EPISODE SUMMARY:

In this episode, Dr. Jane is joined by Harvard-awarded fertility specialist Gabriela Rosa, founder of the Rosa Institute and author of Fertility Breakthrough. Together, they unpack why the conventional fertility system often fails those facing unexplained infertility, how the lack of individualized diagnostics leads to ineffective treatments, and what needs to change to improve outcomes. With over two decades of experience and a proven 78.8% live birth rate, Gabriela shares what truly moves the needle - from proper testing to evidence-based protocols, and the critical role of patient-practitioner alignment. This is an essential conversation for anyone navigating fertility challenges and seeking a more effective, results-driven approach.

ABOUT DR. JANE’S PRACTICE:

Dr. Jane is a Naturopathic Doctor and a Natural Fertility Expert. She and her team of expert practitioners help couples navigate infertility for 1+ years, get to the root cause of their struggles, heal, and bring healthy babies home.

After having a family member struggle with infertility and experiencing a miscarriage herself, Dr. Jane realized how little support and education women receive. She is on a mission to change that. Since 2020, she has dedicated her practice to fertility, where she and her practitioners work with couples 1:1, running functional lab work, customizing treatment plans and providing her couples with the support they need to get pregnant, have a stress free pregnancy and a healthy baby.

Learn more about Dr. Jane’s practice: www.drjanelevesque.com/practice

Apply to work with Dr. Jane & her team: www.drjanelevesque.com/application

Join to receive Dr. Jane's weekly Fertility Files: https://link.getcmm.com/widget/form/JStvkHpRAamc7VwPMEQE

CHAPTERS:

00:00 Introduction to Fertility Challenges

01:10 Understanding Unexplained Infertility

03:59 The Limitations of Conventional Treatments

08:43 The Importance of Proper Diagnostics

12:38 Case Study: A Journey Through Infertility

18:33 The Role of Minor Factors in Fertility

22:29 Navigating the Healthcare System

28:44 Testing: What Works and What Doesn't

32:18 Lifestyle Choices and Their Impact on Fertility

34:46 Caffeine and Sleep: Understanding the Impact

35:57 Food Sensitivities: Practical Approaches to Diet

36:43 Functional Lab Tests: Importance and Limitations

39:34 Heavy Metals: Testing and Implications for Health

41:43 Shared Decision-Making in Fertility Treatment

43:44 Choosing the Right Fertility Provider

46:45 The Importance of Patient-Practitioner Relationships

48:51 Investment in Fertility Treatment: Costs and Considerations

50:32 Understanding Success Rates in IVF

53:22 The Role of Testing in Fertility Outcomes

56:37 Preparing for IVF: The Need for Individualized Care

01:01:45 The Importance of Alignment in Fertility Goals

01:02:33 Changing the Future of Fertility Care

TAKEAWAYS:

Unexplained infertility often stems from a lack of nuanced understanding in healthcare systems.

The healthcare system prioritizes urgent health issues over fertility, leading to inadequate care.

Proper diagnostics are crucial for effective fertility treatment.

Integrative approaches can enhance fertility outcomes but require thorough testing.

Minor factors can compound infertility issues, making it essential to identify all underlying causes.

Lifestyle changes can significantly impact fertility and should be prioritized.

Choosing the right fertility provider is critical for successful treatment.

Testing should be personalized and focused on relevant factors for each individual.

Dietary changes can improve fertility, but they need to be practical and sustainable.

Heavy metal exposure can affect fertility and should be monitored.

ABOUT NATURAL FERTILITY:

Pregnancy is a natural process, so if it’s not happening or it’s not sticking, something is missing. Join Dr. Jane, a naturopathic doctor and a natural fertility expert, every Tuesday at 9am for insightful case studies, expert interviews and practical tips on optimizing your fertility naturally.

If you’ve struggling with infertility, pregnancy loss, women’s health issues or just want to be proactive and prepare yourself for the next big chapter in your life… this show is for you.

SUBSCRIBE TO & FOLLOW NATURAL FERTILITY:

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About My Guest

Gabriela Rosa, DrPH (Candidate, Harvard), is a Harvard-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 fertility care, making evidence-based solutions accessible worldwide.

Gabriela also created and hosts The Fertility Challenge, a free online program that reaches tens of thousands globally each year. Her F.E.R.T.I.L.E. Method® has supported more than 204,000 people across 111 countries, with published research demonstrating a 78.8% live birth rate among patients in her signature program—even after years of infertility, recurrent miscarriage, and failed treatments.

Connect with Dr. Rosa:

Website: https://fertilitybreakthrough.com/

Facebook: https://www.facebook.com/FertilitySpecialistGabrielaRosa

Instagram: https://www.instagram.com/dr.gabrielarosa/

Twitter: https://x.com/gabrielarosa

Find Dr. Rosa’s book and services:

https://fertilitybreakthrough.com/

https://fc.fertilitybreakthrough.com/fertility-challenge

https://www.amazon.com/Fertility-Breakthrough-Overcoming-infertility-miscarriage/dp/1781333637

CONNECT WITH DR. JANE:

Website - www.drjanelevesque.com

Instagram - www.instagram.com/drjanelevesque/?hl=en

Facebook - www.facebook.com/dr.janelevesque.nd

YouTube - www.youtube.com/@dr.janelevesque7319

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Join to receive Dr. Jane's weekly Fertility Files: https://link.getcmm.com/widget/form/JStvkHpRAamc7VwPMEQE

Individualized care is essential for effective treatment of chronic fertility issues.

Hi guys, welcome to another episode of Natural Fertility with Dr. Jane. And today I'm joined by Gabriella Rosa, who I'm so excited to have you. Thank you so much for being here.

My pleasure. It's so wonderful to be here.

You have done some incredible work. know, a Harvard awarded fertility specialist. You've written a book, Fertility Breakthrough, and you're the founder of the Rosa Institute. I have a lot of questions for you, and I try to really simmer them down to what will be helpful for the audience. And maybe some of them are a little bit selfish, but I thought I'll go for it because I have so much respect for the work that you do. So thank you for taking the time to be here. I really appreciate it.

Yeah

Thank you, thank you, that's lovely.

So let's get into it. You've worked with, I mean, thousands of couples, I'm sure at this point worldwide, and you've probably seen every version of unexplained infertility. So from the conventional standpoint, what do you think is most practitioners are still fundamentally missing and misunderstand about fertility cases that just doesn't respond to standard treatment?

Yeah.

