941 Gabriela Rosa:

Melinda Wittstock:

Coming up on Wings of Inspired Business:

Gabriela Rosa:

When I had a baby, I realized that actually, no, there are days that you have to make a decision between whether you go to sleep, whether you eat something or whether you shower. And so, okay, right, we’ve got to do this differently, I decided it’s going to have to be fully program based. People are going to have to come in, invest up front, do the thing that they need to do, and we’ll get the results. But I don’t want to have to be reconvincing that person each time that we’re working towards an outcome here. And so that was also a big decision that was personally focused. Like it was literally about me and my bandwidth not being there at the same level that I’m like, listen, this is how we do business here. This is how it works. This is what is on offer. Take it or leave it.

Melinda Wittstock:

The confidence to say, “take it or leave it” doesn’t necessarily come naturally to many entrepreneurs. Our people pleasing genome often gets in the way of building businesses that work for us—rather than us working for them. Gabriela Rosa is the trailblazing founder of the world’s first entirely virtual and holistic fertility clinic. Today Gabriela opens up about her remarkable 24-year journey, navigating the challenges of entrepreneurship, motherhood, and advanced education—all while completely transforming how fertility care is delivered. We talk resilience, innovation, and the power of doing business differently—as well as practical resources for anyone on the conception journey. 

Melinda Wittstock:

Hi, I’m Melinda Wittstock and welcome to Wings of Inspired Business, where we share the inspiring entrepreneurial journeys, epiphanies, and practical advice from successful female founders … so you have everything you need at your fingertips to build the business and life of your dreams. I’m all about paying it forward as a five-time serial entrepreneur, so I started this podcast to catalyze an ecosystem where women entrepreneurs mentor, promote, buy from, and invest in each other. Because together we’re stronger, and we all soar higher when we fly together and lift as we climb.

Melinda Wittstock:

Today we meet an inspiring entrepreneur who shifted from a traditional, bricks-and-mortar fertility clinic to a fully virtual platform, driven by necessity as a new mom. Gabriela Rosa wanted to build a business around her own life and needs, while meeting the growing need to serve women and couples struggling with infertility around the globe. CEO and Founder of The Rosa Institute, the world’s first entirely virtual and holistic fertility clinic, Gabriela shares the ups and downs of her entrepreneurial journey, 

the lessons she’s learned about building a business around expertise rather than hours, and how she’s helped thousands achieve their dreams of parenthood—even when other treatments have failed.

Melinda Wittstock:

Gabriela will be here in a moment, and first: 

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Melinda Wittstock:

Women entrepreneurs share a unique journey—many of us balancing motherhood with the birth and nurturing of our businesses. It can be tough to balance all the competing demands, but it is possible as I know firsthand juggling a 6-week-old baby with the launch of my first business and mothering my two kids as I navigated the twists and turns of entrepreneurship across four other businesses.

Melinda Wittstock:

Today our topic is fertility and reproductive health, and how an innovative entrepreneur and fertility specialist navigated the growth of her holistic clinic from in-person service to scaling virtually to every continent, barring Antarctica. Gabriela Rosa and her team have educated over 140,000 couples in more than 110 countries, and her journey has been one of endurance, growth and determination since she founded The Rosa Institute in 2001. Gabriela shares her insights on fertility, why IVF is not the answer for everyone, plus her free resources like the 30-day Fertility Challenge and her podcast, TalkSex with Gabriela Rosa™.

Melinda Wittstock:

Let’s put on our wings with the inspiring Gabriela Rosa. 

[INTERVIEW]

Melinda Wittstock:

Gabriela, welcome to Wings.

Melinda Wittstock:

Lovely to be here. Thank you for having me, Melinda

Melinda Wittstock:

I want to hear all about your story and how you’ve built it. I mean, 24 years, that’s a long time. Amazing.

Gabriela Rosa:

It’s a long time. 2001, when I look back, I go, wow, where did the time go? And it feels at the same time that it feels like it’s a long time. It feels like it was just yesterday. And as you running any business, you’re going to go through lots of challenges and lots of obstacles that pop up along the way, and there’s changes in the landscape all the time. And so as much as we think that each day is just business as usual, there’s usually lots of other forces trying to either undo or do differently what it is that you’re trying to do. So, it’s an interesting journey, that’s for sure. But I will say, even though there are massive challenges and I decided to bite off a little bit more than I could chew in the last seven years, doing a second master’s and a doctorate alongside running my business, it has been a very, very steep growing curve and learning experience that has been really beneficial in many ways. So, yeah, I. I can say that 24 years has gone in a flash and taken forever at the same time.

Melinda Wittstock:

Well, you are the world’s first entirely virtual and holistic fertility clinic. And I mean, being first is an advantage, but it’s also hard, you know.

