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Jenny Swisher: [00:00:00] Welcome [00:01:00] friends to this episode of The Sink Your Life podcast. Today I’m joined by my friend Gabriela Rosa. I’m super excited for this interview. We’ve had the chance to connect in advance, um, and I just, I love this woman’s knowledge. I think it’s gonna be the perfect matchup here for Sink Your Life. I think my listeners are gonna love this.

Gabriela is a Harvard trained and awarded fertility specialist, founder of the Rosa Institute and author of Fertility Breakthrough Overcoming Infertility and Recurrent Miscarriage when other treatments have failed. She pioneered telehealth based integrative, evidence-based, fertility care accessible worldwide.

She’s also the creator and host of the Fertility Challenge, a free online program that reaches tens of thousands worldwide each year. Her fertile method has supported more than 204,000 people across 111 countries with clinical research showing a 78.8% live birth rate for patients enrolled in her signature program, even after years of infertility, recurrent miscarriage, and failed treatments.

So, Gabriela, wow. Like, I’m so excited to have you on the show. This is exactly what my listeners need to be, uh, hearing and learning. So welcome. Without further ado, [00:02:00] could you tell us more about you? Could you tell us, you know, what got you into this business of, um, helping, helping couples conceive?

Gabriela Rosa: Thank you for having me.

First of all. It’s so lovely to be here and I love when I’m speaking with kindred spirits, you know, so this is a, a really great thing. So look, I think what got me started and what keeps me going is pretty much the same thing. I knew from the very start that I wanted to make a difference in the world. I wanted to make a difference to people.

I wanted to. Alleviate human suffering really was the reason why I got involved in the kind of work that I do. But it was interesting because in the beginning, the way that I saw it was that I wanted to help people who. In a good place, but felt like they could be in an even better place in terms of their health and improving, you know, their, their health to be able to have healthier babies.

That was kind of my, my whole idea. And I was very naive at the time because I thought [00:03:00] that would be a good, great, wonderful thing to do, um, in the world and that what better way to make the world a better place than one healthier baby at a time. Right? And it took quite a while and quite many years to figure out that actually not everybody thought like that.

And therefore it wasn’t really such a great idea at all. And because, you know what I found, which was really interesting, people are much more invested in putting in the time, the energy, the effort, the money into solving problems than preventing them. And to me that was a sad day. Where I realized that.

Gosh, you know, there’s so much that people can do not to be in pain, not to be experiencing all of these challenges. And I felt like I was speaking to a wall, you know, that was unresponsive when I was [00:04:00] speaking this, this message of, you know, let’s be proactive, preventative, and optimize what is already good so that we are not kind of just laying back into en entropy and, you know, fast rushing towards, uh, uh, unhealthy quality of life and, you know, an earlier death, so to speak.

So it, after I kind of got over the fact that I ended and realized all of this, I also had situations and experiences in my life through work and work experiences where I started to see that, okay, people need. A different way of understanding that there is more they can do and, and I was very, very fortunate when I was first studying to become a naturopathic doctor.

I worked for an obstetrician gynecologist who has this, that remained a wonderful mentor. And he was very, very sweet when I was graduating. He was like, Gabriella, we have a spare room, we can [00:05:00] practice from here. And I’m like, oh, that’s so lovely. And so I did, I started practicing in, in a, in an OBS office and he, to refer patients to me and I started to see some of his patients who had been through difficulties either hormonal imbalances or miscarriages and wanted to kind of, you know, get themselves back into better health.

And after a couple of years of this, I ended up being asked to work in a integration of medicine, uh, practice. And these were the whole lot of doctors who basically worked in integrative medicine and I was the naturopathic doctor in residence. And so I used to support a lot of their patients. And of course in that focus on my, specifically on my work in women’s health and fertility.

And after several years of doing that, I ended up getting patients, you know, that were coming in for a little bit of more challenging cases of [00:06:00] infertility. You know, they’ve been trying for a year or they’ve had a couple of miscarriages and you know, they had F cycles that didn’t work and they wanted to prepare for an IVF cycle.

So kind of those very kind of basic things. About 10 years into my career, I got referred a lady who changed everything and she didn’t know it at the time, and I didn’t know it at the time. You know, it was really interesting how sometimes your life changes in a split second and you don’t recognize it until much later when you look back.

You know, and this was very much what this interaction with, with this lady was. She came to me after 10 years of infertility, multiple failed IVF cycles, and literally what she told me changed everything in my mind, which was, ’cause I said to her, I said, look, I don’t think that what I do is gonna be enough.

For you to be able to, you know, get pregnant if you’ve tried all of these other things and it hasn’t worked. I was kind of like underselling myself there, but, uh, but that’s exactly how I felt at the time. I really [00:07:00] didn’t think that, you know, in the situation like her, she was 40, over 40 actually, and I was like, okay, I’m not really sure if this is gonna be the thing, but I said, look.

And she said to me, she actually was the one who convinced me to treat her. She literally said to me, said, Gabrielle, I’m gonna give up anyway. I just wanna prepare for an IVF cycle, and I know you can help me do that. I’m like, yeah, I can, I can, you know, I’ve done that before. So we did, we got into work. I got, you know, I always treat both partners.

So we, I started working with both of them and optimizing their health and did doing all of the things that I was already doing in a very systematic and methodical approach. You know, I was, because I was trained in the way that I was and, you know, had the experience of working with many doctors over many years.

I was very, um, focused on protocols and making sure that we had checklists of things that were absolutely hit every single time and that we didn’t miss certain things, you know? So I basically started working with her about four months later. She was pregnant for the first time ever, [00:08:00] naturally, with her own eggs and didn’t need IVF and I was like, okay, that’s a good coincidence.

You know, like, this is nice. This is lovely. And I don’t know if it was really this, but it’s great to see that okay, even for somebody who has been trying for 10 years, that there could be things that could help them. Again, I really didn’t put two and two together in the sense of like, I didn’t believe that it was because of that, because of what I did, that she actually was able to conceive.