You know, it's really interesting because the reason that a lot remains or stays unexplained is not because it can't be explained, it's because the healthcare system is structured in such a way that is not focused on understanding nuance for people who are having difficulty. And what ends up happening is that people who are struggling to conceive, keep a healthy pregnancy to term, or even going through IVF cycles,

get treated in the same way as the general population. Now what we do need to be reminded of is that in the general population, most people can see without trying. And that's why we're always hearing about, you know, the friend that had a drunk and one night stand and got pregnant, or the sister who wasn't trying and oops, you know, got pregnant. And the reason is that, you know, within two years of trying,

96.3 % of people will be pregnant and on their way to having a baby, which leaves us with about a 4 % rate of people who are not in that boat. And so you've got to understand that healthcare systems around the world are burdened on many levels, are fragmented on many levels. And so guidelines are put in place.

to really to be used as guardrails for excess use of resource in places where resources are scarce, right? And so if we think about what the healthcare system is meant to do or public health system is meant to deliver is not health for every individual under it, unfortunately, it would be nice if that was the case, is not death for as many individuals as possible under it, right?

And there are major priorities in terms of how those resources get distributed and get used. And mostly these days, we are in a epidemic of non-communicable diseases taking over the world. You know, we have diabetes, cardiovascular disease, cancers of every type. And a lot of it actually has their source in metabolic dysfunction, metabolic disease.

And so does fertility for that matter. You know, like that's one of the things that I think is really important for us to highlight. But because of those priorities that usually are more urgent than what happens for people trying to conceive and also infertility as heartbreaking as it is, isn't life-threatening. And so it gets de-scaled in priority because of those reasons. And so...

Certainly.

To answer the question of why is it that we end up with so much being unexplained is because, well, population level assessments and screening and diagnostics are not going to be enough to really deep dive and understand the issues of people who have been trying for two years or more. And this is another thing that happens is that because doctors are then working under

a very guideline driven, guardrail driven healthcare system. They are benchmarked against their peers, against a guideline that is ineffective for addressing infertility miscarriage and failed treatments at a higher level. Now, if we were to take a next step from there, why is it that, you know, IVF is the standard therapy when

over 90 % of cycles actually fail. know, like if you look through the data across the world for the number of cycles that get started that yield a live birth, they're very, very small numbers, you know, over the entire population that gets treated to the point that, you know, over 90 % of cycles that get started do not yield a live birth. And yet it is called the golden standard

treatment for infertility. Now IVF was literally designed to address tubal factor infertility in women who had either blocked full open tubes or were born with no tubes. These days it's used for everything from male factor infertility to immunological conditions to genetic issues and everything in between. Now without the discernment of why is it that we are going down the path, you see, and so

It's like, well, if you're going to treat, and this is one of the things that happens in the healthcare system across the world, is that if you're going to treat anyway, why test? Literally taking cost effectiveness classes in at Harvard was eye opening on so many very heartbreaking levels that are, know, as a naturopathic practitioner, I go.

It's laughable though, it's true. It's laughable.

Yes.

How is it that this is even possible that we're not talking about prevention and we're certainly not caring about prevention when it comes to healthcare. Like I'm doing my doctorate public health at Harvard right now. And really, we're looking at populations, population level, data, information, support, and you've got to put some guardrails in place because you're talking about billions of people on the planet, right? So of course,

And really, if we think about it on an individual and personal level, if you are the person experiencing infertility, it changes your entire world. It is heartbreaking on every possible level. But yet, that literally is such a tiny percentage. It's like millions of people experiencing infertility. It's like about 50 million. Let's kind of round it up. So 50 million people experience infertility or infertility-related tragedies, right?

we have 8 billion people on the planet. 50 million, 8 billion. You can see why such important issues become deprioritized because ultimately, in the healthcare system, there's only so many resources. And then, of course, there are these guidelines that get set that it's like, well, if you're going to treat, don't test. Now, that's one of the reasons why.

we have such a failure rate when it comes to fertility treatment because you're not actually understanding what are the foundational issues. You're literally just applying treatment and people think that more treatment is going to give more chances of having a baby. I can tell you right now, in my experience over 25 years of treating people to overcoming fertility miscarriage and failed treatments and my master's thesis at Harvard.

was my own program and that's how we found that the program that I'm running has a 78.8 % live birth rate because we actually test first. That in the first-hand method, which is the method that I developed, the F is fact-find and that's deep diagnostics because we can't, I'm a true believer that you can't fix a problem you don't know you have. So that's the difference between standard care and population level care and the

quote unquote golden standard of fertility treatment and personalized precision medicine, which is obviously what we deliver and the difference in results is clear.

Yeah, it's huge and I'm glad you touched on that point because the next part of that question for me was like, but like even an integrative and functional fertility.

there's still plenty of people who are not getting the results that they're hoping for. And so you have this 78.8 success rate. And I remember when I first started following you, believe it was like 72.3. So it's super cool to see that you're actually increasing your success rate. And I have so much respect for that because I know what it takes to do that and the percentages. And so, you know, when you're experienced, what are the most, the most integrative approaches are still missing that doesn't move the fertility case forward.

How is, what is so different about your approach? Proper diagnostic?

Diagnostic, proper diagnostic. Like literally, it's proper diagnostic. Like most people don't spend the time to properly diagnose the problem or the money and, and, or spend the money in the wrong tests. Like,

or the money?

Let's talk about some of the testing. think that's something that I'm like, push so hard to advocate for. And I think, you know, I have one of the couples where I've taken them on after they were with another clinician and they just like didn't want to run.

this assessment because they're like, I don't really understand why. And I think a big component of that is cause the clinician didn't explain why, but now a year later you've moved the needle on so many things, which is amazing, but you still have this big problem, which is yes, sure. It's infertility, but like hormones are not doing what they're supposed to be doing. You're still tired. You're still can't lose this weight. And it's like, we need more diagnostics and it's so painful to be like, yeah, you spent five grand two years ago, but you should have just spent seven.

because now I need the other two grand.

Yeah, look, think that, you know, the thing about testing is a similar thing to supplementation. And this is another place where people go completely haywire and off the rails and in a completely wrong direction. Right. But if we come back to testing, what I often find is that testing is nuanced. Testing has to be personalized based on the history and the things that haven't worked. And I'll give you an example.

Yes.

I had a couple of ones who were trying for 14 years. The first eight years of trying, they were kind of blase about it. You know, they were literally like, oh, you know, if it happens, it happens. And then when eight years kind of came about, they were like, okay, eight years is a long time. She was a pharmacist. So obviously, you know, it wasn't like she was lay in every possible way. And so she basically was like, well, probably we should start looking at something a little bit more now.

And they did and they did six failed IY cycles and then they got recommended to do IVF. So they then started down the IVF path, did two IVF cycles that didn't work. And then by this time, what she's starting to hear is, yeah, it's your eggs. Your eggs are no good. You you need donor egg. And she's like, what?

She really wanted to, she still didn't have a diagnosis, right? She still was asking a case about why has it not worked? Oh, you know, it's unexplained. And so she was like, okay, I'm not happy with that answer. You're too old now. What about, no, this by then was like 13 years, right? To start to see here that she's old. It's like, but yes, exactly. That wasn't the case 13 years before. And so.

You're too old now. But like, what about the eight years when I wasn't old? We don't know.