Gabriela Rosa:

It’s hard. Yeah. And I think that a lot of times, you know, the funniest thing that I recall, when I decided to go fully telehealth, you know, I had a. I had a bricks and mortar clinic, and I hired practitioners who were working alongside me in a physical space. And then all of a sudden, when my first son was born, who is incidentally about to be 13 next week, I decided that, okay, it’s going to be a bit too hard for me trying, trying to coordinate all of the things, the team, the showing up for patients. And at the time, I was. I was coordinating the team as well as seeing 60 patient hours a week, you know, which is crazy. Exactly.

Gabriela Rosa:

So, you know, to say that I had an 80 hour plus week is not an understatement. And it was a really deliberate choice at the time where I was pregnant to go, okay, I do need to do things differently, and how is that going to look? And at the time, I was already seeing some patients remotely. I was, you know, and it was via the corded telephone. Imagine that. Where we had telehealth calls, where people were who were not in Sydney or who were not in Australia were reaching out to me and my expertise in trying to get pregnant. And so, I basically, you know, decided late into my pregnancy that, okay, sustaining 60 hours a week plus, you know, an 80-hour week kind of curriculum and having a newborn baby is going to be incompatible with sanity. I think they’re just impossible maybe. I mean, exactly.

Gabriela Rosa:

Doing one of those things I think is hard doing all at the same time. It was definitely kind of like it made me, it forced me to be creative, let’s put it that way, because I knew that I didn’t want to give up my business. I knew that I didn’t want to close it down already. I had been working, you know, for more than a decade in what I had created. And I knew that it was something that, you know, children will grow, and they will do their own thing. And I knew that eventually that was going to be the case. And if I was to give it up, because now here I have a new role in being a mom, I would have regretted doing that. 

Gabriela Rosa:

At the same time that I couldn’t continue business as usual and doing things in the way that they were, I also had to figure out how else do I leverage my expertise? And so then was when I decided to fully commit to only seeing the kinds of patients that we see, which were patients who had been trying to conceive for more than two years, had experienced previously failed treatments and you know, things that hadn’t worked, and generally recurrent miscarriages and pregnancy loss. And I basically at that point decided that I was also going to do it entirely virtually and nobody, because, you know, like, let’s be honest, I was, you know, with a newborn baby, breastfeeding and disheveled without makeup or hair made and had to kind of be patient facing. And so, I was like, you know what? We’re going to have to leverage this telephone thing where nobody can see me and I can just, you know, do the thing that I need to do and that I am an expert in. But that doesn’t depend on how I show up, you know, whether I have makeup on or not that day and even whether I’ve had a shower or have done my hair. And that was literally why I made the decision. Like it was, it was so deliberate from the perspective of like, I have to put minimal time into getting ready every day. And you know, as a new mother, one of the things that struck me so hard because I Always used to think like, oh, this is so, like it’s so over the top, you know, when I used to hear moms or women say that, oh, I haven’t even had a time, you know, a moment in my day to shower today. And I honestly used to think like, oh, come on, like surely you can find five minutes to shower.

Gabriela Rosa:

And very, what is it? Unempathetic of me. And when I had a baby, I realized that actually, no, there are days that you have to make a decision between whether you go to sleep, whether you eat something or whether you shower. And so showering is the last of that list, you know, and, and that was a big wakeup call because I thought that surely that’s not going to happen to me, you know, and, and so in the decision of kind of going, okay, right, we’ve got to do this differently, I decided that I was going to do, I was doing consultations and doing kind of semi STR programs at the time. But I decided it’s going to have to be fully program based. People are going to have to come in, invest up front, do the thing that they need to do, and we’ll get the results. But I don’t want to have to be reconvincing that person each time that we’re working towards an outcome here. And so that was also a big decision that was personally focused. Like it was literally about me and my bandwidth not being there at the same level that I’m like, listen, this is how we do business here. This is how it works. This is what is on offer. Take it or leave it. You know.

Melinda Wittstock:

This is a big lesson. I’m just gonna just pause here for a moment because this is a big lesson that women in particular need to learn because there’s so many women who get into business selling their time rather than the value of their expertise. And when you combine our, I don’t know, our learned behavior for people pleasing into it, plus perfectionism, it’s a real rep, you know, recipe for, for burnout. But it’s also antithetical to any idea of scale or even.

Gabriela Rosa:

Absolutely.

Melinda Wittstock:

Or even building your business as an asset, right. Which you want to obviously build value, you know, in your business. And so, it sounds like just circumstance forced you to that like, like you’re just like, yeah, the only way I can do it.

Gabriela Rosa:

So, it’s just, yeah, right, so there.