But what happened next was even more fascinating to me. And I had another lady who came to me. In fact, her husband came and brought her. She was really not wanting to be there. Um, she had been in fertile for 19 years. Again, as a couple. They had tried many different things and at this point I said to them, I said, look.

I don’t know if this is going to work for you, but I’ve had this result with this patient and told the story and you know, she was kind of like, she really wasn’t that excited. Her husband was like, we’re doing [00:09:00] this. And so in the end she, in the end of the conversation, she was like, listen, I’m doing this, but this is the very last thing I’m doing and never again asked me to go anywhere ’cause I’m not doing anything else.

And I was like, oh my God, this is what I’m getting into, you know? But she was one of the most diligent people I have ever met to this day. Like, even though she was like, she really wanted to make sure that she did everything so that she would not have to hear from her husband that this didn’t happen or didn’t work because you didn’t do the thing.

So she was very invested from the beginning because she was like, you know what, this is the end. I’m not doing anymore after this. And so about five months later. After 19 years of infertility, she ended up getting pregnant and con, you know, conceiving and having her baby after multiple failed IVF cycles and things that hadn’t worked.

And it was just at that point that I realized, hmm, [00:10:00] maybe, maybe there is something here, you know, and it, and it was because of those two people, and I still, I’m still in touch with them today. And they, they really, they transformed my life in ways that they don’t even know actually the first one knows ’cause I told her.

But, um, but that was why I then decided, you know what, it seems like a strange coincidence that both people who were in this kind of longstanding infertility, multiple failed cycles and treatments and things that didn’t work, were able to get pregnant. And the common denominator was what it is that we were doing.

So I thought, okay, you know what? Let me now start to have the conversation with people who have been trying for more than two years to conceive or keep a healthy pregnancy deter, or have had failed treatments. And so I changed, I pivoted everything that I was doing to, instead of really kind of focusing on people who wanted to be [00:11:00] healthier, to have a baby, to people who were at their very last resource, they’re like, they literally were giving up.

So I decided, you know what? These people were great to work with because they didn’t have the anxiety of, oh my God, what if I don’t get pregnant? They were quite resigned about never having a baby. You know, they, they literally lost that, oh my God, can I live without a baby to, you know what? I just wanna know when it’s all said and done, that I’ve done everything that I possibly could.

And that was when I realized those are my people. You know, those are my people and I’ve started to focus on them and the rest is history, you know? Then I was able to collect enough data over MO more than a decade to be able to demonstrate that. Okay. Yeah. What we do, which is very framework based and very specifically focused on a systematic, methodical process, can help deliver healthy babies.

Even when, and in fact in our, in my study, this was my master’s [00:12:00] thesis for my Harvard Masters in Public Health, and I basically identified that the people who, we had 544 patients, and this was a seven year analysis and we had, of those patients, the average number of years of infertility was four years plus or minus two and a half.

Almost 50% of people had gone through and done IVF cycles that didn’t work before our treatment, and 51.5% had experienced miscarriage prior to the intervention. After being treated, that miscarriage rate dropped to 13.5%. The overall live birth rate was 78.8%. And 47.7% of those patients conceived naturally without needing IVF and only 5.6% of the patients who had been told, if the majority of them had been told by that point that they needed donor egg, only 5.6% actually needed donor egg.

So it really, for me was kind of a, a [00:13:00] 360 moment, you know, of figuring out that, okay, there’s value here. Yeah. We help people.

Jenny Swisher: Fabulous. I love this. I feel like you’re the, you’re the person and this is the program that I needed at age 27. Uh, for sure. And it’s, it’s, it’s interesting because I know even when we connected before, you know, women end up in my community usually because I say their check engine light is flashing.

So either a, they’re trying to conceive and it’s not going as smoothly as maybe they anticipated or. Or maybe they’re in their thirties and forties and they’re like, wait, is this perimenopause already? Like, what’s going on? Right? So regardless of who’s, of who you are, listening to this, like I think we can all resonate with the fact that, you know, sometimes it’s our fertility, infertility journey that can bring us to the realization that like, wow, hormone health is a really big deal.

Like maybe I need to pay more attention to this. Right? For other women, it’s like the age of 40 or perimenopause seems to hit, right? And, and all of a sudden it’s like, wait a minute. Whoa, I need to, I need to kind of figure things out for myself. So I say this because. Um, you know, we talk here [00:14:00] on the podcast about ovulation being our fifth vital sign.

And so regardless of whether you’re a woman listening to this and you are looking to conceive and you’re like, this is the perfect topic for me right now, or maybe not, maybe you’re in your forties and you’re like, that ship has sailed. I have older children now. Or whatever the case is for you. Um, stay listening to this because if you can optimize, I’ll say your fertility, but just know that I don’t always mean fertility.

I just mean your ovulation, your menstrual cycle. If you can optimize your menstrual cycle and your hormone health, it is game changing for your energy. It is game changing for just how you appear in the world, like how you are in your relationships. I truly feel, I was jotting down notes as you were talking.

I feel like so much of both infertility, but also just we could say women’s health in general is just completely missed because of lack of education. And for me personally, had I had the right education, had I understood. My menstrual cycle, if I had understood my unique, I mean, for me it was PCOS and [00:15:00] endometriosis.

If I had understood that better, if I had understood the role of nutrition in that, if I had understood the role of endocrine disruptors in that, right? My husband also had issues in our fertility journey. If I had understood more of, of how this all could be different in a, I think you said something about preventing not solving type, um, perspective, right?

It could really, it could really change the game, but, but here we are, right? And in my personal story, as my listeners know, chronic migraine infertility, hormone imbalance, and now perimenopause, right? Turns out the hormone issues really don’t go away. So again, whether you’re looking to conceive or not, maybe you’re someone who’s like, this is not me.

Like what? Maybe you see the title of this podcast and you’re like, I don’t know if this is the topic for me right now. It’s, it is, it is the topic for you because understanding your menstrual health and your, just your, you know, your ovulation and your, and your menstrual cycle, it can be game changing for you.

So I wanna start.