But 13 years ago, she wasn't too old. So they explained to me that one.

Exactly. And this is the thing that a lot of times, know, it's, it, is the proxy for everything and it's not right, but that's, it's the lazy explanation, right? Of like, this is just what it is. And it's like, wow. So anyway, long story short, they came on to, have an assessment with me and they came into my clinic and we started treating them and we don't take on face value.

that the results that you had from two years ago or three years ago or five years ago, or the results that you'd never had are going to be okay just because you're not having major symptoms. So we go and start to really foundationally test the basics. Like, what is your blood glucose doing? Like, what's your two-hour GTT doing? What's your thyroid doing? What's your... You know, like we literally are going to like...

Thank

really look at everything that needs to be looked at, even if it means again, because we know that if you've had tests six months ago or more, those results are telling us the story of what happened in the past already before that time, not what's happening right now. And so it's going to be a thing that, and I'll talk about the funding of fertility treatment in a second, but you know, I think that it's going to have to be a situation where you just got to like,

close your eyes and go, how much do I want a baby and spend the money? Cause like you're not going to get this done in any other way. But with this particular couple, we start this process of retesting and she had diabetes and there were complicating factors, you know, that were, that were getting in the way. And there were other issues that we found as well. There was also some major sperm parameter issues. You know, he had 2 million sperm.

And so when I asked him and I said, how, like, have you always had low sperm count? And he goes, what do you mean low sperm count? I'm like, well, your sperm is 2 million instead of the minimum 20 million that we need to see. nobody ever told me that.

Yep. 13 years of infertility. Like, are you out of your mind, you know?

Okay. So basically I'm like going, okay, well, you do have lesbian count and we need to find out why because it doesn't just happen for no reason. So is this a lifestyle issue? Is this a varicoseal issue? Is this an infection? Is this like, I don't know. Anyway, so we start testing and we do all of the STIs again, turns out they both have chlamydia. That was not picked up by anybody else in 14 years or

Mmm, there you go.

However long it's been there, right? And then I'm thinking, gosh, now, fallopenture is going to be blocked, hepatidimus is going to be blocked, like we're going to have no chance of, you know, making this work. But we did treat them, obviously antibiotics, heavy duty antibiotics, 40 days, we got the whole thing, you know, kind of cleared and they were able to conceive within the first attempt after all of this was done. So, you know, this is the thing, like sometimes and

Chlamydia is one of those things that it's a silent infection, you don't really know you have it. It may not cause any other problems that are visible, but if it's there, it's going to be stopping implantation, it's going to be stopping conception, it's going to be doing all sorts of things. And that is an obvious big factor that gets identified. But in many, many cases, it's lots of little minor factors that are getting in the way. And so what happens is that we can't expect

that we are going to find one major big thing because for the majority of couples that I treat, we don't. We don't find one major big thing. We find lots of little minor factors, a little bit of like sperm parameters that are suboptimal. We have slightly irregular cycles, irregular ovulation. We have endometriosis diagnosis or whatever it is. These are minor factors that compound each other.

Mm-hmm.

And what we know again from population data is that if we have zero minor factors, we have an average of three months time to pregnancy. So most people, over 94 % of people will conceive within three months of trying. Okay? If you're still trying after that, the modeling that has been done in terms of fertility and fertility rates in the world, it goes a little bit like this.

No zero minor factors, average of three months time to pregnancy. You add one minor factor and again, sperm count being low is a minor factor. All of a sudden we go from an average of three months time to pregnancy to two years. You add a second minor factor, we have an average of seven years time to pregnancy. You add a third and it takes us to 40 years average time to pregnancy. Now, nobody has 40 years to get pregnant.

Hahaha

Right? And so we need to figure out, absolutely. So then it becomes a matter of like figuring out what are all like, you know, I often say that we're often project managing hundreds of minor factors for our patients at any given time. So then it becomes a matter of having to really prioritize, you know, what are the things that are happening upstream that are leading and causing all of these other minor issues that, you know, lead to a no result.

No, you've missed your window.

inability to conceive, inability to keep a healthy pregnancy, to term failed treatments, whatever it is. And what is it that is just going to be resolved by us working upstream of that issue and that we don't need to address, you know, at an individual level? Because if you are dealing with hundreds of the amount of factors and most couples who are struggling to conceive are, trying to do this in a linear way is absolutely the surest, far way to run out of time to have a baby entirely.

Right? You're not going to have time for that kind of thing. So it just means that we have to do so much more to be able to get the clarity that you need. So that for me is the first step is really taking a step back, understanding the landscape, understanding what's getting in the way to then move forward and go, right, now we have the information and the understanding that we need, let's apply treatment.

Mm-hmm.

That then becomes effective because otherwise what we're dealing with is a situation where, you know, people think that they, I just talked to a lady just before actually getting into this conversation with you and it was really interesting. Six years of infertility and she's done my fertility challenge, which is a free program that I've run for the last 15 years to really help people understand what are the evidence-based ways that you can self-care to optimize fertility.

which are all important. But as I talk about, those are foundations. They are very strong foundations upon which to overlay effective treatment. And you can't overlay effective treatment without understanding what it is that you're treating. And that's where diagnosis becomes so important, right? But the really interesting thing, she had done my fertility challenge. So she was having a conversation with me after that. And she's like, because, know, like I'm doing all of these changes and I'm applying all of these things. And I'm like, okay, that's great.

And that's never going to be treatment. You know, that's not actually the answer.

That's just like what you need to be doing, period, like as a human. Yes.

Just to survive and hopefully thrive, but just to kind of like be okay, you need to be doing all of those very important foundational things like eating well, sleeping well, exercising in the right way. There's very specific things. Absolutely. Those are all very important foundational things that we need to put in place. But if we don't know, again,

in 2026.

Drinking clean water.

that we're dealing with chlamydia or something like it, right? Or various multiple things like it. Then we end up with a situation where we're going around in circles, having more and more IVF cycles being told. And look, mind you, I had patients. So, you know, like I talk about a case in fertility breakthrough, book, which incidentally is free on Spotify and YouTube. People can go search it. But one of the cases that I talk about in that book was a lady who had tried

when she failed IVF cycles, right? And private clinic.

Here's my first question. Who is letting her do that?

Well, and this is the thing, private clinic, right? And there's a whole thing about, there was a really interesting paper that was published in Atlanta, no, the JAMA actually. The JAMA where it's talking about private equity investment into fertility clinics and how in private equity clinics, which this was one of those, basically you have a...

I know, like who is letting a woman do 20 cycles?

almost 50 % increase in the number of cycles that are done compared to academic hospitals, right, or public systems. 100 % because there's profit. mean, IVF is a multi-billion dollar business, right? So it serves, yeah, exactly. So it serves the whole purpose of profit-making, right, which is the more cycles, the better.

And that's because there's profit.

39, I think, 38, $39 billion. It's not a small business.