Melinda Wittstock:

But there’s a certain confidence, like bravo to you because there’s a confidence in just saying take it or leave it and having the confidence to do that. And so how, just for anyone listening who’s struggling with this particular problem where they think, oh, well, maybe I won’t have any customers anymore. All the fears that come up around that, you know, what was your mindset at the time? How did you deal with that? It was just like you were just forced to do it and you just didn’t think about it. Well, yeah, it’s a great question. And I think that, you know, part of me was like, you know, what if this thing tanks? If it burns to the ground, so be it. Right now, I just need to cope with the fact that I have a child that never sleeps, you know, and I think that that happened as I was about to give birth to him. I found it really difficult to get somebody to replace me clinically and to able to do what I was doing because I was already kind of doing some things outside of the realm of conventional, you know, so I, you know, most, I was trained as a naturopathic doctor, as a naturopathic practitioner. And so, you know, the model there is very much hourly rate based. You kind of, you know, people come in and they pay for a session. And you know, that’s essentially how most naturopaths actually operate.

Gabriela Rosa:

And so, what happens is that, you know, a person by the third, probably by the second or third consult has already quote, unquote, got their value, right, because usually the clinician is not. They don’t understand how to build value. They don’t understand that this is a long-term journey. And they don’t know how to position that. They don’t know how to sell it. And so, they basically get stuck in this thing of like they have a patient, they pour everything into that person. They basically see them two or three times. It’s usually kind of like, you know, a month apart.

Gabriela Rosa:

And then by that time that, you know, they kind of see them the third time, the person is kind of. Because the conversation has surrounded itself very much around, you know, what was happening before. There has been momentary improvement, but not really with a very long-term look to the future of how do we optimize health for the long term. And so, then that relationship kind of dissolves and the next person comes in and it all repeats itself and starts again. And I knew that that was never how I wanted to work. And so, you know, very kind of early on in the process, I knew that I wanted to be in long term relationships with my patients. I knew that life is something that you constantly are having to navigate, you know, challenging things around. Your body has to Adapt in many ways.

Gabriela Rosa:

I also understood that, you know, just because you might be having a little bit of an easier time now, doesn’t mean that in six months from now you’re going to be in that same place and that the circumstances around you aren’t going to require more of you and being ready. I think that that’s the thing, you know, when you are at your best level of health is where you are going to be the, the most ready for when things get hard. And as we know in business, things get hard all the time. So, you know, the one thing that I knew that was important to me was that I was building those long-term relationships. I had restructured what I was doing to have long term programs, you know, with general health as well as fertility. I was positioning people for a much longer working relationship because I knew they needed it. And obviously they kept coming back and showing up and paying because they knew they needed it.

Gabriela Rosa:

That was the first kind of thing that really I decided that I needed to implement way before I even got pregnant. That made me first consider, okay, we’re going to shift this yet another level up, so to speak. And so when I got to the point where, you know, this and I was trying to replace me to be able to work in that way, as I was saying before, I had a lot of difficulty because the vast majority of people that were employable at that stage were not used to and fully untrained to work in the way that I was working. And so, it was. Even to find someone who was willing to give it a go was a little bit of a challenge. I ended up finding this person like literally a week before my job due date to go and have a baby. So, I hired her and, you know, put her in charge of my patients for a period of time.

Gabriela Rosa:

But at about four months into after giving birth and into the whole thing, I started to see numbers, you know, kind of going down, natural attrition because they’re seeing someone new. There was a need for more kind of strengthening of that foundation. And I was so exhausted with, literally, I don’t know if I had had my first child the second time, I probably would. I would have been very, very much more shocked than I was. But I had a child that never slept. He probably, he had silent reflux. We didn’t know. And so basically, but every 20 minutes or an hour and 20 minutes through the way, all the way through the day and night, this child would wake up and he had to be held the entire day.

Gabriela Rosa:

So obviously I had a nanny, and I had my mum for the first three months, and she was very much. She was very supportive and helping me through all of that. But it got to a point at about four months where I was not getting any sleep because I was breastfeeding. So, during the night, I probably was getting about 30 minutes of sleep, and I started to see that, you know, revenue had decreased, and I was kind of being forced to go back to work. And I remember one day waking up in the morning knowing that I was about to have to restart, you know, seeing patients again, thinking, oh, my God, how can I possibly, you know, when seeing patients in such a high energy, because you’re having to lead that person, you know, in front of you, you’re having to show them a possibility that’s not there. You’re needing to really drive that experience for that person. And I remember thinking; I don’t even know my name. How am I going to do this? You know? And so that was the moment.

Gabriela Rosa:

That was the very moment that I went, okay, I have to do this differently. And at this point, I don’t even have the energy to care if it fails entirely, so I’m just going to have to go with it. And my decision was to do less and to really focus solely on. I ended up giving away. And literally, I didn’t even sell. I gave away 50% of my practice to keep only the people who are treating for fertility and then building an entire program based on that, specifically in a very, you know, robust and solid way, and then deciding that, okay, this is the only thing we do now. So people used to come to me for all sorts of health and. And women’s health and other reproductive conditions, you know, optimizing period pain and perimenopause and premenstrual symptoms and, you know, all of those things.