Gabriela Rosa: And I actually just wanna point out something, ’cause I think what you’re saying is very important from the perspective of, you know, every lens within the reproductive [00:16:00] life cycle. Because the reproductive life cycle doesn’t start with wanting to be pregnant. The reproductive life cycle starts when you’re a child.

Mm-hmm. And then you go into menarchy and you have your first period, then you go into, you know, your menstrual cycle, then you go into the conception attempts and getting pregnant and having a baby. Then you get into the post, you know, kind of pregnancy stage. And of course then perimenopause and menopause.

But perimenopause is a really interesting thing because a lot of people don’t understand, they obviously understand menopause, which is, you know, the absence of menstrual cycle for 12 months and that’s where you go, okay, it’s all said and done, and I no longer have periods. But the reality is that most people enter perimenopause five to 10 years before.

Menopause. And so having that understanding that reproductive lifecycle is a continuum [00:17:00] in a woman’s life, and there are things you need to do before you get periods. There are things you need to do when you have periods and there are things that you need to do after periods stop is critical. Yeah.

Jenny Swisher: Amen to that.

Amen to that. And I love that you just, um, described that because I, I always tell people that people think like, oh, I’ve been in menopause, I’ve been having these hot flashes for 10 years. I’m like, you’re not in menopause. Like menopause is a birthday. No. And you know, five to 10 years before that is when a lot of women we see suffering or they start to say, what’s going on here?

I don’t feel myself. Right. So, yeah. Yeah. So I, when I start off with sort of a maybe controversial question, but I think, um, I’d love to just hear your, like if we were having a conversation that no one was listening to, I would ask you this question. So I wanna, I wanna just ask, you know, after having done this for so long, having done the research that you’ve done and seen the patients that you’ve seen, how much of infertility that we’re facing right now do you think is.

Perhaps lack of education, for lack of better phrase versus malfunction, like physical malfunction. Yeah.

Gabriela Rosa: I think [00:18:00] that there are more things, it’s not just two things that, uh, bring about the infertility rates that we’re seeing. And I would say that body is so incredible at managing dysfunction and. Subpar function.

Mm-hmm. Suboptimal states. Okay. It really will do the best that it can. So I’ll say this, in a general population, the majority of people will conceive without trying. And at peak fertility, a couple has an average of three cycles to pregnancy. Literally it’s have sex, get pregnant, have a baby done. We’re no longer having this conversation.

And within two years, 93.6% of the general population of people in a reproductive age will have, who are wanting to be pregnant, IE not using contraception, will have conceived. So that is the huge percentage of people, and I’m sure some of those people will have [00:19:00] intervened in some way, whether it’s naturally or through other means.

But the reality is that for the most part, on the top of that funnel of the reproductive funnel, most people conceive without having to think about it. Okay. And so. And again, that happens because of a function of earlier being younger. And, you know, all of those different aspects will come into play. So the issue starts with the fact that we have a social component to infertility.

And particularly these days, we have a situation that women have decided we don’t just want to be housewives and be home tending the, the, the home for the husband and the children and this and that. We have dreams, goals, aspirations. We wanna be out in the world, we wanna be working, which essentially means that we don’t prioritize having babies in the same way that we used to.

Mm-hmm. So is it, you know, the chicken or the egg [00:20:00] kind of situation, you know, because the reality of the matter is that we know biological systems are more likely to experience. Chaos, IE entropy as we age. So in time we know that the, the second law of thermodynamics is that there will be more chaos, right?

As opposed to less entropy has to be worked for. You don’t just get to maintain your health without working for that purpose. Mm-hmm. So the answer to your question is a really difficult one to disentangle because there is an environmental component and an exposure component that increases our risk of disease and our exposures are even to things that we don’t even think about in our day to day, for example.

Water and food. I mean, we don’t think as water and food as exposures, but if you’ve studied nutritional epidemiology, you will know [00:21:00] that water and food are exposures and disease or health are your outcome. Okay? And so what happens is, let’s pick food for example. These days our food sources are very different to what they used to be 50 years ago, right?

There are more chemicals, there are more chemical combinations, there’s more, you know, kind of industrialization and processing of nutrients and lack thereof, and a whole lot of things. Foods that are more likely to increase in insulin, insulin resistance that are more likely to create inflammation in the system.

So we’re exposed to these things and food is something that we’re exposed to daily on a, you know, several times a day. So then you have to question. Are my exposures leading toward health or leading towards chaos and dysfunction and disease? And then let’s talk about water for a second, because a lot of people don’t think about this as an exposure, but you know what?

In, in a sample of urban [00:22:00] water, there are hundreds and thousands of chemicals and chemical signals that will be present in unfiltered water. What does that mean? Well, you have pharmaceuticals, you have runoff of industry. You have, you know, pfas, so forever, chemicals, you have, gosh, you name it, you have it in the water supply.

Now, if you’re not adequately filtering your washer with a proper water filter, and we can talk about microns and you know what people should be looking for and all of that, but ultimately, if you’re not adequately filtering your washer, you are ingesting the or contraceptive pill on the daily, several times a day.

So you then talk about, you know, hormonal imbalances and you’re surprised on how, why this is happening, you know? And then we have the whole component of microplastics where we’re talking about, you know, the fact that every single thing we touch has plastics in a, a [00:23:00] receipt from the supermarket, the food comes wrapped in, you know, plastic wrappers and you know, you name it.

All of these things are endocrine disruptors. So when you ask me this question, it’s almost an impossibility to answer it in an objective way, because I think there is a combination of many factors that go into this answer. It’s not a simple answer to give you, it’s not as simple as just saying, oh yes, we have more infertility because of, you know, one thing.

No, there’s like so many different factors that go into this for sure.

Jenny Swisher: Which leads us right into what I was hopeful for, which is this conversation around. Like, you know, what is it that we’re faced with right now that’s affecting infertility? Right? You just alluded to exposures, endocrine disruptors. I certainly have done a lot of deep dives recently here on the podcast on this exact topic.

One of the things that I covered recently was, um, a study that was done just this year on 41 Siemens samples of 41 different men, all of which testing high for high levels [00:24:00] of BPA, and not a single one of those men were working in an industrial environment. And so there’s a lot that I wanna touch on here, but we’ve talked about endocrine disruptors here at least a little bit.

