Fertility, Food, And Real-Life Choices

We break down how everyday nutrition shapes fertility, energy and hormone balance, and why preparation beats quick fixes. Gabriela Rosa shares field-to-plate eating, the 10% for the soul, and a clear plan to reduce endocrine disruptors while making meals doable.

• field-to-plate eating and nutrient-first meals
• 10% for the soul to sustain consistency
• protein and produce as anchors for blood sugar
• minimizing endocrine disruptors from food and packaging
• batch cooking, leftovers and simple weekly planning
• responsible supplement use and regulation pitfalls
• IVF economics, root causes and smarter preparation
• timelines for egg and sperm improvement
• free resources: Fertility Challenge and audiobook

Act Pregnant Now To Get Pregnant Later. Find the Fertility Challenge and my book via Gabriela Rosa Fertility on Instagram or search “Gabriela Rosa Fertility Challenge”.

Gabriela Rosa's IG
Fertility Breakthrough Book on Amazon

Fertility Breakthrough Website 

Thank you for listening. Please subscribe to this podcast and share with a friend. If you would like to know more about my services, please message at fueledbyleo@gmail.com

My YouTube Channel https://www.youtube.com/channel/UC0SqBP44jMNYSzlcJjOKJdg

Transcript

Meet Gabriela Rosa And Her Results

SPEAKER_00 0:17

Hey hey, welcome back to Simple Nutrition Insights, the podcast where we break down the science of nutrition into practical, real life strategies you can actually use, even with a busy schedule. Today's episode is one of one of them that I'm really excited about because we're diving into fertility, hormones, and how nutrition and lifestyle truly intersect with overall health. Not just for people trying to conceive, but for anyone who wants better energy, hormone balance, and long-term well-being. I'm joined by Gabriela Rosa, a harvard-trained fertility specialist and founder of the world's first fully ritual fertility clinic. Gabriela has helped over 140,000 people in 111 countries achieve parenthood with a 78.8% life birth rate, which is incredible. What I really appreciate about Gabriela's work is how grounded it is in science while still being practical and approachable. Very aligned with how I teach nutrition and sustainable habits. Gabriela, welcome to the show. I'm so happy to have you here.

Why A Virtual Fertility Clinic

SPEAKER_01 1:19

Thank you so much for having me. It's wonderful to be here.

SPEAKER_00 1:21

Yeah, so I'd love to start with your story. What originally drew you into fertility science and what problem were you really trying to solve when you created a fully virtual fertility clinic?

From Teen Curiosity To Harvard Training

Nutrition’s Long Arc: Epidemiology Lessons

SPEAKER_01 1:33

Ah, I love that question because it takes the the answer takes us through about 15 years of my career. So what got me started certainly wasn't what kept me going. And what made me decide to go fully telehealth in 2013 was actually the birth of my first child. It wasn't really, you know, the problem I was trying to solve there was how am I going to breastfeed, run a clinic, and you know, still serve people at the same time. And do I even continue doing those things at all for a period of time? And so there was a lot on my place at that time, as you can imagine. And I was doing about 60 patient hours a week, literally face to face. And I was like, okay, that is incompatible with having a newborn child. And then of course it turned out that my baby never slept for more than 20 minutes or an hour and 20 minutes all the way through the day and night for the first 10 months almost of his life. And so I was like, by the end of the six first six months, I didn't know my name anymore. I was like, oh my God, what is this? You know, what kind of hell is this? And so it was really sheer exhaustion that made me go, okay, I need to do this differently. And at the time I was already treating couples, you know, to overcome infertility miscarriage failed treatments, but mostly in preparation for either starting to try to conceive or they had done IVF and it hadn't worked. You know, combinations of those kind of like earlier cases of like, you know, I've been trying for a couple of years, hasn't worked, and now we need to do something else. And so it was really interesting to me how when I decided, okay, I'm going to stop doing a whole bunch of things. And one of them was to