And it's not about understanding what's not working. It's just keep applying treatment. And because the guidelines in the healthcare system allow for that, because it's like, we're not going to pay for testing, so you might as well have treatment. It's a whole broken system, right? I mean, that really is what fertility couples are having to navigate, you know, a whole broken system. But in saying all of that, you know, one of the things, and, you know, like, I think that we've moved away from the original question.

Yep.

But the biggest thing that I think is really important for people to understand is that unfortunately, the system is not designed for them, right? And in these situations where you've tried lots of different things and you just keep being told it's a numbers game, it's unexplained, it's bad luck, honestly, it's none of those things. It's just that there is a misaligned interest.

You're good.

to continue having people be kind of blinded to what's going on for them.

And I want to just make sure I understand you correctly, but essentially what allows you to prioritize the treatment is the level of testing and like the depth of testing that you do. So you're not just going to do the chlamydia and look for that. You're going to look at a lot, a host of things. So then you can prioritize based on, know, like chlamydia is going to be pretty high up there versus like, well, there's a little bit of this gut bug or whatever. Yeah.

Yeah, and also, you know,

all of your STIs, yeah, all of your STIs are gonna be out there. they are in every, and the thing about it, you know, like, and this is not a popular opinion, but it's the reality of what I've seen in 25 years in clinical practice. Infertility can be really challenging on a relationship. And, you know, if people are already going to be unfaithful in relationships when there isn't infertility,

Yeah. Yeah.

where there is infertility that happens at probably a slightly higher rate than it does just in general. And of course, when people are being, you know, when infidelity is in question and people are not in monogamous relationships when they think that they are in monogamous relationships, that can create a lot of issues, right? I've had patients who literally comes out in fertility treatment that

the high rate.

And we're the ones to uncover it, right? You're like, I've been with one partner. How do I have chlamydia?

Well, this is the thing. Like, you know, I've had, I've had really deep conversations. this is the thing. And look, you know, the reality is that that could have been there for ages, but at the same time, it's like, you know, I've had a guy once literally admit in a consultation that he had been, you know, to stripper clubs and having sex with prostitutes, you know, unprotected in the course. And I'm like, okay, now how do we recover from that?

Mm-hmm.

Let's not even... Wow. That was an interesting situation. mean, actually, that was a unique and different situation. And obviously, there was a lot of conversations that had to go back and forth about, you know, do we still want to be together? Do we still want to have a baby? Do we still, you know, is there healing to be done here? And, you know, it's interesting because sometimes...

Do you, how do you recover from that?

Women will choose to stay in relationships like that because they want a baby more than they want the relationship itself. And that brings up all sorts of other questions that for the future, might be difficult to disentangle in the moment. And I've had situations where people decide that they're going through fertility treatment together and then end up breaking up because they realize that they actually don't want to be with that person or they don't want the same thing.

But infidelity is definitely, and so when it comes back to what we test and why we test it and why we test it regularly, STIs is one of those things that we find really important to test regularly, to test just because, to make sure that we are retesting and that we look at those things because also this is the other thing. There is a incubation period for a lot of microorganisms.

You might test today, and it's really not until six months that you actually start to be able to pick up that microorganism in the culture. And so it's not enough often to test once. The first test is a screening test. The second test is a confirmation test. The third test is like, OK, things are clear. And that tells us that, we're good on that level. So there are certain things that we will test multiple times within the context of treatment.

we're not going to be focusing on like, you know, I'm a scientist at the end of the day, really, I want to know that, what we're doing actually is reproducible, has a result and is going to the next person is going to be able to have the same kind of reproducible result. And so from that perspective, you know, like I'm looking at also doing tests that I can benchmark across within people and across people. Right. And so there are certain things that are not my first go to.

because I know how important it is to understand the basics. For example, I would 100 % every single time prioritize a DNA fragmentation and semen culture over a Dutch test. Like absolutely 100 % every single time. If somebody said I have limited resources, should I do these tests? I'd be like, do not do those, do these. Right? Because ultimately there is a

very much that I can't pick up really from regular testing that a Dutch test is going to give me. And in that situation, I would treat anyway, therefore why test? You know, so there's like, and then of course, if we've exhausted and done all of the foundational work and we've done everything and we still have questions that only that test can answer, which I don't find that there are many things that only that test can answer, I wouldn't do it.

Right? And so it's about also figuring out like, how do I best utilize the resources that are also limited from a couple's perspective to get the results that we need to get, i.e. a healthy baby, as opposed to wasting resources and testing things that are not necessary or that are not really going to add that much further input. I think that if there is a test that, excuse me.

is only going to tell me one thing versus me being able to understand much more about biochemical pathways. I will always kind of pick the thing that I know is going to be the most critical, the more open range that is going to give me the most answers at one given time. And I'll prioritise retesting when necessary over doing new fancy tests that really aren't going to give me a whole lot.

Yeah. And so is this where you feel like most practitioners like integrative practitioners are going wrong? Is that they're actually spending the time and energy on the wrong testing?

Yeah, I think that I see that often. You know, I see all of these like, I mean.

Where do I begin? I often will see like food sensitivity tests done. And I go, what a time and resource and money spent on food sensitivity tests. Because the reality is that you can adjust diet and nutrition and get 90 % of the benefits that you need to get from somebody going through treatment that

pretty much the major, and address leaky gut without doing these silly tests, you know, that really, most things will come up positive anyway, you're gonna be sensitive to most things. Pick, you know, areas that are of concern. I always, for my patients, I always make sure that they are avoiding gluten and dairy, and I will always test gluten because obviously celiac disease is an independent risk factor for infertility and miscarriage.

and address leaky guides.

And so, you know, from that perspective, that's obviously very important to test, but those are different tests and that's obviously also immunological red flag, right? So it's not something that I would be looking at from any other perspective, other than to know, okay, do I have a disease that I need to address as opposed to some food sensitivity that if I know that I'm going to be sensitive to a particular food, just avoid it, just be done with it, you know, and that's it. Like, really, to replace the nutrients.

That's too simple, Gabriella. But isn't it like if people just stopped eating gluten, there's so many things that would go away, but it's so difficult.

Ugh, honestly, I got practicality people.

thing. I'm like, what do you want more? Do you want a baby or you want your gluten? Like really, you can't have both. you know, like which one is it going to be? And look, I actually, I actually say to my patients, you know, like I have a rule which is called the 10 % for the soul, which is if we test and you are not lactose intolerant and celiac intolerant, gluten intolerant, right, or IE celiac, then I'm okay for you to have gluten and dairy once a week.

Yes, I know. You can't help it.

go for your pizza. Like that was a rule that I had for myself when I was going through my own treatment. Right. I literally was like, you know what? Pizza is my religion. Like, let's just be honest. That's just how it is. I have pizza once a week, no matter what. Yesterday was my day. And no matter what happens. Absolutely. And I never feel good the next day from pizza, but I still eat it anyway. Right. Because I love it. But I know that. And so I also know that

Yep.