But what else? What else are we up against, right? Because

Gabriela Rosa: I

Jenny Swisher: know for me, um, you know, I, what I see in my community is, or what I talk about most. Tends to be endocrine disruptors, tends to be nutrition. How do we optimize our nutrition so that it’s better so that we’re not, like you said, through food exposures and that kind of thing.

Um, also making sure that we’re addressing both males and females, um, that that tends to come up as well, which we can get into. But I would love to kind of just start with like this idea of optimizing our reproductive health. So does it start with, you know, eliminating the bad and, you know, starting with, you know, what, what am I exposed to that I can sort of handle within my control or what’s within my control that I can eliminate or, you know, do we talk nutrition?

Like where, where is the starting point for people who are looking to optimize this?

Gabriela Rosa: That’s a great question and I wanna open a little bracket here about BPA. You mentioned [00:25:00] BPA and SE analysis and samples and you know, one thing that I talk about this all the time, and so one thing that people are often surprised about, they literally will specifically seek out products that say BPA free.

So bisphenol A right. What they don’t realize is that bisphenols are a class of chemicals that are found in plastics. Like, you know, phthalates also are another class of chemicals found in plastics that, you know, essentially we won’t talk about right now. People will be here all day. But with bis fennels, you have an entire alphabet of bis, fennels, there’s A, B, C, like, you know, you name it.

So just because it says BPA free and BPA is one of the ones that is most studied, there’s most scientific evidence to basically understand its impact. What is known in 2025 is that all of the BIENAL classes actually have a very similar effect as VPA. So [00:26:00] if it’s plastic, it should be avoided. It’s really that simple.

Right? So it’s, it’s an important bracket, I think to open here. But to answer your question about, you know, where is it that we begin? Okay. Um, with optimizing fertility, I have a very simple way that I like people to think about this. Super simple, and it basically is with. Pregnant now to get pregnant later.

And here’s what that means. Okay? And this applies to both men and women. And men often have to indulge me a little bit ’cause they need to kind of like try and imagine what it would be like to be pregnant. I think their population rates would decline even further if, if that was the case. But all jokes aside, gentlemen, indulge me for a moment and just imagine for a second that you could be pregnant, that you could just date your child, and in fact, that you are the one responsible for bringing it into the world, right?

Let’s not imagine how, just imagine that you would. [00:27:00] Okay? And, uh, and with that in mind, think about the thoughts that you would feel or the, the, the thoughts you think and the emotions that you might feel in terms of what is it that you would favor protect. Add, remove from your day to day. So what are all of the things If you were just dating a child right now, literally you have your baby growing inside you, what all, all of the things that you would absolutely start doing and absolutely stop doing so that you could give your baby the best possible start in life.

That is your answer. That is simply your answer. All of the things that you would absolutely start doing or absolutely stop doing if you wanted to gestate your baby, are the things that you would start doing or stop doing at the time of pubescence. You know, it’s literally like that [00:28:00] because fertility is a transgenerational fact, right?

We, all of us who are listening to this right now, we’re actually in our grandmother’s womb. When our mothers were being gestated in their mother’s web. And so everything that your grandmother, great-grandmother was exposed to are essentially things that you in some way have been imprinted within your genes, right?

So it’s not a situation of I’ll start doing this to optimize my fertility today, and it hasn’t worked in a month. This must not be a good approach. You know, it doesn’t work like that. It only optimizing fertility only has a starting point. The end point is when you actually are holding a baby, and even then it’s not an end point.

It’s a new milestone towards taking care of that baby. And then of course, you know, some people decide that they want to have a second or continue on with their journey to have [00:29:00] more children. So the, the takeaway here is this, right now within you, you are already carrying 50% of that little baby that you want to create.

And therefore you need to think about it in those terms. So for example, would you want to protect yourself against infections and sexually transmitted disease? Would you want to ensure that you are taking all of the nutrients that you need? Would you stop drinking alcohol? Would you stop smoking? Would you stop taking drugs?

Would you actually put in other beneficial inputs to again, help to optimize the way that your body is actually helping to develop that baby? The answer is yes to all of those things, right? So why do we think that it’s any different when you’re trying to get pregnant? It shouldn’t be, and the reason it shouldn’t be is that by eight weeks gestation, a baby has all its little organs and all its little fingerprints developed, formed [00:30:00] by eight weeks, which means that after that point, it’s growing.

Into a fetus that is going to be getting ready for the world. Some people don’t re don’t discover or understand that they’re pregnant by 12 weeks. You know, I’ve had people discover that much later in their gestational period. And so if you are not optimizing your health and your reproductive function overall in a deliberate manner, you are then leaving a lot on the table when it comes to fertility.

And so the starting point is going to differ for each person, Jenny. And here’s why. Let’s say you are a person who eats McDonald’s seven times, seven days a week, okay? And you kind of. Don’t take a lot of care of your health. You don’t really, you’re sedentary. You sit by the couch and do all of the things that you would do in that kind of context, whatever they are.

A person starting at that point [00:31:00] versus a person who cooks all their meals at home is active, is exercising, is, you know, taking care of every other aspect and inputs that go into their environment, their health, who may still be having issues conceiving. I’ve seen many of those people, right? They have a different starting point and a different baseline from which to benefit.

So let’s put, let me put it to you this way. The person who eats McDonald’s seven days a week just by, you know, literally replacing five of those days with healthy meals, maybe enough to get their body to start ovulating again or get their sperm to improve again. Right. Whereas somebody else, they may, they will have no positive net impact or improvement from eating another healthy meal in a week because they’re already eating out of 21 meals in a week, 19 or 20 meals that are perfect.[00:32:00]

So their starting point and their baseline and what it is that we need to do for a person like that versus, you know, somebody else is going to be different. And that, and so that question that you ask has a very personalized answer. And this is why I say that if a per, if an individual is asking themselves for me, my life in my experience and the things that I know about myself, where are my places of improvement, they’re going to be able to find a much better kind of, you know, position and starting point than if I was to say, oh, you have to do this and you have to do that, and you have to do this other thing because they may already be doing all of those things.