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Melinda Wittstock:

And we’re back with Gabriela Rosa, holistic fertility specialist, CEO and Founder of the Rosa Institute, and host of the Talk Sex podcast.

[INTERVIEW CONTINUES]

Gabriela Rosa:

And all of a sudden I was like, no, we don’t see any of those patients anymore. This is the person who I would recommend go there. And we then started having the conversation to market which. Which was just this program, and this is just the way that we did it. And really, as a package, because the proven. The methodology was already proven. Like I had 10 years before. I was already using it and refining it, and I had written books about it and program and all of that.

Gabriela Rosa:

So I had all of that base already in place. Then it was just a matter of repackaging it from a marketing perspective, but also from a structural, logistical perspective. And because I was at that point of just sheer exhaustion thanks to my wonderful, beautiful bundle of joy, I decided that. That, well, there’s no better time than now, because either this is going to work, or it isn’t. And if it doesn’t work, I will be able to restart this in the way that it was before, when, you know, I have more kind of bandwidth if I need to. However, if it does work well, then we’ve started something, you know. And so, I think that that was really the big, almost decisive fact. And it wasn’t even so much about having courage.

Gabriela Rosa:

It was just like figuring out that what is it that’s possible and what is it that’s impossible? You know, and at the time, seeing 60 patients a week had become impossible, even though it had been utterly possible, you know, a year before. So, I think that, to answer your question, yes, it took guts. It really did, to face it and go, you know what? This whole idea of mine might completely tank. And it took faith to go, well, it might tank, but I’m gonna try anyway, and I’m gonna see, you know, it’s either gonna work or it’s not, and let’s go with it. So, I started and I decided, and I completely shaped it and, you know, got training about how to position it and how to organize it in a way that actually made sense for people and all of that, and started doing it in the way that I had envisioned, which was very, very outside of the status quo. Like, the biggest thing that I used to hear on the phone, because I was here, I was, you know, having conversations with people on the telephone. The biggest thing I used to hear is, like, is there a place I can go to? So where are the consultations gonna happen? You know, because I was at this point talking to people all over the world, and we were using Facebook ads to drive these initial conversations. So, it was really a matter of, like, whoever signed up for help with this particular issue, no matter where they were in the world, was somebody I would get on the phone with.

Gabriela Rosa:

And of course it was. I was very lucky that technology had. There was a confluence of, you know, the. The ability to. To reach people all over the world had become possible. I remember when my parents moved from Brazil to Australia in 1992, and my mom used to try and call her mom on the telephone. It used to be $25 a minute, you know, to be able to have a conversation. Conversations couldn’t last all that long.

Gabriela Rosa:

By 2007, you know, 2012, actually, 2013, that had become, you could actually call VOIP. You could actually call other places. Around the world. And, and it was a very easy kind of, you know, just dialing another number, just as long as you had the country code and you knew the time zone. And so that’s how it started. It was people giving me their phone numbers, me calling the phone numbers and, you know, having a conversation to see if my expertise was a match for what it is that they did. And I started advertising it only to bring on people that have been trying for two years or more or had experienced miscarriages or failed treatments. Because in the six months prior to this whole thing, I had had two cases in my clinic that really gave me the confidence to know and understand that actually what I was doing was quite transformational.

Gabriela Rosa:

One woman had been trying for 10 years, had had multiple failed IVF cycles, and the other had been trying for 19 years, similar story. And both of them conceived in under like a five-month, six-month period after years of trying multiple things that hadn’t worked. So as much as when they first conceived, I was very kind of skeptical. I was like, really? Was it really this that made the difference? You know, clearly they had gone through a huge journey prior lots of other things that they had tried that hadn’t worked. And then when the second person had the same result, I was like, okay, this is more than a coincidence. Let me start now focusing on, you know, it became this thing of like, well, since I’m only going to be doing this program and I can see that this has worked for those women, I’m only going to want to see people who have been trying for two years or more. And the other reason why I decided that again, very deliberately, was that I realized through years of practice. By then I had been in clinical practice for over a decade.

Gabriela Rosa:

At that point I’d realized that anybody who had been trying for less than two years was still too hard to help. And what I mean by that is that, you know, sometimes when people are trying to get pregnant and they in those early stages and they haven’t tried very many things, standard therapy or conventional medicine follows a very specific path, which is you go to your GP, your GP basically says, oh, yes, you have been trying for more than a year, therefore you’re infertile. Now let’s go and send you to IVF, which is all well and good, but 70% of IVF cycles fail, right? And so, the general population conceives within three conception attempts. It’s literally have sex, get pregnant, have a baby, done. We’re no longer having this conversation when we’re having this conversation still beyond 3 months, we arrive to the second subset of the quote unquote infertile population, which is the people who have been trying for about a year and then they go and do IVF. Or they recommended that IVF is their next step. Those people who conceive, they leave the next subset of patients who then become the people who go through multiple failed IVF cycles. There was a study that was published in Human Reproduction recently, a few years back, basically showing that in order to be able to have a close to 80% live birth rate through IVF based on 178,000 cycles, a couple needed on average, eight IVF cycles.