do so many clinic patient hours and so many consultations. I'm going to focus more on a program like a fertility program that is going to be run in a very specific way. And it's going to cater only for people who have been trying for two years or more and who have done lots of different things or have done lots of different things, and or maybe even experienced miscarriages and other things that didn't work. And so that was essentially the starting point of what today has become really, you know, very much what we do entirely. And now we treat people who have been trying to conceive sometimes for 10 years without success, who then go on to conceive naturally, or have had multiple failed IBF cycles and finally get it to work. And I've even had people who have had multiple failed donor aid cycles who then understood what were the drivers of the dysfunction that was causing that to happen, and of course, to reverse it. So it's been a long time in the making, but in the very beginning, when I started my clinic, it really was again, um, I was very young. I was literally like 16, 17, thinking about, you know, what am I going to do for the rest of my life? And as we all do. And, you know, I had a couple of different professions in mind. One was interior design. That was um, that was my first choice. But my mum really thought that that was not a good idea. And uh I don't know why she thought that wasn't a good idea, but you know, whatever. I basically started to then think about other possibilities and thinking about also what do I actually enjoy? What do I, what am I interested in? And so that's how it became really me thinking about, okay, what conversations can I see myself having for a long time? What is going to drive my continual desire to learn? And those were questions, believe it or not, like I look back at myself at 17, 18, and I think, gosh, you were wise for your ears, you know, like because I was literally asking myself these questions back then and thinking, like, okay, but what do I really want? You know? And I think that it's really, it's it's actually wonderful. As I ponder about this here with you right now, I think, gosh, isn't it lovely how when we ask ourselves that question, we really connect with what's most important for ourselves in our lives, and it makes things so much more enjoyable, you know? And truly, I believe that it's one of the reasons why it has given me the longevity in this career that I have had. I mean, I've now been treating patients for 25 years. And the reason that it continues to be something that excites me is because I'm interested in the conversation. But when I first started, I decided to study nutrition, I very quickly recognized that, okay, by the time people have developed disease, food is going to have a limited effect, you know, in intervening and in treatment and prevention of serious health conditions in the short term. And actually, that's something that I think we should get into because I did a concentration at Harvard for my master's in public health in nutritional epidemiology. And so the interesting thing about how we view nutrition is that we think that it's a short-term effect. We think that, ah, you know, I'll just have the chocolate cake today, and then today becomes tomorrow and the day after, and the day after that. And it's like, oh, it's okay, just a little bit won't harm me. But what we know from nutritional epidemiology is that when we track nutrition over a 30, 40, 50 year period, that is where those exposures that we have had start to develop into either health or disease. And, you know, we don't think about that in in the short term. But what was interesting when I decided to start studying it, it was really for my own personal interest. It wasn't that I kind of thought that I could necessarily make a whole career out of it. Although I very quickly, as I said, recognized that I probably would need additional tools if I really wanted to intervene at a much speedier level and higher level in someone's situation. And so I started studying, I changed my course from nutrition to naturopathy. And so I studied naturopathic medicine and completed that degree, and then went on to do reproductive medicine and human genetics and a master's in public health at Harvard, and I'm just completing my doctorate of public health at Harvard right now. So it's been a long, long time, but um, that's how it all began, basically.