Jenny Swisher: Yeah. Yeah. So what you’re saying to me then is that health is individual, which is one of my favorite sayings. Health is

Gabriela Rosa: highly personalized.

Jenny Swisher: Yeah, absolutely. Absolutely. Of course, of course it would be here, right? And so I love that answer. Um, my goodness, I hope we can cover all the things I wanna talk about.

So let’s, let’s dive a little bit. I’m like, oh, we’re gonna squeeze this, [00:33:00] squeeze this in. I don’t know. There’s, there’s so much good stuff here and I, I feel like I could just talk to you forever. Um, one thing that I wanna do is I wanna make sure that I, I am thinking, okay, if this becomes like, which it will be the, the shareable podcast that I give out to women who are in my inbox that are like, struggling with fertility, right?

This is, this is so needed. This is a topic we just, we haven’t dove deep on. Um, so I’m so glad you’re here for this, but. I’m thinking to myself, what would I want her to know? Right. So for this episode, and we might have to have you back, um, to, to go over the other stuff, but like, for this episode, like, let’s dive into like I can tell you Yes.

What I

Gabriela Rosa: want her to know. Yes.

Jenny Swisher: Please tell me what you, let’s just start there and see what you say. Yeah,

Gabriela Rosa: let’s start there. Let’s start there because I have many things I want her to know. First thing I want her to know, it’s not a numbers game. Fertility is not another’s game and fertility does not start with the egg for the love of baby Jesus.

Okay? It is absolutely essential to understand that the egg and the sperm are end results of biochemical chain [00:34:00] reactions that start much more upstream than that. The egg and the sperm are outcomes of biological, physiological, biochemical chain reactions that lead to the quality that we have today. So they’re then going to lead to other milestones, and that’s going to be either ability or inability to conceive or keep a healthy pregnancy to term or whether an IVF cycle is actually successful.

Okay? And here’s the thing that people need to know more. Treatment is never the answer when IVF hasn’t worked the first time. This is so critical, and the reason that this is so important is this. 29% of started IVF cycles will yield a live birth. 29%, 71% will fail. And understanding that difference and why it hasn’t worked and [00:35:00] optimizing every aspect of what could be leading to that outcome is critical for another cycle to work.

Because otherwise what you’ll end up doing is this, you end up going through cycle after cycle after cycle believing that fertility is a numbers game and that your end quality is a problem and that this is not working because of whatever thing you are doing or not doing. And it’s simply not true.

There are usually very specific things that are going on, like I’ll tell you this couple is a, is a fantastic case demonstration of this. They were not using contraception for eight years. She was a pharmacist. He basically, you know, had a sperm count, which we found out once I actually assessed their case.

’cause I assess every case into the fertility breakthrough program. Like people can’t just like join. I actually have to say this is something that I can help. ’cause if I can’t help, then I’ll refer them elsewhere. Because basically as I was assessing this case, I look at his semen analysis. So they [00:36:00] had done by this stage, by the time they come to me, they had been trying for eight years, no success, sorry, they had been trying for eight years, no success.

By the time they came to me, they had tried deliberately for another six years and had done six IUI cycles, two failed IVF cycles. So they found me at the 14th year of trying to get pregnant and they basically had been told at that point that her eggs were old. And I’m thinking, yeah, but it didn’t start out that way.

You know, like this is not how this started years ago. So as. Exactly right. As I’m, as I’m assessing the case, I look at his sperm, his semen analysis, he had 2 million sperm. The minimum that you need for the natural conception is 20 million. So I said to him, you know, as I’m kind of describing and discussing with them some of the issues that I was looking at, he goes, what do, sorry, what do you mean low sperm account?

I’m like, yeah, you only have 2 million. And he goes, what should it be? 20 million. But nobody ever told me that. 14 years of [00:37:00] infertility. Nobody ever told him he had a low We count. Okay. Alright. So then we continue, they decide to join the program. We start doing all of the, the diagnostics and the deep dive that we do in terms of understanding more about the case.

What do we come across? There were many different health issues. She had diabetes. There were many different things, but what do I come across? They both had a sexually transmitted infection that is silent, that nobody picked up, and that we know causes implantation failure. A miscarriage 14 years. They had tried to conceive and are told, oh, you need donor egg.

Guess what would’ve happened if she had gone down the donor egg path? That too would’ve failed. Mm-hmm. Multiple times. So at that point, you’ve really got to, and this is why I say this is a cautionary tale for people, because don’t believe what you are being told. If things have not been straightforward, if it hasn’t worked, more treatment is not the answer.[00:38:00]

Mm-hmm. Understanding why it’s failing is the only way that you are going to be able to actually put together intervention that is going to support and guide you toward the outcome that you are looking for. And this is the same answer that, you know, you’ve, you’ve asked me before, what is it that people need to do?

Well, it starts with diagnostics and unfortunately in the standard healthcare system, people do not get that. And they don’t get that for various reasons. I mean, you know, I’m doing a doctorate of public health at Harvard, and I can tell you the healthcare system is fragmented around the world. It’s not just in the United States.

And we treat people in the us, uk, Australia, you know, all every healthcare system in the world. And so I know, and I can see what actually happens for most people is that unfortunately, the healthcare system worldwide is not designed to well serve couples [00:39:00] experiencing fertility problems because the majority of people can see with our tribe.

So why do we, when we have limited budgets in healthcare systems and governments around the world, why are we going to focus on the treatment of infertility when coronary heart disease and diabetes are killing? Millions of people around the world. That’s unfortunately the mindset of the healthcare system.

So don’t expect that you are going to get help within the healthcare system for this ’cause you’re not. If it hasn’t been straightforward, unfortunately, you may find a blessed doctor that might take compassion and actually go above and beyond. You know what it is that needs to happen for you, but it’s very rare and highly unusual.

So these are the things that I think people really need to understand is that on an individual level, doctors really care and they mean very well. They want to help, but in five [00:40:00] minutes there’s very little they can do. The consultation time itself alone doesn’t allow for the kinds of conversations that are required for you to get the result that you need.

