Dr. Asima Ahmad is a reproductive endocrinologist, infertility specialist, and Co-Founder and Chief Medical Officer of Carrot. Triple board-certified and nationally recognized for her work in fertility equity and menopause care, she is a frequent media contributor and speaker focused on inclusive, data-driven reproductive health solutions.
What drew you to fertility medicine, and how has the conversation around fertility benefits changed?
I had personal and family experiences that drew me to women's health. When I started looking into reproductive health, I realized there was significant support—financial, national, international—for family planning and birth control. But not for growing families. Now, don't get me wrong, birth control and options are very important, but infertility and fertility weren't discussed openly. When I first started focusing on infertility as a possible focus for my career, it wasn’t even officially classified as a disease. The world wasn’t talking about it as openly as it is now. People weren't getting treatments, and they definitely weren't getting financial coverage.
When we started Carrot, a big part of our work was education. There was enormous stigma around infertility. Because people weren't talking about it, they assumed it was rare. But it's not just heterosexual couples struggling to conceive. Single people need donors. Same-sex couples need donors and gestational carriers. There are many ways to grow a family that don't fall under the outdated infertility definition.
We made it clear we weren't going to call it "infertility benefits." We were going to talk about it as fertility—proactive. You don't need a diagnosis to build your family. Over time, people started sharing their stories publicly. It became a community effort. Now it's not a frill add-on. It's becoming an expectation.
You've spoken about "culturally competent care" and the idea that "access is not equity." What do these mean in practice?
I always knew I wanted to work in global health. When we came up with the idea for Carrot, we agreed it had to be a global company from day one.
I'd experienced the gaps myself. Growing up in America, during Ramadan, nobody really understood what fasting was. In clinical settings, my diet, my culture, my religion—people didn't understand how these shaped my health choices. Why a single, unmarried, conservative Muslim woman might not be comfortable with certain exams or treatment options. Those experiences taught us how important it is to consider all those nuances—culture, religion, beliefs—not just the financial access.
But access alone isn't equity. You could give $25,000 to someone in Dallas and $25,000 to someone in New York—that's not going to take them to the same level. You have to take a multi-pronged approach: make sure people have the education they need, that the offerings fit what they can access from a personal and cultural standpoint, and that the financial piece is calibrated so it delivers equivalent coverage for people on similar journeys.
We build from the ground up in each region. We have people on the field working directly with us. The UAE might change a law on the types of treatments available for Muslim versus non-Muslim couples—we need to know immediately. You can adapt learnings, but you can't copy and paste across the board.
You've described fertility as part of a "lifelong hormonal and metabolic health journey." What does that mean?
I don't see fertility care as episodic. Your overall health affects your fertility. You can't ignore everything, show up in clinic, get treated, and assume you'll be fine. If you had poor health coming in, it's going to be harder to get pregnant, your pregnancy will be more complicated, and that can cause short- and long-term complications for you and the baby. Treating it as episodic leads to higher costs and worse outcomes.
People need to learn about fertility early—in school, ideally. They're taught how to avoid pregnancy, but not what to do so they can one day have children. It's not "I'm just going to not think about it until I'm ready to grow my family." It's: these are the things I need to optimize before. These are the medications I should start weaning off. These are the things I need to avoid as I get closer.
I think preconception consultations—meeting with a doctor months or years before trying to conceive—would be transformative. Nobody does that. Did you know that if you have an autoimmune condition, it can make your ovarian reserve drop faster? Your autoimmune condition may accelerate your ovarian aging, and fertility preservation may be a good option. These are things people often don't find out until it's too late.
And this isn't just about women. In 50% of infertility cases, there's a male factor component. If that's not compelling, I don't know what is. There's now widespread access to testosterone online. People are taking it without workups, without figuring out why their levels are low. Many don't realize it can crash their sperm counts to the point where they can't get anyone pregnant.
What I tell people is: treat fertility testing as a vital sign, a biomarker of your health. That's how we've diagnosed testicular cancer. Autoimmune conditions. Undiagnosed diabetes—one patient ended up in the ICU within a week of having an abnormal semen analysis and the reason was uncontrolled diabetes which he did not even realize he had. Yes, this testing helps your fertility. But it can also reveal something critical about your overall health.
What are we still getting wrong about menopause care?
The pendulum has swung. After the WHI study in 2002, many providers stopped prescribing hormone therapy entirely—terrified of the potential risks like cancer. Patients didn't want to take it either. For decades, a whole generation of women couldn't find a provider to prescribe it or felt too afraid to try. They missed out.
Now there's so much access to hormone therapy that sometimes symptoms get diagnosed as perimenopausal or menopausal when it's actually something else. I recently read about a woman who was told for years her symptoms were perimenopause. In fact, she had lymphoma. We've overcorrected. The lesson is the same as before: you want people to have the right education, not just information, so they're not led down the wrong path. It's also important to do a full diagnostic workup before treating the patient to make sure you are addressing the true cause and not just the symptom, because you want to treat the right thing.
Looking ahead, what excites you—and what concerns you—about technology in fertility and reproductive health?
I'm excited about AI and its potential in healthcare. What I want to see is better integration of AI in healthcare delivery, whether that's education, treatment recommendations, or access—but without compromising quality of care and the human aspect of medicine.
There's an art to medicine. There's a humanity to it. I don't want that to get lost in the process.