SPEAKER_00 8:14

Yeah, I love the answer, right, and how deep it is, and just you know, picturing yourself at 17 years old, right, having these questions. And it was almost so relatable because when I decided to become a dietitian, right, it was around that age, high school age, and just seeing my grandma, right, who has diabetes, and as you mentioned, right, nutrition is not something that is thought about. Oh, we have to start since the beginning, right? It's almost like now we have to start to you know manage a healthcare or a health condition. And so just seeing her frustration, you know, from going to the doctor or telling her, oh, you need to stop eating beans, tortillas, rice. And as Mexican, this is like traditional diet.

SPEAKER_01 8:58

I mean, it's exactly. It's like it's uh it's almost like you're telling, you know, uh, I don't know, carnivore not to eat meat, you know, like it's yeah, I I understand what you mean.

SPEAKER_00 9:09

Right. And so I said, okay, there has to be a way to be able to show people, right, or give them the tools on how to number one, prevent, you know, health, you know, conditions. But if there is a chronic condition, how can we manage it in a way that is sustainable? Right? That it's not like, oh, well, I cannot do that. So well, we'll see what happens. If I die, I die.

10% For The Soul And Meal Principles

Field-To-Plate Eating Explained

Protein, Produce, And Barcode Rule

Endocrine Disruptors And Packaging Risks

SPEAKER_01 9:31

Yeah, yeah. And it's really sad, isn't it? Because like so many times, people don't don't link that those effects, you know, they don't link the the cause to the effect. They we often think because it is so long term, we often think that it's just going to it's that that effect is going to dissipate itself over time. But the truth is that it accumulates itself over time. So it's the little, it's kind of like, you know, the little drop of rain into the ocean. That ultimately ends up, you know, sustaining a river, a lake, an ocean. So those drops matter, and and when they happen frequently over time, we we see the impact, you know, and when they are dysregulated, the flood is certain, nice and and it's excessive. You're going to see an effect of that action or that cause much, much faster. And I and I and I truly believe that if we were to see the effect of the chocolate cake, and I'm not even saying, like, I believe that you should have a 10% for the soul. I talk about this with my patients all the time, is the fact that, you know, 90% of your nutrition should be nutrition. 10% should be whatever it is that you want. And in the whatever it is that you want, I really quantify this very, very clearly for people. Let's say that you have 21 meals in a week. Breakfast, like dinner, seven days a week. So you have 21 meals. 10% of that means two meals. So two meals in a week, you are having a chocolate cake. Like I literally schedule my pizza once a week. You can be sure that one evening on the weekend, it's going to be either Friday, either Saturday, or either Sunday, I am going to be at the pizzeria having pizza for dinner. Like, it is an absolute. It's not even a question, you know? And the other night I might have a burger, right? So I do like to have that kind of flexibility where I know, like, for example, last night my dinner, and this is a very common dinner for me on an average kind of like, you know, night of the week. 600, 600 grams of vegetables, literally, and a piece of salmon. So, like, that is typically, and that's also how I raise my kids. Like, that was exactly what they had for dinner. You know, they're 10 and 13, and there wasn't bread, there wasn't pasta, there wasn't rice. It was literally protein and vegetables. Lots of different types of vegetables. Sometimes I bake the vegetables. Most of the time we eat it like it's a salad or raw. Sometimes, you know, I very, very seldom I spend a lot of time in preparing weekday meals, but they are always going to be some kind of healthy variation. And it's not to say that I won't add pasta from time to time or rice from time to time, but it literally would be like maybe once or twice a week as well, you know. So basing my meals on vegetables and protein, because I know of the long-term health effect and long-term health consequences of loading apple carbohydrates, of, and it's not that I'm low carb by no means. Like, you know, it really I don't focus on, you know, being necessarily low carb or any particular kind of diet. I like to teach my patients about field-to-plate eating, right? And I have a couple of very specific rules. The barcode rule is one of them, and I'll spoke about it, and the 10% for the soul. And so that's how I encourage people to visualize their meals because if I don't like diets, I hate having the same thing every day. I hate the idea of a diet. Like, oh my God, do you want to kill me? Is tell me that I have to go on a diet. I'm like, Jesus, no. But you see, I can eat for nutrition. And I read something recently that again reminded me of, you know, instead of being a calorie avoider, be a nutrient seeker. And it really made me think and stop and go, you know what, how true is that? Like, and and this is the thinking behind how I prepare meals. It's like, how many more nutrients can I put into my plate right now? So my salad of yesterday was like all different kinds of colours of peppers. So capsicum in Australia, for those of you who don't know what a pepper is. Um, you know, it was all kinds of peppers, it was all kinds of colours of tomato, it was cucumber, it was cilantro or coriander. Like I literally get an entire bunch, I chop it and I put it through as kind of like a green thing. It's the most delicious thing. Red onion, snap piece, sugar piece, I slice them raw and just, you know, put it into a salad. It gives it the most amazing crunch. So delicious. What else