That's why you feel so good today.

Yes.

Mm-hmm.

the threshold because food sensitivities happen on a threshold. And so if you are staying under that threshold, it's likely that your immune system also isn't going to be overreacting. But if your immune system is constantly overreacting because you're constantly exposed to that food, it's going to have other immunological red flags that are going to impact fertility and the ability to keep a pregnancy to term. So why risk it is really what I say to my patients.

It's the fact that we need to make sure that we are really addressing the important things, the things that are not going to be that important. And also, I really believe that people have to be able to live. It's not about restriction and, know, alcohol is my absolute no-go zone. That is a zero tolerance for alcohol because we know for both partners, 100%.

Yes.

And for both, right, men and women?

So alcohol is an absolute no. I did on Instagram, I do a lot of patient education on Instagram, Gabriella Rosa Fertility is the place. I did a mini literature review on alcohol and the impact of alcohol on fertility, IVF treatments, the increased cost of even one to two drinks of alcohol on an IVF journey for couples can take you upwards of $100,000 in treatment costs because of one...

It's not worth it.

It's this is the thing like give me the money. you're like, what? Hey, what's the point? Like, why are you, why are you actually sabotaging that result? Like if you just want to throw it in the bin, just, you know.

I think most people don't realize that because they're also fed this story that like alcohol isn't bad. You can have one to two drinks. A woman can have one to two drinks and it's healthy. A man can have three to four drinks. And I'm like, why are we still talking about drinking as a healthy lifestyle that it has flavonoids or whatever? What is the, I don't even know what the angle is anymore, you know?

No, you can't. Exactly. Precisely. No, I'm sorry. The whole paradigm is completely, you know, like the French paradox is really not a thing and that has been demonstrated already across multiple population studies across the world. fact,

Yep.

Harvard has one of the biggest data sets in the world that tracks people over decades. And alcohol, even one to two drinks, increases the risk of breast cancer, colorectal cancer, you name it. And again, this is not massive doses. These are small, tiny doses, one to two drinks a week. And you have these women having a much higher incidence of breast cancer and colorectal cancer and liver disease and metabolic dysfunction.

everything.

actually, which then obviously impacts everything else. And so, you know, like it makes no sense. And it's still one of those things that I think we have to dispel and demystify for a lot of people. Now, when it comes to coffee, it's not the same thing. You know, and some people can have a half a cup of coffee a day and not have a negative impact on their ability to conceive, ability to keep a healthy pregnancy to term.

it's going to be more a situation of whether it impacts your sleep. And some people obviously have specific, do know types that are going to be more affected by, coffee than other people. So if you have a half a cup of coffee and you feel gist, it means that it's not for you. Okay. Like that, that is just how. Yeah, absolutely. So then you know that, okay, that's not for you. And that's just how it is. But if.

Yep, it's not for me. My husband can drink and he's good.

that is not you, then you're going to be okay and you can drink it as long as it doesn't impact your sleep. And you have to remember the half-life of caffeine is also huge. know, like you can have a cup of coffee at 12 o'clock and it's still be half-life circulating in your stream, in your bloodstream at 8 p.m., which can impact your sleep. And if coffee is impacting your sleep, then that's where I go. Don't have it or have it very early in the morning and, you know, limit it. But

You know, so there are these kind of nuanced things and, you know, and that's why when it comes to food sensitivities, I don't even waste a second or a dollar doing those tests because I just feel like they're useless. You might as well just keep a food diary and track your symptoms and adjust your diet accordingly. And you'll be much more successful at pinpointing what doesn't work for you and your body versus what does by just doing that. And like you said, you know, like if you just remove

From the diet, gluten and dairy, it's a world of difference that it will make for most people. And so from that perspective, that's essentially sometimes you just got to be practical.

Totally. Do you have any functional lab tests that you love that you like really stand by and everybody has to do?

Look, I am not like, there are some very specific things that I will always make sure that I cover. There are bases and metabolic dysfunction is one of them. So, and those are usually done by a standard test. So it's not really something that, a, we do hair mineral analysis, hair tissue mineral analysis. We do make sure that all of our patients do them really to understand excretion of heavy metals.

Right? Because if I see it in a hemorrhoanalysis, it doesn't necessarily mean that I'm going to do anything about it. But it means that I will then be flagged to test blood levels of mercury and aluminium and, you know, whatever heavy metals that we've got to figure out, OK, what are we actually dealing with here? Because if we don't do that and we have a recent exposure situation, because you see with heavy metals,

Mm-hmm.

They get stored in deep tissues, right? They get stored in hair, organs, brain, et cetera. If they come out in the hair, it means that you may be getting a pocket of heavy metal that's being excreted, or it may mean that you have some ongoing recent exposure that's coming out in the hair at this point. Now, I'm not going to go and test every single person for every heavy metal in their blood because that

is expensive and you're not usually going to find very much because by the time it is in your blood, either it's very high dose recent exposure or there's something else going on that you, you know, that you're not really aware of. And so most of time you pick up nothing by doing blood tests of heavy metals, right? So the way that I approach it is I want to know on average, how are we going in terms of nutritional status, right?

And again, it's a retrospective analysis. It's not, you know, what's happening, what you're seeing in here is six months delayed, right, of what happened six months ago, but at least it's a gauge of what's going on. And so when I then look at the heavy metal piece, I'm going to ask the question, do I need to test blood? And the initial test that I'm going to do is going to be an unchallenged test. It's literally just going to be, do I pick up anything?

Because if the answer is yes, then we know it's recent exposure and high level exposure. And we need to find out where it's coming from. Is it a leaking tooth filling that is all of a sudden coming out into the bloodstream? Is it that somebody is eating too much high, tuna? Why is it? I had a patient once who had eight miscarriages and I test her hair and it's off the chart. I go and do an unchallenged test and it's off the chart. I go do a challenge test.

And it's 40 times higher than the maximum toxicity range that somebody should have. And it came out that she was just eating way too much tuna. And then basically what ended up happening was that it took us a year of chelation therapy to get her levels back down. In the end, she ended up with four children. It's all well and good now. But that was the first time that I went, wow, okay, this is something that we do have to have on our radar because this is something that is going to make a difference.

It's huge, yeah, it's huge.

you know, for a lot of people. But again, there is a staging process for testing for this because it's not going to be effective to test everybody for everything. And not everybody needs it. And when they do need it, then the question becomes, is the unchallenged test enough? Do I need to challenge? Because this is the other thing too. If I challenge, then it means that there's a chemical that needs to be inserted into the bloodstream.

Not everyone needs it. Yeah.

and then I'm taking blood, but then you can't try to conceive for four months after you've had that test. So you then have to also consider fertility potential and fertility timing and all of these things. And so it doesn't make sense to do that for somebody who's 47 trying to have their first child and with their own eggs, who's not yet ready to consider donor egg. Like we wouldn't approach it that way. Right. So it just depends on what it is that we're dealing with and how we need to approach things.

moving forward.