And on a corporate level, you are not gonna get the help you need because it’s a business and it’s a multi-billion dollar business. So the more cycles, the better the profits. And at the end of the day, these big corporates, guess what, they actually function to serve shareholders best and highest interests.

Simple as that. So there’s many competing interests, you know, so it’s a difficult, it’s a difficult topic

Jenny Swisher: for sure, for sure. But you, you hit the nail on the head with, you know, how much time does your practitioner or doctor have to actually sit down and work with you through your bio individual health circumstances, which we’ve already alluded to being the key here.

Right. And so I know in my experience, in our experience with infertility, although short-lived, was very stressful and also felt like you had [00:41:00] to communicate everything you wanted to communicate in a short amount of time. And then you’re given sort of a cookie cutter approach to, well, this is how every, this is what we do with every woman, and this is what we do with every.

Whether it was, you know, Ava drill injections or um, IVF or whatever the case was, it was like, here’s our protocol, this is what we follow. And looking back now as a 41-year-old woman, and knowing what I know now and the education that I’ve given myself on, on understanding this, I look back and I’m like, holy cow.

Like so many basic things were just like, skipped over. That would’ve been crucial for me. You know, my husband and I were both at the time, we don’t wanna, I don’t wanna derail us too far, but when we were going through our journey, I owned a gym. I was teaching bootcamp classes multiple times a day. And one of the things that our fertility specialist said to me on the very first appointment was he kind of alluded to endometriosis, given the period pain that I had experienced my whole life.

He was, you know, who, who know how many doctors I had seen OBGYNs, et cetera. Nobody had ever mentioned endometriosis to me. Um, and I think the average woman, you know, it takes five or six doctors before she gets that [00:42:00] diagnosis. So that was the first time I’d heard that. But then also he said something to me about.

You know, oh, well, you know, a lot of times those ovulation test strip that by the way you’ve been using for six years, they don’t actually work very well for women with low body fat percentage. And I was like, huh. And it was the first time that I ever thought in my mind that like the, the level, the level of health and fitness that I was, was a problem, um, for conception, right?

Like that, that I, that I necessarily could have been, I thought I was healthy, but maybe not in the sense of reproductive healthy. And so, had I understood the roles of cortisol, had I understood what I was, you know, the, the li the lifestyle that I was living, it would’ve been game changing for me. Right?

And so, but just to be told, come back on this day. We’ll, look and see if you have any eggs through an ultrasound. Then we’re gonna give you some timed sex options, which is super fun, you know, and then all these different things that, that we did. I look back on that and I just think, whoa, like it is, you know, because health is individual, I wish I would’ve had someone like you or someone to say, Hey.

[00:43:00] Let me, let me sort of teach you what you need to know, how this should go, and then let’s look at maybe what’s, what your hangups are, right? Or let’s look at your nutrient deficiencies or your spec specific needs. Um, and I, that’s agreed that that is one thing that I hope the listeners will take from this.

The other thing that I just wanna throw in too, um, and I touched on it earlier, one thing that I tell women all the time is make sure your partner is also being evaluated. And I hear this all the time, and I also had, we also had issues here where I went through endometriosis, laparoscopic surgeries, um, all different things before my husband’s semen was ever tested.

So it’s funny to me that we look back, and it was probably about eight months of our journey was spent focused solely on me. And I still hear this, I still hear this from women who are saying like, well, my husband didn’t get checked until everything else started failing. And so I, I love that you said, you know, you’re evaluating both.

I have, um, good friends of mine who went through an infertility journey as well, and he shares [00:44:00] openly about how he, you know, he didn’t wanna go to the appointments. Like he felt like it was sort of like her problem and she needed to work through it. And when he started to attend, um, it was like, wow. Like it changed their marriage, right?

It changed to change the relationship. So I would love for you to touch on this as well, because I know for me, I like to tell women that, come to my inbox, make sure this is a, a both of you thing. Make sure that you’re evaluating both. So I’d love to, yeah.

Gabriela Rosa: One thing. One thing you will, if you Google my name and put in team sport, you’re probably going to find what I say to everybody all the time, which is, fertility is a team sport.

Okay? There is no way to disentangle that. Often people don’t realize that 40% of reproductive dysfunction, and when it comes to infertility, miscarriage, and failed treatments, that’s exactly what I’m talking about. 40% of that comes down to male factor and sperm health basically, right? And then of course, 40% comes down to female factors, and [00:45:00] 20% comes down to embryonic factor.

So all of the things that essentially can support or negatively impact implantation. Now, the thing that most people don’t realize is that most men are not actually dragged into the doctor’s office to go, okay, listen up. This is 50% on you. So the miscarriage that happened, the infertility that’s going on, and of course the failed treatments that are happening.

I’ll give you another, another wonderful story of one of my patients, three different doctors, three different clinics, tell her after three failed IVF cycles. That and a miscarriage, uh, that was naturally conceived in between, essentially tell her that, well, you know, you probably need donor egg and you should get again, over 40, you know, all of these things and you probably should consider donor egg.

But even donor egg is unlikely to work because ultimately you have thin lining, thin than a neutral lining. And you know that’s probably not gonna work either. So you’d [00:46:00] probably be better off with a surrogate. Imagine. So at this point, she is like going, okay, I’m not ready for that. I think I can still have a baby.

Met me. We had a conversation. I assessed the case. As I’m looking through this, listen to this. First two IVF cycles. 12 eggs retrieved zero embryos. Third cycle about six or seven eggs retrieved two embryos. No pregnancy miscarriage in between cycle two and three. So okay, I am looking at these numbers already thinking there’s an issue with the sperm.

There’s obviously an issue with the sperm ’cause you’ve got 12 eggs twice and seven eggs the second time. So there’s, there has to be some something more. So I request the same analysis. I look at the same analysis. Poor sperm count, poor morphology, zero motil, zero motil sperm. No. Told her the same thing that he had a spa issue.

So we [00:47:00] bring him into the office. He was not happy, but he was made to come. And, you know, by this stage as well, it’s fair to say that it gets very exhausting for the male because they really, I, they, you know, they, they feel scared for themselves, for their partner, for the life that they dream about, that may never eventuate for various things.