did I put? I don't know. I I often put like eight or ten different vegetables in my salads. And so that kind of thinking of like, okay, how can I get as many colours as possible and as many nutrients as possible? And I call that field-to-plate eating. Because you see, if I look at the food on my plate, I want to be able to recognize it on the field. That's the first rule, right? Where basically, let's give the example of corn, right? Because corn is something that is very, it's everywhere and everyone knows. So if I say to you, one step from field to plate is the corn cob. You can recognize it on your plate. Sure, you took it, you took it from the field, you you steamed it, boiled it, whatever, put it on your plate. That's one step, right? Now think about how much more difficult it is to eat that corn than if you were to remove the kernels and put that on your plate. Also, think about how much more or less of a food you would eat if you had to eat it on the cob versus removing it, you know, removing the kernels from the cob. So one step from field to plate is where the food is very highly recognizable on your plate as it is in the field. You get to a second step, which would be then removing the kernels of corn and putting that on your plate. Now, when I do that, one corn is not enough. It's kind of like that's not a lot. And so, you know, you tend to go for a second corn, right? So you're already doubled your calories. Not that we're counting calories, but like your nutritional density, nutritional intake of whatever macronutrients that you are going to be eating, whether it's carbohydrate, fat, or protein, has doubled. And of course, in corn it's mostly carbohydration. So you've doubled your carbohydrate intake in that action of removing the kernel. Now, it's not to say that that's a problem. I mean, depending on how many carbs you, as a person trying to be healthy, can eat and your body can tolerate, that probably is going to be a very small amount still. But if you had insulin resistance, prediabetes, diabetes, you need to start thinking about these things in a different way to whether if you didn't, right? But that would be a second step from field to plate. Now, a third step from field to plate is if I take those kernels and I puree it, right, and then I add other ingredients and I make cream corn. That's a third step. Still, you can recognize it, but you can see that there's also it's not the same food from field to plate. Now, if you go take that corn and you puree it and you then dehydrate it, right, you might end up with a different thing altogether, right? You might look at polenta, you might have, or if you add other ingredients and then you make a tortilla out of it, and then you eat that. Like again, we're we've now stepped into three or four or five steps from field to place. Like you can no longer in a tortilla as much as you might make it traditionally. By the time you get to tortilla, you don't recognize that food, which means that the carbohydrate content of that food is higher. The other nutrients or lack thereof ingredients that you know are present in the food will have changed and will have increased. And so you are eating something else that possibly has a much higher glycemic index and glycemic load than the corn on the coal, right? And so I say to my patients, let's aim to stay within that three steps from field to plate. Because if we stay there, we're likely to still be eating highly nutritious and you know, kind of harder to eat food. And why is that important? Well, it takes the brain about 20 minutes to recognize that you're eating when you're hungry. And so by just having to sit there and pick the corn out of your teeth in between taking bites on a corn of cob, right? You're delaying the process of eating. And therefore, you're giving your brain and stomach the time to communicate that, okay, there's something happening here on a metabolic level. Soon you're not going, you're gonna be feeling satiety, you're not going to have to eat more, and that is just how it is. Now, when I sit with my bucket of salad, because if you've ever measured 600 grams of vegetables in a in a bowl, it's a big bowl. My kids laugh at me every day. They're like, oh mum, like seriously, how how is it that you manage this? But like, as I sit there chewing on every one of those things, right, like it takes a long time. It takes a much longer time to eat that than they would to eat rice and beans and something else. And by the way, my I'm I'm I'm from Brazil. So I was born and raised in Brazil up to the age of 13 or 12. So traditional Brazilian food is like what I grew up on. Right? And I can tell you, even though Brazilians eat pretty healthily for the most part, the reality is that rice and beans are extremely high glycemic, you know? And so there's a lot of carbohydrates in them. And if I was just going to eat rice and beans and not add a salad or vegetables or whatever else, I would certainly be intaking a whole lot more than by adding those other nutrients and and other nutritious foods. But with that aside, you know, when we're looking at this whole field-to-plate idea, really what we're wanting to be doing is as much as possible recognizing what it is on our plate. And then of course, about the size and the thickness of the palm of your hand of some protein, ideally lean protein, at most meals, you know, lunch and dinner is essentially going to ensure that you're getting enough of your of your protein for the day. And so, with that, of course, you know, there are better cuts and less ideal cuts of meat, but certainly red meat, as long as it's as lean as possible and you're not eating the fat, which is high saturated fat, is going to be better for you than if you were eating very fatty cuts. And of course, the best ideals here would be things like, you know, your fish and your chicken, ideally organic