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#125. How to Navigate a Broken Fertility Care System with Dr. Gabriela Rosa

Writer: Clara O'Rourke
Clara O'Rourke
15 hours ago
5 min read

Fertility Care That Starts With Better Questions

When you have been trying to conceive and keep hearing that everything looks “fine,” it can be hard to know what to ask next. In this episode, I talk with Dr. Gabriela Rosa about the value of understanding your own health information and finding care that considers your full story.


Gabriela explains why a test result needs context, why sperm health belongs in the conversation when applicable, and why repeating a treatment without understanding the reasoning can leave people feeling stuck. We also talk about the emotional weight of fertility challenges and how to prepare for an appointment so you can take a more active role in decisions about your care.


There is no universal checklist or guaranteed path to pregnancy. My hope is that this conversation helps you feel more able to ask for an explanation, a copy of your results, or another perspective when something does not make sense.


In This Episode, We Cover

  • Why “normal” or “fine” test results in typical fertility assessments may need more explanation

  • Looking at both partners’ histories and test results when relevant

  • How a fuller health history can guide questions about next steps

  • Preparing specific questions before an appointment

  • Finding support without taking on the burden of figuring everything out alone


Listen to the podcast now:


Asking Better Questions When Fertility Care Feels Fragmented

There is a particular kind of exhaustion that comes from doing everything you were told to do and still not having an answer. Another appointment. Another result described as “fine.” Perhaps another treatment recommendation, when what you really want to understand is why this is happening and how the next step fits your situation.


If that sounds familiar, I want you to know that needing more context is reasonable. In my conversation with Dr. Gabriela Rosa on The Mindful Womb Podcast, we talked about fertility care, health literacy, and the relief that can come from being able to ask a more specific question. It is not your job to become your own fertility specialist. You can, however, expect to be included in the conversation about your care.


What Does “Everything Looks Fine” Actually Mean?

Gabriela described meeting people who had been told a semen analysis was fine but had never seen the report. That one word can mean different things depending on what a clinician is looking for and which treatment is being considered. It does not tell you which measurements were taken, whether anything has changed over time, or how the result relates to your goals.


That does not mean every result hides a problem. It means you are allowed to ask: “Can I have a copy?” “What does this measure?” and “Does this result change what you recommend for us?” A clear explanation can help you make a decision you understand, even when the answer is uncertain.


Why Sperm Health Belongs in the Conversation

Fertility conversations often place a disproportionate share of the testing, tracking, and worry on the person who would carry a pregnancy. Gabriela challenged that pattern. When sperm is part of the conception plan, its health deserves attention too. And when a person is pursuing parenthood on their own or using donor sperm, the questions may look different. Care should fit the people involved.


The key is getting a fuller picture and sharing the work of understanding it. If a semen analysis has been done, ask what was measured and whether follow-up is appropriate in your circumstances. If it has not, ask your clinician whether it belongs in your evaluation.


A Fuller Picture Is More Useful Than an Endless Checklist

The episode also explores how cycle patterns, medical history, prior treatment, and broader health concerns may shape a fertility evaluation. Gabriela described the difference between ordering more tests and choosing tests that might answer a question for a particular person.


I think this matters because the search for answers can so easily become another exhausting job. You may feel pressure to change every habit at once, buy every suggested supplement, or ask for every possible test. A thoughtful clinician can help you identify what is relevant, what is supported by evidence, and what the result would actually change. There is room for evidence and for your lived experience of your body without turning either into a promise of a particular outcome.


How to Prepare for a Fertility Appointment

One of Gabriela’s most practical suggestions was simple: prepare before the appointment. Gather the records you already have, including test reports and a brief timeline of what has been tried. Write down the questions that keep circling in your mind. You do not need perfect medical language to ask them.


You might begin with: “What do we know so far, and what remains unclear?” “What is this test or treatment meant to tell us or change?” “What are the alternatives, including waiting or seeking another opinion?” “How will we decide whether this plan is working?” These questions can make the next step more understandable. If an answer feels rushed, it is okay to ask for it in plain language or request a follow-up conversation.


Health literacy is not another standard you have to meet before you deserve care. It is a way to be a participant in decisions that affect your body, time, finances, and emotional well-being. Support can also mean inviting a partner or trusted person to listen, take notes, and share the mental load.


You Deserve Care That Makes Space for Your Questions

Fertility challenges can create a painful sense of urgency. In that pressure, it is easy to feel that asking for an explanation will slow everything down. Sometimes a clearer conversation is exactly what helps you move forward with more confidence. You can respect clinical expertise and still ask to understand the recommendation in front of you.


Thank You for Listening

If this episode lights you up, I’d love it if you’d rate and review the show on Apple Podcasts, Spotify, or wherever you listen to podcasts. After you review the show, snap a pic and upload it here… and I’ll send you a little surprise as a thank you.


Your feedback helps this podcast grow, and I am so grateful for your support!


Don’t forget to subscribe to the Mindful Womb Podcast on iTunes so you never miss an episode.


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