Gabriela Rosa:

Now, I don’t need to tell you IVF cycles aren’t cheap, right? In the United States, the average is about 15 to 17,000 US dollars for, for a cycle. So, you do the math. It’s like, it’s a big thing, but also what happens when people have been trying for a long time, they start to become more almost kind of resigned to the fact that it might not happen. And many don’t lose the hope that it will, but they become less desperate and therefore more open and willing to do things differently, which has always been kind of my passion. You know, it’s kind of like looking outside that status quo, looking outside the box and saying, okay, well, how can we actually get a different result by looking at this problem in a different way? And so that’s how this whole thing kind of like evolved from there. And some years later, I basically decided that, okay, this seems to be working very well for people who have been in fertile for a very long time. So, I decided to become a little bit more curious from a scientific standpoint about our results. And I started a master’s in public health at Harvard.

Gabriela Rosa:

And my thesis was actually studying my own program to understand what was our success rate, who were the people that we were helping, and you know, what was the outcome that we were seeing. And you know, it was quite interesting because I had a gut feeling about the results, but the results actually ended up being better than what I expected. So, we had a situation where the average number of years of infertility for the patients that I was treating was about four years, plus or minus two and a half. We had 51.5% of patients experiencing miscarriage prior to treatment, and that dropping to 3.13.5%. In the general population. The expected rate for miscarriage of pregnancy loss is about 15%. So that was even better than that. And almost 50% of the patients who came to us had experienced previously failed IVF cycles.

Gabriela Rosa:

And the majority of the people in our program conceived naturally without needing IVF, despite some having been through 20 failed cycles of IVF. So, the success rate of the program was 78.8%. And so, it was like, okay, yeah, so I’m not crazy. I’m not imagining things. What we created and what we deliver is definitely effective, you know, from that standpoint. But that’s how it all started. It literally all started with me just going, okay, I don’t know that I can continue doing this in this way. And I built upon each one of those challenges that I faced with, you know, kind of curiosity and I would say, like, a desire to see, hey, what else is possible? You know, And I think that in business, that’s one of the biggest things that I take away with me, even to this day, it’s like, whatever we’ve accomplished, I’m constantly asking, like, okay, we got here.

Gabriela Rosa:

What else is possible? You know, and that’s. That continues to drive me today. So that’s a little bit of the background.

Melinda Wittstock:

That’s amazing. But just, Just that learning from your own results, I think it’s fascinating that you went to Harvard to study your own.

Gabriela Rosa:

Thing. I don’t do things halfway, you see, which is a good thing and a bad thing.

Melinda Wittstock:

So, this is, I mean, so getting into the actual how this works. I mean, you’re, You’re. Your methodology is unique. You’re identifying essentially the biochemical obstacles. So, talk a little bit about that. What’s going on there?

Gabriela Rosa:

Yeah, absolutely. You know, what happens is that the body has an incredible ability to regenerate. And usually what happens when we find these results or these kind of outcomes that we’re seeing, whether it’s inability to conceive, inability to keep a pregnancy to term, or, you know, things are not quite going to plan. You know, sometimes I hear this from my patients and certainly even sometimes hear doctors say this, and I just kind of like, have to scratch my head and go, let’s just clarify what normal means when it comes to pregnancy and having babies. If you have had sex, you have gotten pregnant and you don’t have a baby, that’s not normal. In the same way that if you have time, intercourse, and you don’t have a baby after a period of time, or if you go through an IVF cycle and you create an embryo and you transfer said embryo and you still don’t have a baby at the end of nine months, that is not normal. It might be common. It might happen more frequently than what we would like and certainly in the way that we do not want to expect. But that is not normal. And I think that that is such an important thing to highlight because it is so frequent that I hear people having outside of range results and having real imbalances, you know, in their, in their blood work and in their, the tests and the results even from, you know, going through treatment. And literally they’re just told, oh, you know, everything’s normal, just keep trying, or another variation on that, which is, you know, like, let’s say that when we’re trying to find a biological reason or a biochemical reason as to why fertility is not working in the way that you would expect, I. E. Intercourse, baby, we have to then figure out, okay, what are the obstacles that are getting in the way and what is it that needs to be done in a different perspective rather than say, oh, everything is normal, just keep trying. If we were to investigate those things in more depth, let’s just say, for the sake of this example, and it’s not far off from what’s actually real, let’s just say there’s a hundred different tests that you could do to assess someone’s fertility potential and ability to conceive and keep a healthy message to term and also identify things that are actually getting in the way to the outcome that you’re looking for. Let’s say that there’s 100 tests that you can do because of the way the health care systems are structured around the world, and we treat patients literally from every continent other than Antarctica at this point.