where possible. You know, those are the things that I would probably recommend in terms of healthy, nutritious fertility diet, and for anyone who's actually wanting to just be hormonally balanced. The other important thing about this is the barcode rule and why I don't recommend processed foods or ultra-processed foods when it comes to fertility and hormonal balance. And one of the reasons is that a lot of the ingredients that are contained in those foods are endocrine disruptors in themselves. The other aspect to it is that the packaging itself contains endocrine disruptors. You know, a tetra pack is full of BPAs. And here you are, people going, you know, oh, BPA bottles. First of all, bisphenols come in every letter of the alphabet. B, C, D, E, F, G, like literally. Okay. So you can go type bisphenyl G and you will find something. Which means that if it's plastic, if it's if it contains plastic in any way, and some food ingredients that are meant to be added to foods for texture and flavoring and preservatives, they contain these endocrine disruptors. They contain these types of plastic molecules, believe it or not. I mean, all you have to do is look at a packet of shapes, you know, or whatever it is, like these savory snacks. And what do you see? You see a plastic bag inside a cardboard box, right? Do you think that? Those plastic bags are inertia. No, they're not. They are in contact with the food and you're eating whatever is being essentially, you know, exhaled from that package of food, you know, that you are that you are consuming. And so we've got to think about not only how do we prepare our foods and what kinds of foods do you prepare, but what other exposures do you have simply because of packaging? And it is a really hard thing because, for example, meat, most meat these days is comes wrapped in plastic, right? The way to ideally avoid that is rinse it so that the surface, you know, kind of plastic removes it, is removed from the food. You're not going to be able to completely avoid these things. You can minimize exposure. And that is an important thing. And that's also why I talk about the fact that, you know, yes, have your 10% for the soul. And in that, include the types of foods that typically you would want to avoid because of the exposures that they represent. Make no mistake, food is an exposure. It's the biggest exposure we have day in, day out, multiple times a day. And any exposure will lead to either health or disease. There's no two ways about it. There is no mutual exposure. You're either going to have health or you're either going to have disease in a long enough time frame. And so ultimately, this is how we need to start thinking. We need to think for the long term because otherwise we are going to be caught on the hospital bed on a quadruple heart bypass situation, having thought, like, oh, I thought our lint pretty healthy, which is my dad, actually. He has always, for the most part, in his later life, like let's say from 50 to 70, the very healthy life. And at 71 had to have a quadruple heart bypass, you know, and it's like, well, clearly the exposures from zero to 50 led to some kind of accumulation. And it's not just to do with diet and nutrition, but certainly plays a role. And, you know, those are the types of things that we need to think about in terms of like these exposures. Health or disease, there's no neutral position, right, in terms of all of this. So these are some important concepts. And that's where anything that's packaged, anything that has a barcode because it has multiple ingredients and is processed. I usually tell my patients, avoid, right? Or add it as a 10% for the soul. If we look at, again, the example of corn, you know, here we have savory snack, savory snack twisties. They say it's from corn. Totilla chips and corn chips and all, they say it's from corn. You would never be able to recognize other than the putting a picture on that package. You would certainly not say that that thing is made from corn. How can you even, you know, and the number of ingredients that have these kinds of effects that we're talking about. So there's a lot there to unpack, but I think that those are important concepts, you know. And we've started with, of course, the the 10% for the soul, which is for my patients, what I recommend is absolutely zero alcohol when trying to get pregnant and when pregnant. And so that does not make its way in on the 10% for the soul. And neither do fried foods, especially when we're talking about fried foods out, right? Because you have such reuse of the oil that, you know, you have so many toxic elements that arise as a result of that reuse and re frying. And so it becomes a highly toxic food. So that's one thing that I absolutely will not recommend and encourage strongly that my patients avoid as part of their 10% for the soul. But other than that, you know, plan those two meals in the week where you're gonna have the chocolate cake, where you're gonna have the pizza or whatever else, right? And for me, pizza always comes with ice cream. So, you know, it's pizza for dinner and then ice cream for dessert, and then that's my one 10% for the soul, you know? Let's be reasonable about this. And then of course, the next time it's whatever else I'm gonna have, you know, and and look, you know, in all honesty, some some weeks I'll just have my pizza and just have my one 10% for the soul just because you know I didn't plan enough, didn't organize myself enough, whatever it is. Um, but you know, I I like to make sure that that's that two number is the the guide, the focus, you know, it's the guide for what it is that needs to be done. So that I I I know that that was a very big long explanation of how I recommend nutrition for fertility, but I think that those are some concepts that people can really visualize and take away and implement in their lives.

