freezing, Perimenopause & GLP-1s Explained
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The NYU Langone Fertility Center Blog
At NYU Langone Fertility Center, our first job is to support our patients as they become educated about their reproductive health and fertility treatment options. Our blog connects patients with the most up-to-date information, technologies, and insights into fertility care. From egg freezing to IVF to third-party reproduction options, we explore every facet of assisted reproductive technology and empower patients with the knowledge they need to navigate their family building journeys.