Gabriela Rosa:

So, I see very much in depth the different types of patients and healthcare systems and, you know, like the, the nuances of how things are done in the UK versus the US versus Australia versus Brazil, you know, many different countries around the world. But one thing is very common amongst all of them. When it comes to a workup for infertility, a woman might go to their doctor and say, I’m trying to get pregnant. It’s been close to a year, it hasn’t happened. They really only have to do four things. The doctor will typically, a general practitioner will typically only look at four different things. Are the fallopian tubes clear? Are the hormones indicating ovulation? Do we have uterine abnormalities? So, you know, to learn ultrasound, is the uterus normal and do we have sperm? Okay, so those are the four kind of basic, let’s just say four basic tests that are going to be done and there’s some couple of little subtests that, you know, are additional. But toward the diagnosis of that, those four things, they do those four tests and then results come back with nothing noticeable or nothing that’s really majorly wrong.

Gabriela Rosa:

And patient is told these words, we’ve done all the tests, everything is normal. Now let’s reason here for a moment. If there are a hundred tests and you’ve done 10, that’s not every test. We haven’t done everything. And if there is mostly, you know, within range results, that doesn’t necessarily mean that that is optimal for that person. So that’s why precision care and precision medicine and personalization is completely left of what’s going on. And the reason being that, you know, fair enough, in the general population, over 93% of people conceive without trying. That’s why we hear so many of these stories of, you know, oh, my sister had a one-night stand and got pregnant, or, you know, such and such, they drink, they do drugs, they party all weekend and they got pregnant.

Gabriela Rosa:

Well, that’s kind of what happens out there. It’s common, it’s not ideal. But when it hasn’t happened like that for a couple, then we need to start seeing that situation in a completely different way. Because if it hasn’t happened easily, it probably will not. And so then just keeping a surface level and you know, doing four tests and essentially proclaiming that everything is normal doesn’t serve the couple. Because then the next thing that’s said is you need to go and do IVF. You go into IVF because you haven’t understood why natural conception isn’t happening to begin with. There usually is a situation where, you know, they fall into that category of lots of cycles that fail about 70%, as I said before.

Gabriela Rosa:

And so, then what ends up happening is that they just keep being told, oh look, it’s a numbers game, just keep trying. Or meanwhile, it’s like, how many times, how many cycles do you fail through before you go, okay, this is, this is not normal, you know, and doctors will even say, and it’s, you know, like they’re not trying to be ming. But at the same time, I’m a little bit skeptical because the IVF is a multi-billion-dollar industry and it’s privately driven. Right? So other than the, in the UK, when we’re talking about the NHS, which is fully government funded, but then they also have a very hard limit on how many cycles you can do. Like the NHS would never agree to doing 10 cycles on a woman and saying, oh, it’s a numbers game, it’s like it’s two. And if you don’t get pregnant. Well, we tried. Whereas in a private system, what ends up happening is like, oh, no, it’s a numbers game.

Gabriela Rosa:

Just keep trying. 10, 20 cycles later, oh, you know, it’s going to happen eventually. So, which one is it? You know, and that happens very much because of the way in which the incentives are aligned or misaligned. So, when it comes to fertility, and just going back to your original question, in the terms of what it is that we are looking for, we are completely impartial about how people actually get pregnant. So, we don’t do IVF, but we support couples who do need to go through IVF. In our 78-point birth rate, 47.7 conceived naturally. The remainder needed IVF. Very slow, very low number.

Gabriela Rosa:

Despite being told that they needed donor egg, it was 5.6% in our study, actually need a donor egg. So, we know that even when patients are being told, oh, you know, you’ve tried all of these cycles, it has failed, you need donor egg. They actually not always do. It’s just that they, in the standard care in conventional medicine, the doctors that were treating them just ran out of tools to be able to actually figure out what else is happening. So, what we do differently is, exactly, we start with the end in mind. We start looking at, okay, what has failed and why. Like, that is literally what I’m investigating when I see a patient to begin with. I’m looking for all the gaps and all the places of opportunity, all the tests that, based on their symptomology, based on their medical history, based on what’s going on, have been left out of creating that full picture for us to be able to understand what are the issues here, really.