SPEAKER_00 27:07

Yeah, no, it makes perfect sense, right? And it's simple and sustainable. And so I think one of the follow-up questions that comes to mind is for those listeners, right, or for your patients that are extremely busy, and you're so busy too, but you're still making it happen, right? Like, what are some of the tips that you offer to make sure that they're getting these nutritious foods under the plate in a day-to-day?

Busy Lives: Planning, Batch Cooking, Leftovers

SPEAKER_01 27:29

I think that simplicity is like queen here, right? Like, really, excuse me. I don't like eating the same food every day, right? And so I like to kind of have variety. I like to have different types of foods. And so what that means is that I've had to have, I actually have like a go-to plan for the week in terms of like simple but delicious, and that I want to eat. And I have that rotating, like I have two weeks of this plan of, you know, like how I actually organize my weekly night meals. And then I cook enough so that we have enough for leftovers for lunches. You know, I have, as I said, I have two kids, and so they basically take whatever they had for dinner as at lunch the next day, you know. So, which is, you know, that's a really interesting thing because I don't know how it is in the US, because obviously my children go to school in Australia, but um, and I I went to to school in the US, but as an adult, it's very different, right? You have you have different preferences. So, but as children, it's very unusual in Australia for you to send actual lunches, like a thermos with lunch, right? For kids. But and I've had to deal with the disgruntled, why can't I just take sandwiches for lunch? You know? Why can't I just be like every other child? And so, you know, I've had to be strong and just hold the position that we eat for nutrition, and this is why, and you're my child, so I don't care what other parents do, but this is what we do. And so that's been the line, you know, that I've managed to upkeep for a very long time. My son is now 13, my eldest son, and he's in year age, which means that there's only four more years of school left for him. And so, you know, I think I've done pretty well with the sending leftovers for dinner. Again, I think that in and and and I'll be honest, like for a few years there, it took having to be really strong about that decision, you know, and kind of not deviating from what it is that I knew was best for them to the point that, you know, like I was not a preferred parent when it came to why do I not take sandwiches, you know, and even their dad is like, surely they can take sandwiches now. I'm like, no, they can't. They can't. That's just not gonna happen. So we're just gonna have to figure out a different way. But that has also simplified, you know, what happens in terms of nutrition for the household, because it it means that also I'm not, you know, there making sandwiches at five o'clock in the morning for them to take lunch. It's like I packed the lunch the night before, put in the thing, that's it. You know, heat it up and put in the thermos and we're done. And so all of those things have definitely made things easier. Um, in terms of how else this needs to be organized, just depends on, I guess, values and preferences, and also preferences in terms of like how people like to eat, because that's going to be something that also needs to be taken into account. And so that planning and preparation is going to be very important. I also have, I mean, I do have help, which does, you know, help a lot in terms of like the kids, you know, when when my my nanny is able to organize certain things for dinner and all of that, like that makes a world of difference in terms of my time and how it is that I utilize my time in preparing the food as opposed to having to get everything done from scratch. But when I did do everything from scratch, what I would do is I would prepare a couple of times, a couple of meals in a week that either I could freeze or that I could have in the fridge and basically reheat. So that was always like, you know, something that I would do on the weekend, you know, and batch cooking also was something that I used to do a lot. And in those stages, at those times, we used to have a lot of casseroles, a lot of soups, a lot of salads, because salads are just easy, you know, you're just chopping up things. There's not a lot of cooking and preparation, you're just washing vegetables and chopping them up. So I do like to kind of see one, what works for one's lifestyle, what works for one's kind of values and preferences. And then, of course, you know, like what when do you have time to prepare? Because that makes a difference. And I, and as it is, I prepare things that can be reheated and eaten the next day because of their lunches and everything else. So again, simplicity, organizing, planning. You know, it doesn't take long. And especially these days, gosh, with Chat GPT, you can literally go make me, you know, three meals that I want to batch cook on a weekend and that has this kind of nutritional profile and that is going to last. And it will give you a plan, you know, that you can then check with your clinician, check with whoever to see that that's actually suitable for you. But for the most part, if you're following the recommendations that I've already given you, uh it will do a very good job. Like, trust me, I've tested it. It will do a very good job. And is it actually for my patients when it comes to like specific food preferences? I tell them to do that. I say, listen, take this kind of guideline in terms of what I've just given you and go and see based on the ingredients that you like to eat and the types of food that you like to eat, what other options, what other ideas are there? I I make that, I compare that to when we used to look at food magazines for recipes, you know. Like I think that one of the great users of AI these days for this kind of thing, I mean, it's it's not really gonna get it wrong. Like, you're either gonna like the food or you're not, or you're gonna prepare a recipe that it gives you and you're gonna go, yeah, no, that's not good. I don't want to do that again. Or you're gonna like it and you're gonna use it. Like the other day, I wanted to do a low-carb, pre-free um overnight oat. And I wanted it to have very specific nutritional composition. I want it to be, you know, I wanted to have at least 30 grams of protein, I wanted to blah, blah, blah. I had a lot of specifications, right? And I didn't have a recipe that I found that fits the specifications that I had in my mind. And so I literally went to Chat GPT and told it all of these things. Like, I want to use this protein powder, I want to have this number of grams of protein in it, I want to use, I want to have all of these, I want to have a nut butter in there and maximum of this melt, this amount of fat and carbohydrate. Give me a recipe that's going to work. So literally, it was a couple of back and forths because I could see from the recipe that, oh okay, this is not good. You know, first of all, I actually forgot to say that I didn't I wanted it to be dairy-free. And so it gave me something with milk and then told me to use nut milk. And I'm like, I don't want to use tetrapaps and I don't want to use nut milk, I just want to use water. So give me that. And so it was kind of like a little bit of back and forth on getting to the bottom of what this recipe was gonna be. But in the end, I actually got the recipe, I made it, and it was actually really delicious. So I ended up putting that as one of my go-to's, you know, for breakfast. So, you know, this is I think that we need to use technology as well in our advan to our advantage. And in a situation like this, I think it does very well.