I do find that a very difficult clinical decision to make because if you know and you see somebody who has heavy metals but then you see the age and then you're like, well this is obviously impacting their fertility. So how do we make the best out of the situation without opening up the can of worms?

And that's the thing. And often you just have to do the best that you can without opening the can of worms. Like literally. Because if you don't have time, right, fertility potential time, then you can't test heavy metals in that way or treat it in that way. Because unless of course somebody says to you, hey, I'm open to any possibility.

I want to, and again, this is where shared decision-making with a patient is very important because you need to explain to the patient, look, this is what's happening. This is what it means. These are the pros and cons. These are the ways in which we can address it. This is the benefit of doing this. This is the drawback of doing that. These are for this other path. These are the same things. What is it that you feel is going to be important? What is it that you would like to do? And then from that,

value and preference perspective, we can then figure out how to approach the situation with that person based on what it is that they feel they can live with. Because that is also what it comes down to. the end of the day, fertility treatment is so sensitive because we have an influence and an impact and a responsibility with somebody else's rest of their life, right, whether they have a baby or not.

Yeah, it's big.

And so we have to, in my opinion, part of the fertile methods, the second piece is educate, is really we have the absolute necessity to educate that person to be able to make the best decision for them, which may not be the same decision that we would make for ourselves. But I think that that is the way in which somebody will then be able to sit on their porch when they're 90, sitting on their rocking chair, looking back at their life.

and not have regret over what they did and how they did it, but feel empowered by the choices that they made at such an important pivotal point in their life. And that's how I always think about this. It's like, okay, how is it that I know this person would like to feel based on this conversation that we are going to have, as opposed to me just arbitrarily making some decision?

about them, their care and their situation, that I'm not going to live that life, right? I'm not going to be the one that's going to have to show up to that life every single day. They will. And so I want to help them to get that clarity and that level of autonomy, advocacy, empowerment over their own decisions and choices from a place of knowledge and understanding about their situation and what the options are for them.

Right? They may still choose that they don't want to do that thing or that they want to do that thing, but at least they now understand why or why not they would go about doing it.

shirt.

Yeah, it's a big, I I was just thinking about like, what are some of the red flags that when you're choosing a fertility provider, like what actually signals that you are in good hands versus this isn't the right path for you. And I find that that's very difficult. I try to educate that, you know, through the podcast because it is very difficult for someone who is in distress and already feels this pressure of time to make an actual like

proper decision that's not emotionally driven to work with somebody and have that, hey, these are the things that I'm looking for. And it does come down to the conversations that you have with people and practitioners, right? And it's hard to create space for that when you're in distress.

Yeah.

Absolutely. Yeah.

And I think that it is, and I think that this is where people need to be able to have that reflection in advance of going into a consultation as well from the perspective that if you don't feel heard, if you don't feel seen, if you don't feel validated, and it's not that you will agree with every aspect of what that practitioner says. Like today I had to tell somebody, I absolutely disagree with everything you're saying and here's why.

Yes.

I know and it's hard. It's like, yeah, I have to tell you that I had a patient with a miscarriage and the male factor, was like, listen, you're still drinking. Like, I don't, I don't know what to tell you guys, but you know, it's like.

And, no, really. And look, you know, and...

I had a couple the other day smoking in the car, talking to me in a telehealth consult and I'm like, okay, we're going to go there. You know, and so we're going to go there. We're going to go there. And you know, when I go there, I go there. Like, I'm not afraid. You see the thing about it. And I think this is the benefit of one being experienced and having done this work for 25 years, very, very seasoned and no longer willing to take BS.

What are we, we are gonna have a co, yeah.

A seasoned practitioner.

Yes.

you know, the thing about it is that, I mean, I've always been that kind of personality, even very early on in my, in my practice, in my clinical life. But I think that over time, as I personally have, you know, come to a situation where like, I'm not here for BS, I'm here for the job, I'm here for the work, I'm here for the baby. you know, there are things that you just have to say that people just need to hear, even if they don't like it. Right. And I think that this is important, but at the same time.

Yes.

If they're not being heard, they don't feel that the person in front of them has their best interest at heart, that is not the right clinical relationship for them. And so I think that, and if they are dismissive, if they don't care, if they disregard your concerns, next, next, there is no other word for this. You know, it's like you are not going to get the best care from somebody who's not listening to you to begin with.

Yes.

Yes.

And so I think that that's a really important thing for people to understand and to internalize is that the person who's taking care of you, yes, they need to be highly well-trained. have to be good at what they do. They have to have a proven track record. But at the end of the day, the relationship matters. And the person might be...

Yes, for sure.

Yes.

very direct as I am. Like I'm exceedingly direct. Like I, you I'm very kind. I care for my patients. I have been doing this work for such a long time. And the last thing I want to say is for them to go down paths that are not in their best interest. But when they're causing that as well, they're going to hear about it. And they're going to hear about it from me in a very nice way, in a very kind way, but in a very direct way.

for sure.

Right? Because that's what is required. Otherwise people just keep going around in circles and lose their ability to have babies entirely because people didn't want to tell them what they needed to hear. Right? And so I think that that's also not okay.

Mm-hmm.

It's a really big differentiation. When I have your best interests at heart, that doesn't mean I'm only your cheerleader. You know, I am your cheerleader and I believe.

Oh, absolutely. Sometimes I'm showing you a mirror.

a lot of the times.

Sometimes I'm like, okay, tell me what it is that you want, really. Do you want to drink? Do you want to smoke or do you want a baby? Cause like you can't have both, you know, and that's the thing. And this is another thing we were talking about investment in treatment. This is another really important thing. It's like, you can't keep your money and have all of the tests that you need. Like it's not going to work. Right. In the same way.

Yeah. Yes.

that you can't have a child and expect that you're going to be able to invest that same level of money that you would if you didn't have a child into the stock exchange. Like it's not gonna happen. So if you like money, keep your money, don't have children. Because children are expensive, okay? They are very expensive. It costs upward of a million dollars to raise a child to the age of 21.

So if you can't afford fertility treatment or don't want to afford fertility treatment before you have a child, rethink 10,000 times if you want to actually put children in the world because they are going to cost way more than whatever fertility treatment is going to cost you at the outset from birth, right?

Yeah. Well, and for sure, the flip side of that is like children are expensive, but I also don't want you to waste money. Cause and that's where you need to interview your practitioners because if you don't, then you're stuck doing some functional lab tests that are not accurate. Or, I mean, I have people who have had really great tests done, but nobody sat them down and helped them understand what the findings are. And it's like, well, then why are you the test?

100%.

Listen, is there any more waste of money than going through five, six, seven, 10, 20 IVF cycles and being told this is unexplained, it's a numbers game, just keep trying? I'm sorry, I don't think there is, right? If after three IVF cycles, you're still not pregnant and literally on your way to holding a baby, there is something wrong. It's not a matter of if there is something to be found or should we look at

Yeah.