Gabriela Rosa:

And the other thing that’s very different in the way that we approach this is that we know very clearly, I mean, it should be obvious, but again, standard therapy hasn’t cotton on, which is the fact that fertility is a team Sport. It’s a 50, 50 equation. So, there is no world in which you can conceive with just the egg. We haven’t figured out asexual reproduction yet. Right. Which means that we do need the sperm. And when the sperm is poor quality, the egg has to do so much more work to fix the DNA fragmentation within the sperm and, you know, all of the obstacles that are going to be presenting in that fertilization process and then, of course, the development of the embryo. But what happens there is that for women who perhaps have a lowered ovarian reserve or have, you know, egg quality, that could be optimized or that needs to be improved either because of age or environmental toxins or circumstances, whatever the reason might be.

Gabriela Rosa:

But they are in that situation, wherever reserve is lowered and quality of eggs is diminished, we have to have superheroes burn. And no one is saying to the men, hey, you need to like, step up on this conversation here. Right? And so. And that’s because society just accepts them. Fertility is a female issue, but actually it isn’t entirely. And it’s never going to be fixed by just looking at one side of that equation when things haven’t been straightforward, you see, and that’s really where people need to wrap their head around that there are different populations within couples trying to conceive. You have the ones that have looked at each other and you know, oops, I’m pregnant. Then you have the ones that have tried for a little bit and IVF has worked first try, which is that those are the, those are the things that we hear in the news.

Gabriela Rosa:

Those are the stories that the news portrays, which is a high overestimation of what actually happens in the field. Right, but that’s a subset. Then you have the subset of the people who have tried many things and it hasn’t worked, many cycles and it hasn’t worked. And then you have the people who basically have given up and just gone, you know what? I still think that there is something that’s being missed, but I don’t know what it is. Usually, people come to us at that last resort, which is so sad for me. Like, another reason why I went to Harvard was that I was just like, I had to. I couldn’t bear continuing to see these people struggle to and go through infertility for 10 and 20 years, knowing that there was a better way, but not knowing how to insert it into the healthcare system. You see.

Gabriela Rosa:

And so that was another reason as to why actually that was the reason I started my doctorate. So, after I saw that, yeah, okay, this is effective, I had to then figure out, okay, well, how do we start the conversation about inserting it, you know, given that it is effective into the healthcare system? And that’s how, you know the idea to do a doctorate whilst running a business, probably the second worst idea I’ve ever had came about. Right. The good news is that I’m about one year away from finishing. But, yeah, that was a. That was a challenge in its own right, let’s put it that way.

Melinda Wittstock:

Amazing. Wow. I mean, just so. I mean, it’s so interesting how much money people spend on ivf just simply out of ignorance, thinking that’s the only way.

Gabriela Rosa:

Exactly, exactly. And it’s so. For me, it’s heartbreaking. It really is.

Melinda Wittstock:

So, people should really. So do you have. Gabriela, do you have, like, resources? And I imagine you do for, like, before people engage you, where they absolutely learn about this, before they’re even thinking of wanting to have a child, like, because 100%, it seems like the fertility, like, I don’t. I don’t know. You could answer this question for me. It seems like fertility is becoming a bigger issue than it ever has before, or people just talk about it more. Maybe it was always an issue, and people didn’t talk about it, so we just didn’t know about it. Like, do you know what I mean?

Gabriela Rosa:

Yeah, yeah, there’s a combination of those. Yeah, there’s a combination of those two things. And, you know, I mean, there’s. There’s also a really interesting trend that’s happening these days, which is people actively deciding not to have children. You know, so. But that’s a different story, because at the end of the day, that’s a conscious choice. It’s a conscious decision of, like, you know, I actually don’t. I don’t want to partake in that whole societal ritual, which is, okay, you’re still going to have lots of people who will want to do that.

Gabriela Rosa:

But there are, I think, a couple of confluences here, which. The first thing is that fertility is certainly less taboo than it used to be. Technology has improved to a level and a degree in which it’s much more visible and understandable to see that, okay, there are things that are not quite right, and there are things that we need to do. I think entrepreneurship has added to this because now there is money to be made right, whether it’s in IVF cycles or in tech and devices that help women track and, you know, do things. So then that conversation becomes more appealing, even in. In the general kind of media, because there’s something to sell, right? So, I think that there is definitely a combination of all of those factors. And, you know, there’s a couple of things that I’m very. That are very important to me and have always been.

Gabriela Rosa:

I’ve written four books on fertility, and my last book, I actually decided it really encompasses our whole kind of process, how we work in terms of helping people understand the pieces that they need to understand. Because this is the. This is what happens. What you. What you spoke to, Melinda, is exactly why people stay stuck. It’s because they don’t know what they don’t know, they don’t even know that there are other ways of doing things. They don’t know that there are other options and that really they need to be preparing their bodies before they go and do IVF. So, I decided that, okay, the first way to help people understand this at a, in a much more scalable and leverageable way was to write a book about it.