SPEAKER_00 35:10

Yeah, most definitely using your resources to make your life a bit easier. Um, awesome. So we talked about the nutrition, right, and their impact and fertility. Now you it's interesting because you see so much about fertility and hormones, and sometimes you sometimes my patients ask me, you know, what do you think about this TikTok? This TikTok recommended a supplement and like whatever. What are your thoughts on supplements and trends? My God. You ask very, very hard questions because I have lots of thoughts.

Using AI For Simple Meal Planning

Supplements: Help, Hype, And Regulation

SPEAKER_01 35:44

You know, look, you can't you can't be doing the same thing for 25 years and not see through so much BS that goes on, right? Um, supplements is one of them. I find that every man and his dog that, you know, these days has a supplement brand that they push uh onto people, and then of course it's the best supplement that ever was, and it's the only thing you should take, and you should take lots of it. And it makes me tired, honestly. It makes me like just go, really people, don't be so foolish, right? The reality is that supplements do they can help. They absolutely can. And in fact, in my clinic, it's one of our, you know, kind of foundations for optimizing health. But there are very specific ways in which we'll use supplements and personalized prescriptions is absolute, absolutely necessary when it comes to getting that piece right for my patients. So one of the things that I absolutely, and mind you, if we go back to very, very early on in my career, I used to work for a supplement company formulating supplements. So if I wanted to create a supplement range for fertility that does or claims to do, quote unquote, all of these amazing miraculous things, I could very easily do that. Very easily. The reason that I have never done it is because I don't believe in band-aid solutions for complex problems. You know, like supplements, they are useful, they can be useful. Not all supplements on the shelf of supermarkets, Amazon and whatever actually are even worth the second look, let alone you spending your money on it. There's a lot of things on the market that are just pure rubbish, like literally. You know, they do not contain the nutrients they say they contain, they the format, the form of nutrients that they say they contain, or even the doses of the nutrients that they claim to contain, let alone the benefits that they claim. And so, you know, like it's a it's the Wild West, especially in the US, where the laws and regulations are so flimsy, to be honest, when it comes to supplement formulations. We don't actually, that's one thing that we don't do. The TGA in Australia is much, much stricter than the FDA. And we don't prescribe US-made supplements because it's very difficult to validate what is actually in a supplement in the US and supplements that are sold in the US. So for that reason, we actually prescribe things that are made in Australia under the TGA because it's it's much more strict. And you can actually, because there's so much third-party testing that is the owners of the company to do to be able to actually have a supplement listed with the TGA, like they have to provide the independent testing reports to be able to maintain their listing, which basically means that ultimately they are responsible for ensuring that what is in the supplement is what it says is in the supplement, and they can be audited at any time. Right. And there usually are. Like when I used to work for a supplement, we used to literally get like random audits and audit requests. And you've got to provide all of the documentation on that supplement and samples so that it can be third-party verified again, you know. And if you don't follow the rules, you can lose your license, you can lose like there's a whole lot of repercussions. Whereas in other countries around the world, that is not necessarily the case. Another very dysregulated market is Brazil for supplementation. You can literally have anything on a pill and call it whatever you want. And the people will buy it and they might live after taking it and whatever, you know. So there's a lot of challenges. And so knowing what to take, that it's been prescribed for you for the reasons that you actually need. Sometimes people are taking 10 or 20 different things and they don't even know why. You know, and I just go like, hang on a second. Like that's my number one thing for patients often when they first come into treatment is like, stop everything. Let's just like, you know, as you run out of what like obviously we don't do that with medications, but with supplements that are random and just, you know, like there's no, there's no random reason as to why somebody's taking something. I'm like, okay, less is more. Let's focus, you know, let's remove the obstacles and let's focus on the solid foundation so that you can actually get a better result. But TikTok trends, please, whoever is out there selling supplements on TikTok trends, they have, they don't have my attention. And certainly uh a loss of credibility is certain. Because if you're gonna say that, oh, you have to get this one product because it's the thing that is going to help your fertility, no, no, there's not one thing. You see, fertility is a multifactorial event. And like such, when we are dealing with infertility, recurrent miscarriage, failed treatments, it's a multitude of minor factors that usually are causing the problem. It's not one thing, and it's not a simple thing, usually. I mean, they're they're simple things on their own, but when they compound together, it becomes a very different conversation. And so you need to really uncover what are the upstream drivers of the cause that you're seeing, of the outcome that you're seeing, what are the causes that happen before it? Because otherwise you're just going to end up with these kinds of trying to have very simple solutions to very complex problems. And if it comes in the form of a pill, even better. The problem is that it doesn't work and it doesn't work long enough that sometimes people run out of time entirely to have a baby because they think they were doing quote unquote all of the right things, and they did everything and nothing has worked. Actually, no, they did a kind of, you know, kind of I don't even know how to describe it, but uh some kind of tactic that wasn't a full strategy and they pushed that like it was some kind of treatment strategy for too long and run out of time to have a baby. It's very sad. It's something that I see happen frequently. It's devastating because rather than figuring out what are the issues that we're facing and how do we address them specifically, we're trying to use some random supplement to fix, you know, something that a supplement cannot fix. So that's my thoughts on random TikTok, you know, things. Yeah. And and Instagram for that matter, you know, like I do a lot of patient education on Instagram, Gabriella Rosa Fertility is where people can find me. Gosh, the number of times that I have to like eye roll and go, can you please share your reference, you know, your scientific study that is making you make this claim? Because I clearly am looking at the wrong papers, you know, and of course, not once do they come back with here's a reference, here's a PMID, here's a DOI, you know, and then you know, yeah, okay, just another peddler, you know. So yeah, not ideal.

SPEAKER_00 43:09

Yeah. Thank you for bringing that up, right? Because it especially for parents, right, that that maybe have struggle. Sometimes this last resort, right, the supplement, like, oh, this is gonna help me, right? And it could be that because they struggle so much, but again, coming to someone that knows, that actually knows what they're doing, like yourself, it's so important, right? Because they're gonna, it's gonna save them the headaches, the heartaches, and also financially, right, I'm sure. Oh God.