And there isn’t really a platform in society for men to really express these feelings. And it’s difficult for them to express these feelings within the relationship with their partner, because in their mind, they need to be the strong one. They need to be the rock, right? And so men feel extremely vulnerable in this process, and their lack of willingness to engage comes from that vulnerability.

So it’s important that we acknowledge that. Right. And they feel confronted for their [00:48:00] masculinity being questioned that there could be something here that is to do with their vir virility, their masculinity, their seed, you know, whatever it is that you wanna call it, which is kind of like 1950s, but real in a men’s psyche, right?

And so the reality of it is that there’s all of these competing interests going on in this conversation. But I think that the men who, and the couples who fed the best through fertility challenges, they’re able to look at the situation and literally not take it personally and not blame each other. You know, they can literally see it for what it is.

It’s like, okay, we are wanting to build a house together. We are having some difficulties with our contractors, you know, and our building materials need to be changed and we need a different blueprint, and we need a better architect, and we need a building team [00:49:00] that’s really going to help to support this as opposed to, this is not happening, it’s your fault.

That mindset changes everything. And so the more that we can come into this conversation, looking at the fact that, okay, we are a team wanting to build this house, as opposed to wanting to kind of fight each other in the process, that is definitely the best way to actually get through this. But just going back to finish that story, what ended up happening was that kicking and screaming, he came in, we dramatically improved his sperm to the point that they were able to conceive naturally with her own eggs.

And have their first baby and two years later come back on the program to revisit and have their second baby naturally conceived after being told three different doctors, three different, uh, fertility clinics, that it was never gonna happen. Uh, and she was older, obviously by the second time. So it’s possible when you actually get to the bottom of what is the actual problem [00:50:00] and you address that.

And the actual problem wasn’t just to do with her ANGs. Yeah, yeah.

Jenny Swisher: So you’re talking about, you know, couples who are, you know, going through a lot of, I’ll say trauma, a lot of like, just stress during this process. You’re talking about men and women who are counting on these processes, right? And then, and then they get to the point where it’s like maybe things are failing and they think they’re failing.

And something so small is, has been overlooked. That is so, so big, right? And so you think about the money and the time and the stress and. The relationship and like all the different things. Right? And so I, I think this is a perfect way to sort of just interlude that this is exactly why self-advocacy and understanding and what I call hormone literacy, or in this case like reproductive health literacy, like understanding.

These if, if this is new to you, if you’re listening to this and you’re like, what does she mean by morphology? Or, I wonder if my husband’s semen should be tested. These are all new concepts [00:51:00] to you. This is what you need to learn. Right? You don’t need to go get Yes. Your Harvard PhD or whatever, but you can go and and say like, how can I learn more about, I wouldn’t recommend it.

Yeah. I would recommend it and you know, just simply go ask the right questions. Right. Because I know for me, I didn’t know what I didn’t know. And just like in migraine journey, in my infertility journey, it was a matter of putting the fate into the hands of the doctor I was seeing for 10 minutes at a time and assuming that I knew how I was going to best get pregnant.

Right? And I look back on that experience and I, I feel like I could have done so much more to step into my own advocacy and to really understand, understand things better. So, you know,

Gabriela Rosa: I think that it’s also important to have self-compassion on that because, you know, I’m talking to you and everybody listening to this really, because, you know, I often talk to women who feel so, so.

Guilty and so many feelings and emotions about, oh, maybe I should have done this better and I could have done that better. And I, you know, the result [00:52:00] could have been different, whatever else. And I think, you know, yes, it could have been, but give yourself the grace of not, you know, you knew you did the best that you could with what you knew at the time.

And I 100% agree with you. Learn more. This is the moment. If that was the best moment to learn more, great, but now is the best next moment to learn more. And so, and I’m so passionate about this, you know, Jenny, because I see this struggle that people have because they don’t understand and they don’t know what they don’t know for years.

And sometimes people run out of time to have a baby trying because of this very, very issue. You know? And this was one of the reasons why, you know, fertility breakthrough the book. I made it available free on Spotify. On YouTube because I want people to be able to literally like go, okay, and it’s, it’s audio.

So you can just listen to it and just gain some of that understanding and that context that then can help you make decisions about, okay, what, what, how do I wanna show up? [00:53:00] Situation. What story do I wanna tell myself when I’m 90 sitting on my porch in my rocking chair, looking back at my life? Mm-hmm.

Right. Do I want to know that I’ve given it my best, that I’ve done everything that I possibly could? Absolutely. You do. So then go learn the things that you need to learn and action the things that you learn. ’cause this is another very big point, is that medicine in a bottle has no effect. Right. My mother always says that.

She says medicine in the bottle has no effect, which basically means there’s a, it’s a Brazilian saying, and she says it in Portuguese. So it sounds very different there, but, but it’s a, it’s basically to say that you can know all the things to do. If you’re not doing it and implementing it, well guess what?

It’s as good as zero. Mm-hmm. It’s as good as zero. So this is again, why the fertility challenge is something that I’m so passionate about, have taken hundreds of thousands of people through that program over the years, because it’s 14 days. You get in there, [00:54:00] you learn, you implement, you learn, you implement, and then you actually get to that clarity that you need about, okay, now that I know this, what is the choice I am going to make?

And that is the agency that every person going through fertility challenges, needs. Because I’ll tell you what, the one thing that you don’t want to do is give up, but you know when you’re done, you know when you are just like, you know what, I no longer want to keep pursuing this dream, this goal, this objective.

This is no longer for me. That is okay. That is okay to change your mind on any endeavor is perfectly fine. Giving up is not. Mm-hmm. And I think that that is a distinction that people going through fertility challenges also really need, because it’s so easy to feel overstretched, overburdened over, you know, kind of capitalized.

’cause you’ve put all [00:55:00] of your money’s savings, your everything into this dream that didn’t eventuate. And you go, I, I can no longer, oh yes you can. Oh yes you can. But if you choose that, you want to stop. And that is a conscious and deliberate decision. More power to you.