Gabriela Rosa:

And so, Fertility Breakthrough Overcoming Infertility and Recurrent Miscarriage When Other Treatments have Failed was the book that I wrote to depict that. And I actually ended up putting it free on YouTube and Spotify because I want people to get access to that information. You know, that’s for me as much as, you know, yes, I run a business and yes, I have a program that people can join if they are eligible because that’s another thing. The reason why we have a 78.8% love birth rate is that we use, we basically screen for the patients that we can help. Like, we use selection bias. It’s, I’ll be very transparent about that. Like, if I have a couple who seeks my help, who I cannot help, I would rather, I think that the kindest thing I can do is have that conversation and let them know what it is that’s going to help them, them instead. And it’s going to be, you know, from my perspective, a better, better experience and a better process for them and a better process for me because I’m going to help only the people that I can help and that is going to be reflected in my success rate.

Gabriela Rosa:

Right. So ultimately we screen for cases, we assess cases, we do complementary assessments to assess cases to see if we can be of assistance. And when I can’t, I will give very detailed information about what, what people need to be looking at and thinking about in terms of their fertility. So, I think that that’s a, you know, that’s one way in which we add value, you know, to patients who are struggling for such a long time. But the book, it’s available free on Spotify and YouTube. And then I’ve created another program that. It’s a program that I’ve been running for, gosh, since 2011. I’ve been running the Fertility Challenge.

Gabriela Rosa:

And the Fertility challenge is a 30 day, a educational program that is all focused on implementation of what is it that somebody who knows nothing about how to improve their chances of getting pregnant and improve their fertility needs to understand from the very first beginning about how to look at fertility to all of the things that they can actually implement and do to improve their chances so that Was my way of going, you know, what medicine and the way that these interests are misaligned in medicine in many ways in healthcare systems around the world, I can’t change that. I can’t influence that. But I can make available information that people can use, that people can learn from and people can actually understand about how to help themselves. I’m very passionate about that. So, I run this free program, have run it for, you know, a couple a decade now, and have taken over 140,000 people in more than 111 countries through it. And it’s wonderful. Like, literally we start a new group every month. And, you know, I’m there to support people, answer questions, do all of the things that essentially is going to help them to understand the situation in a better way.

Gabriela Rosa:

So those are the free resources. Like, literally, people can just Google it and find, you know, if they Google my name. Gabriela Rosa. Gabriela with one L. And fertility challenge is essentially the name of the program or Fertility Breakthrough, the book. Those are things that they will be able to find easily to help themselves and understand more about, you know, what are the things that they need to learn to make better choices, better informed choices on their journey to parenthood.

Melinda Wittstock:

Fantastic. And of course, you also will have all of this in the show notes. But, Gabriela, you also have a podcast, Talk Sex.

Gabriela Rosa:

I do, I do. I do talk about that. Yeah. So, Talk Sex came about because I had lots of patients who want to have babies, and babies basically were like, but do I have to have sex? It’s like, well, Biology 101. Let’s talk about that. And so, Talk Sex came about from the perspective of, like, people in long term relationships, but also people in long term relationships who are experiencing infertility. It becomes. Sex becomes a really challenging thing, you know, for people, and it becomes a traumatizing experience almost.

Gabriela Rosa:

You know, sex can be, obviously when sex is… Is happens for pleasure and enjoyment and, you know, all of the things that essentially we usually initially feel sex for when it transitions from a monthly experience. And sometimes with these couples, they’re literally just having intercourse to be able to conceive. And when it hasn’t happened and each month, month, they, you know, kind of equate the fact that they’re doing this thing that’s supposed to give them the outcome that they want, i.e. a healthy baby and it’s not working, they start to hate on it a little bit, right? And they start to feel somewhat traumatized by it.

Gabriela Rosa:

And so, the idea of talk sex was really to kind of help people rediscover the enjoyment in intimacy and, you know, rediscover the enjoyment in, in partnership in, at that level. And so, we have lots of episodes, you know, are sitting there. I have had to pause the podcast for a little bit as I was doing my doctorate and feeling like again, you know, it was the beginning of having another baby. But. But yeah, it’s something that I hope to get back on next year once I once I graduate. For sure. It’s a fun podcast to listen to.

Melinda Wittstock:

Oh, fantastic. Well, Gabriela, thank you so much for putting on your wings with us today and, and flying. This is really, really interesting. And appreciate your work. 

Gabriela Rosa:

Such a pleasure. And thank you for having me and allowing me to share. It’s been wonderful.

[INTERVIEW ENDS]

Melinda Wittstock:

Gabriela Rosa is a holistic fertility specialist and CEO and Founder of the Rosa Institute, helping 140,000 couples in more than 110 countries. She is also the host of the TalkSex with Gabriela Rosa™ podcast.

Melinda Wittstock:

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Melinda Wittstock:

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