It's a matter of what it is that hasn't yet been found. That is as simple as that. Right. And so, and this is one of the things that I see all the time, because people come to me after 10 failed IVF cycles, right? Asking, what is it that, you know, it could be something wrong? I'm like, why are we still at this point in the conversation? Because clearly their doctor has not explained to them that, yes, of course there is something else and we need to look into it because that's not the scope.

Of course.

of an IVF doctor, I often explain to people that the reality of it, you see, this is the difficulty that I have with different clinicians out there. A lot of these unfamed fertility coaches, right, that basically have been patients, now they decide that they're going to help people go through IVF cycles because they've experienced that they've been through it and now they think that they can guide somebody else.

A lot of times what they do is they cost money, yes, and it can be a waste of money, yes, but what they cost more is time and fertility potential, right? And that is a problem because then you run out of opportunities to try it all together, right? Now, then you have a higher level of that, which is people who kind of, you know, are in that realm of functional clinician who basically

you know, is not specialized enough or is not really the best fit, but we'll do some things and further some things forward, but people stay too long and they waste a lot of time. They find some things, but they don't, it doesn't move the needle. Right. Then you have the situation of doctors who basically are not interested in testing at all. They literally just like, okay, here's a referral, go to IVF. Let's just keep doing fertility treatment.

That wastes time, money and energy and heartache and puts people in a completely different kind of life experience because they're not actually taking the time to go through all of that. Now, does it mean that all of those paths are useless? No, not at all. Sometimes you have to start somewhere and you have to kind of make your way to even from what hasn't worked to what else could work and what else could be beneficial. So from that perspective,

Yes.

It's definitely going to be a situation that you're learning through where you don't want to be, but it's still moving you forward. The key aspect is when you linger in any of those places too long, right? And you start to believe the whole thing about it being a numbers game or it being about more treatment or it being about, you know, let's just keep trying. We just need to optimize more. We need to improve your lifestyle more. It's like that's where it starts to

Yes.

know, break down the opportunity to actually have a result in a timely fashion. Like when we first did our analysis, you know, we had 544 patients and we looked at the time to pregnancy. Most of these people on average had been infertile for four years, plus or minus three years. 51.5 % had experienced miscarriages prior to coming to treatment. That rate dropped to 13.5 % and more than 50 % had experienced a failed IVF cycle.

We had an average time to pregnancy when I first looked at 12 months plus or minus nine months. So I was really interested about this large standard deviation for time, right? Because I was like, why is this that some people conceived within three months? And I've had a patient who was trying for 19 years can see within five months. So why is it that some people conceived within three months and other people took two over two years? So none of my clinicians could answer that question.

So I made them reopen every single file. They were not happy with me, but it was the job. We had to do it because we needed to understand what is this difference? Like, why is this happening? What we identified was really so obvious and uninteresting, but critical. And that became a tenet for us, which was the people who took longer to get pregnant delayed their testing.

we had.

So we were still talking six months down the line and they still hadn't had a word to testing them that they were recommended to get done. And we're still waiting for things to be looked at, right? Whereas the people who got pregnant quicker, they tested quickly, we addressed it, we moved on. So when people ask me, so how long is your program? Well, that depends on you, right? Because it depends on how quickly you implement is going to ultimately determine.

I mean, there's so many factors.

Yes.

how quickly you see results. And so at the end of the day, particularly when we have something that's very framework based, like the fertile method and the fertility breakthrough program, we know what to expect. So we're pacing and we're timing people based on what we already know makes a difference, right? And so the variation is really only happening because we haven't yet found enough. We have to keep looking and we have to keep testing. But other than that,

Right. If you don't have a very systematic process for benchmarking your own process, then what happens is that practitioners might be in clinic. It's very, we're very subjective if we don't have these benchmarks, because what happens is that you remember your last three, five cases. You won't remember, you know, your last hundred cases. So you will have a sense.

but you might know exactly what is what I'm doing systematic and methodical in a way that I can literally put A, B, C and know that I'm going to get D, right? And so that also is something that, and this is part of, you know, really where me looking into the future, I want to see a situation where there is a step between people going to a GP and being given a referral to go to IVF.

to something in between that, that actually gets them to really have an in-depth understanding when they have essentially been trying for the number of months or time that they should have already been pregnant, that actually is inserted before it just is a situation of like, yeah, IVF is gonna fix this. And we know that that's not always the case. So I think that this is an interesting next step into the future for us because

you

the more people who are practicing in a way that we can compare and optimize together, I think that makes a huge difference as opposed to these very disintegrated processes that essentially are difficult to benchmark.

Yeah, I mean, I think as a practitioner and that's something that I had a lot of resistance to because it's a lot of work to like keep track of everybody. Do you know what I mean? Like you have to have a whole system and I was really resistant to it. Yeah. But I was like, no, I need to do this and I need to start building cases and understand success rate and understand when I implemented something. So when we implemented this kind of testing, this is the effect. And then it just takes time to actually see it in process. And there's so many other variables, but,

have to have a very systematic process. Yeah.

Yeah. Yeah.

It's really important. Can I ask you like a quick, I know we're running time, but like, about the other 20 % now? And I don't mean this because I think like a 78.8 % success rate is like absolutely phenomenal, but there are still those stories where they're not talked about enough where it just didn't work out.

Yeah. And you know, it's interesting because in 2025, 2026, it's a, it's a choice. It's a choice. And sure, sometimes it's a choice that people make because they think that they have no other choice to make, but there's always a choice. And so here's what I would say. The 20 % of people in my clinic, and we obviously dove deep into understanding the differences between them and the people who actually went through and had babies, were people who basically

they decided and determined in advance a few different things that they would only try in one particular way. So I will only try if it's natural conception. If it's not natural conception, I'm not interested in doing anything else. Or I will only escalate treatments to IUI or to IVF and I do not want to do donor aid. excuse me, or I have decided that I no longer want to have a baby. Or,

I have decided that I prefer to have a divorce or literally this many.

That's how I have it happens all the time and I can almost call it with a couple. So I'm like, do you want to be married? And I don't ask that, but it's like, put that as a note. I do eventually, but it's not usually the first question that I ask. I have to get to know the couple first.

I I do, I really do.

Yeah, that's my first question. Even before they start my program, I treat couples, I treat partners together. I know that fertility is a team sport. So if you come and have a conversation with me, be prepared that there is nothing that is not going to be told to you if it needs to be told to you. And so basically what will happen is that if I see that both partners aren't on the same page, I will call it even before I start treating them.

Yes.

even before I even potentially offered to treat them because what I know, and again, I know that fertility is a team sport and I know the results that we get, we get because we have people working together and are on the same page about where we're headed. When people are in different pages, and trust me, I did this for the first 10 years of my career, and then I went, you know what, stuff this, this is not for me. I'm here for the people who are ready, willing, ready to do what it takes, like me in personality, that they're like, okay.