Jenny Swisher: Yep. Yeah. So good. So good. Well, I, you know, I think that for everyone listening, I mean, this is beneficial because I think it helps us just realize that.

Our health is individual and not giving up on ourselves and not giving up on this goal of whatever it is you’re looking for, whether it’s conception or whether it’s just optimizing your energy, as I like to say, right? Even for those perimenopausal women listening to, um, who are like, does this apply to me?

Yes, it applies to you too. And so I think this is important for us to know. I mean, I, I didn’t get through all the questions that I wanted to ask you, so I am gonna invite you back for a part two sometime so we can go deeper on, I have questions surrounding progesterone and, and all kinds of things that I would love to get into, but I wanted to keep today a bottled up [00:56:00] version of okay, if, if someone came to me, like, what, what would I want them to know?

And I think we’ve done a, a great job of, of covering that. So the other thing that I wanna say is this wouldn’t be my podcast if I didn’t also mention how my story ended, um, in this, in this regard. And, you know, for those of you who’ve come along with me through 350 episodes, you probably already know, but for anybody new to the show.

You know, my husband and I went through, um, infertility after I suffered with chronic migraine for years. And it was funny because as you’re talking, it’s kind of like making me relive some of those moments of leaving the fertility specialist’s office and, um, doing the vid drill injections, doing all the different things that we were supposed to be doing.

I said, I put in quotes and our last appointment with the fertility specialist, I had had surgery, my husband had had surgery. You know, I think as you mentioned before, fertility specialists like to give you the numbers, right? They like to give you the chances or the odds. And we sat down with him and he said, you know, based on the fact that we both, we have issues on both sides here.

He said, I think, you know, I would recommend that we start looking at [00:57:00] IVF. And he said, but even in IVF, I would give you about a 13% chance of conception. And we got in the car after that appointment and my husband looked at me and he said, we’re done. And when he said, we’re done it for me personally, now, this is just my personal story.

For me, it was a breath of relief. Because I first of all had dealt with migraines that were hormonal, imbalanced, triggered. And so part of me was scared. Part of me was like, oh my gosh, like if we go through IVF, like, is this gonna put me back into migraine cycles? Like, what is this gonna do for me personally with my personal health?

But also just the pressure of what we were going through at that time was a lot. And so for him to just say like, we’re done or We’re taking a break from this or something. Like, we’re just, this is, we just need to kind of take a step away right now. We took a step away and um, about six months later, I made a Facebook post, um, on my fitness page.

At that time I mentioned I was working in a gym. I had a fitness. Uh, you know, fitness influencer account on Facebook. And, um, I [00:58:00] posted on their Happy National Adoption Day and it was a picture of my brother and I, we were both adopted at birth, um, though not biological siblings. And I had a picture of us both, and I just said something about our gratitude and, and I had a friend, um, from my hometown reach out and say that she knew someone, um, who was, uh, was looking into adoption and wanted to know if I would talk to that person.

And that person became my oldest daughter’s birth mother. Um, met with her and it changed the trajectory for us. I mean, there’s more to that story. We had looked into adoption and gotten scared, gotten cold feet, and backed out. Um, we thought everything possible could go wrong because that’s, that’s what had been happening so far with, with everything else.

And so when, when I tell people that she literally landed in our laps. That’s what I mean. And it was almost like we had a story that was meant for us. And when I’m talking to women now who are often, I’ve done a few just phone calls lately with women who are in this boat of like wanting to learn more about infertility, wanting to learn more about what they can do to optimize from a more naturopathic side of [00:59:00] things.

I always like to make sure that I mention this story because, you know, regardless of what your journey is, it is meant for you. And I have, for me it was like keeping the faith that like whatever’s gonna happen here is what’s meant to happen for us. And I look now and I look at both of my girls that are both adopted, right?

They both have different skin colors than mine. We’re nav, we don’t look like the traditional family. Um, but I could not love it more. And it’s funny because a lot of times when we’re talking to, sometimes my husband and I will both talk to couples who are looking to conceive and they’ll ask us about adoption.

And I always like to say, um, you know, my husband was, you know, the, one of the two of us that was like, can I love another child? As I would love my own. And I know if he was sitting with me right now, he would say absolutely. Like absolutely. Um, it has been the, the, the biggest gift and the best moments of my life.

And so just for, if you’re listening to this and it’s also been on your heart, just know that there is another way as well. And yeah, and I love, I [01:00:00] love wherever you are in your journey and I just want you to know that the stress is gonna be there. But if you can kind of keep the perspective of this story is meant for me, like the story that I’m living right now is what’s meant for me and, and keep that positivity, it can make all the difference.

So before we wrap it up, you’ve already mentioned, uh, fertility Breakthrough. We have the Fertility, fertility Breakthrough Book. We’ll make sure to link that up in the show notes. We have fertility breakthrough.com, we have the Fertility Challenge. Tell us where to find all this information, how to find you.

Anything you wanna leave us with.

Gabriela Rosa: Sure, so people can go to fertility breakthrough.com, the website to basically find all of the different avenues that are available to them. The Fertility challenge. You can register through the website, you can google Gabriela Rosa Fertility Challenge and you will find it.

It’s very easy. In fact, if you go Google my name with fertility afterwards, you will find me, you will find me somehow. So, um, you know, I’m on every social media platform, et cetera. So, you know, it’s, um, it’s easy. I’m easy to [01:01:00] find.

Jenny Swisher: Perfect. Perfect. Well, we’ll also make it easy for them, ’cause we’ll put it all in the show notes as well, so you guys can simply swipe up to find all the information.

But Gabriela, thank you so much for being here, for, um, for, for giving my audience all this goodness. Like this really is such a great episode that I know I will refer out often. So, all right my friend. Thank you. Thank you for having me. It’s been wonderful. Thank you. Absolutely. Well, we might be in completely different time zones.

It’s dark where I am. It’s morning where she is. But we’re, we’re happy to share this information with you. You guys. If you got value from this episode, please share it out with your friends. Until next time, we’ll talk soon. Take care. [01:02:00]