SPEAKER_01 43:37

The number of times that I hear people come to me and say, My AVF failed, and the doctor just said that, you know, I need to do it again. So just we're gonna do another cycle. And I'm like, okay, why? Because it didn't work. Okay, why did it not work? Oh, I don't know. It's just, you know, I was told it's a numbers game. And I'm like, okay, that that's where your problem is. Is that you're trying to apply treatment and solve a problem you don't know you have. Like you don't know what the problem is. How many times do we solve problems that we don't know that we have? Like, you know, that's why people go around in circles. And, you know, in the US, we're talking about a$20,000 bill at a minimum to do an IVA. Cycle where 90% of cycles fail to deliver a live birth. In literally 90% or more, depending on the age range, of started IBF cycles fail to yield a live birth or a baby, right? And therefore, who in their sane mind wants to go and do an IBF cycle for a, you know, a very little tiny chance of it actually working without preparation if it was not for being indoctrinated and told that it's a numbers game and the system, it's not a like, you know, there are lots of issues around this, you know, like these days private equity and venture capitalists have gotten into the fertility industry to set up IBF clinics. And there are studies that show the sheer amount of increase in number of IBF cycles as a result of driving profits for shareholders. And that many clinics in the US, I think that it's up to 60%, 50 or 60% of clinics in the US are private equity uh backed, which basically means their objective isn't for you to get pregnant quickly. Their objective is for you to have more cycles. So if we can essentially create and craft a narrative that is going to keep patients engaged in having more and more cycles at$15,000 to$30,000 a pop, that's beneficial for profits. Right. And so, you know, there's a lot of misaligned interests in the healthcare system. There's also a lot of challenges because the healthcare system doesn't have the financial ability to be extremely nuanced for the entire population when it comes to having a baby, especially when 96.3% of people are actually going to conceive within two years if they do nothing, right? And so basically, the way that public health works is let's do the absolute minimum for the largest number of people. And that is why we end up with a situation where when couples are struggling to conceive, they don't get the help they need through standard means because it's the system is not equipped to deliver that. Because it's literally there are less than a 4% of the population of people who struggle and who need nuance and who need a lot more than everybody else to be able to conceive. And so it's kind of like, good luck.

SPEAKER_00 46:47

Yeah, that sounds terrible, but it is.

SPEAKER_01 46:50

Here we are. But here we are. It's the 21st century. And I think that the more that people are aware of this, then they can make better choices. They can make better choices of understanding what they can do differently. You know, in fact, one of the programs that I run is completely free. It's called the Fertility Challenge. I've been running it for 15 years. Literally, it's a 14-day event where I literally teach people what are the things that they can do to optimize their fertility from every aspect of health. Not just diet, not just not just the lifestyle things that you can do, but also understanding how to ask better questions of their doctor so that they can get the diagnosis they need, so that they get a treatment that they need, as opposed to just being told, no, just keep trying, it's a numbers game. So people can always go and find that as well. So if they Google my name, Gabriella Rosa with one L Gabriella and Fertility Challenge, they will find a place to register. They can find the link on my Instagram, Gabriella Rosa Fertility. And one last thing I think that is also helpful for people, fertility breakthrough the book. I've made this available free on Spotify and YouTube because again, the more that people understand what they're dealing with, the better they can advocate for themselves. And I think that, you know, there's no other place more important to self-advocate than in the fertility space because fertility is finite. You know, there isn't a situation where you are going to be able to continue trying for decades on end. And the worst thing, you've mentioned the heartache that people go through, the financial cost that people go through. But the thing that you can never get back is your fertility potential, right? And so if we are not maximizing and solving for optimizing fertility potential, we are going to be at risk of running out of time to have a baby entirely when it didn't have to be that way.

SPEAKER_00 48:49

Yeah. Um, and it's great that you're thank you for sharing the resources. I'll make sure to add them in the show notes as well for people that are you know multitasking or doing whatever, you'll be able to find them there. And it's valuable information, right? So thank you again for sharing the book and the free challenge, which I mean, it's free. Anybody should be able to take it. Everybody should do it. Absolutely.

IVF Economics And Misaligned Incentives

SPEAKER_01 49:11

Um, amazing. Yeah, absolutely. Look, I think that whenever people are trying or thinking about trying to have a baby, they need to start as a couple understanding that fertility is a team sport. And the best way to optimize your fertility is to act pregnant now to get pregnant later as a couple. So men also need to act as if they're pregnant because already right now they're holding 50% of the little baby that they want to create. So optimizing every aspect of their health and life is going to be as important as their partner. So acting pregnant now to get pregnant later means what are all of the things that you would absolutely start doing or stop doing if you were just dating and pregnant with your baby right now? Those are the things that you need to start doing or stop doing now because the egg takes a year to mature. Like literally the egg that you ovulate this cycle began recruitment 12 months ago, right? 12 months ago is essentially where it all began. And for men, this that kind of preparation window is a bit shorter, excuse me, is a bit shorter. It's about 90 days to go from beginning to the end of new fresh sperm. But the reality is that sometimes it takes a good two to three sperm cycles, which is, you know, you can take up to 12 months to have a complete transformation of sperm parameters when things aren't going well or when things haven't been straightforward. So, you know, that preparation is essential. And the more that you start to and act pregnant now to get pregnant later, the easier it is to actually get pregnant and take home a healthy baby.

SPEAKER_00 50:52

Yeah, amazing. Wow, I didn't I didn't know any of that. So thank you for sharing that. I'm sure a lot of our listeners didn't know either. Awesome. So thank you again, Vila, for joining me. Um, it was amazing. I wish we had more time to continue to ask more difficult questions. I'll make sure to add all the resources in the show notes. Thank you again. Thank you so much.

SPEAKER_01 51:14

Thank you for having me. It was wonderful to be here.

SPEAKER_00 51:16

All right, everybody. Thank you so much. I'll see you in another episode. Bye bye for now.