I, this is what I want. I'm clear. Let's go. I want a result. And so basically I have an eligibility criteria for people that get into my program. So I assess every single case to make sure that one, can help. So is there work to be done? Is that work we can do? Have we done it before in a similar set of circumstances? Then I go on to figure out, there any deal breakers? Like I get them to fill out a 30 page questionnaire to go and find.

deal breakers? Is there anything here that we need to talk about? And then the fifth thing is that now we've built a predictive model so we can actually have a very high level of certainty on the people who are likely to take home babies and who aren't. So we actually benchmark and compare patients with patients that have been through the clinic who have had success and how likely they are to take home a baby. So I do all of this before any money is exchanged and before anything moves forward from any point in time.

Because if somebody's going to get on my program, I want a baby. I want to demonstrate clinical effectiveness. And to do that, the only way to do it is that we know from the get-go that we're working towards the same outcome. And if that's not what somebody wants, that's OK. I'm not the practitioner for them. And so ultimately, that's why I'm very clear on my mandate. When people come to me, they come to me because they've tried everything else and nothing has worked.

And that is ultimately, and I know that they want a baby because if they didn't, they would have gone somewhere else. Right. And so ultimately that is the focus and I don't allow anything to deviate from the focus. So if the relationship is an issue, we're to talk about that before we even start treatment, because if it's an issue now, it's going to be an issue throughout. they're just going to, you know, they're just going to derail everything. Like, and then it's a spot in my program that I could have given to somebody else that actually would have a baby.

that would do what it is that they need to do, and they're taking up space, right? So it has to be an alignment amongst all the people concerned, because otherwise for me, it's not a fit.

Yeah, I mean, it's funny kind of to wrap up my question to you is there's a lot of heartbreak in the space. And of course, you've seen a lot of success as well. But what keeps you hopeful about the fertility care and just where it's heading?

think that...

Are you trying to make that dent? you trying to, what's your guiding star in terms of like, why do this? Why show such high clinical competency?

Yeah. Yeah. I want to change. I want to change medicine. That's, that's the whole, I want to change medicine. That is, that is why I'm here. Right. And so from that perspective, yeah, absolutely. So.

Yeah, me too. And if we have enough of us, I think we can actually do it.

precisely. so that really is what it comes down to at the end of the day. And this is why, you know, clinical effectiveness is the guiding star. It's actually, you know, it's the first step to being able to actually demonstrate that there is enough efficacy and effectiveness to be able to insert a path that is different to what currently exists for patients who struggle so that future patients.

or future people don't need to have the same struggles that currently are present. And so, and that's why I'm so about the job, you know, and why I'm so about the results because it's like, I want this to mean something. I'm not here just for another day in the office. Like, you know, I want this to mean something.

Good luck.

I do think it's really hard to argue with it as well. I'm not sure if you follow a bunch of people. Like, I mean, my algorithm is just filled with fertility stuff. And then there's some really big names in the OBGYN space. And I'll see some of the things that they're posting and it's around, you know, I can't believe she decided to take six months to prepare for IVF when she's already 40 something. And I'm like,

I can see that. You know, I can see why. And we see the data and we have the data. And there's of course the question of how far we go down the rabbit hole. But you see these clients who are, you know, 40 plus, let's just say she's 43 and she's so inflamed. She has so much blood sugar dysregulation. There's so many, like her gut is a mess. And you're telling me that if she takes six months to get down her inflammation, take some nutrients,

and like balance her thyroid and all of that jazz, you're telling me that the outcomes for IVF six months later are going to be much worse than putting her through three cycles and sorry, it didn't work. And then now it's a numbers game. Like this is what just infuriates me about, you know, the conventional system where it's like, it would be, it's sad to just read research that's only fed to you by the pharmaceutical companies.

You've just touched on a whole other hour of podcasts. so, exactly. But here's what I will say about this is that what you're saying is very right in terms of like, does there need to be a level of preparation at any stage for anybody going through an IVF cycle? Yes. What that preparation is will be dependent on many factors, not just age.

I know, and we're not gonna go there, so I'm sorry.

Yes.

because age is a proxy marker of a whole bunch of things that essentially get conglomerated together. you know, at the end of the day, do we need to be careful with how we make recommendations in terms of patients who are in their 40s going into IVF cycles? Yes. And sometimes, depending on their FSH levels, I'm actually recommending they do not. So, you know, the reality of it is that

It's not gonna work.

It's not going to work. So, you know, if their AMH levels are low and their FSH levels are high and they're in their 40s, their chances of getting a pregnancy to term is the same as natural conception and sometimes even the same as IY. So the reality is Y spend $20,000 on an IVF cycle that is just going to fail. It might be because they want to have that certainty for themselves to know that, okay, you know what, I've tried that tick done.

you

If that's the case, then sure, there's no harm. You will get your answer by not having a result. That's okay. But if you actually want results, well, that may not be the most appropriate way to go about it for an individual. And I obviously don't know that at the outset, you for most patients, I need to have a look and see what are all of the variables that we need to take into account. But this is the thing. And this is the other thing too, which I find fascinating and actually hilarious in the

the most terrible way is when couples are this situation that you just talked about and we have suboptimal sperm at the same time. And I go, excuse me. First of all, we have an independent risk factor for IVF failure, which is high DNA fragmentation. Yeah. You know, we have an, excuse me.

Excuse me. Yeah. Just a strong cough. Yeah, excuse me. We're missing something here.

Jesus. And so then, you know, you have an independent risk factor for IVF failure, which is high DNA fragmentation. And you're saying that a woman shouldn't take time to prepare for a pregnancy. I'm sorry. Are we on the same planet? You know, like there's a whole lot of things, but yeah. So, you know.

Yup. Yup.

Thank you. I appreciate you. I appreciate the work that you're doing. Just an incredible wealth of knowledge and everything. It's just, thank you. And tell everybody where they can find you and the resources that they need to have if they are thinking about a fertility journey, let alone they are on one.

Yeah, absolutely. Thank you. Thank you for having me for sure. So Fertility Breakthrough, the book is, I would certainly recommend it. Overcoming infertility and recurrent miscarriage when other treatments have failed. It's available on every bookseller, but it's available free on Spotify and YouTube. So people can go and listen to that. The other place that people will have, I do all of my content on Instagram. So, you know, obviously I'm always answering questions and educating, you know, on a higher level there.

And my website is fertilitybreakthrough.com. So if people want to reach out and they want to have a conversation, go to fertilitybreakthrough.com and they can schedule a complimentary conversation with one of my team. And then if it makes sense, you know, they can escalate that conversation to me for a further assessment. That's how we go.

Thank you. Connecting and meeting people like you, know that we can. It makes me really hopeful about changing the healthcare space on a big way. So thank you again for being here.

Thank you. Thank you for having me.