Uncover #1 Cause Of Female Infertility

Introduction and Speaker Background 0:00

Dr. Felice Gersh, you are a multi award winning physician with a traditional brick and mortar practice with dual board certifications in OB-GYN and integrative medicine. You're the founder and director of the Integrative Medical Group of Irvine, a practice that provides comprehensive health care for women. By combining the best evidence based therapies from conventional naturopathic and holistic medicines. You've taught about obstetrics and gynecology at Keck USC School of Medicine as an assistant clinical professor for 12 years.

I also was at USC for. 12. 15 years, something like that. You now serve as an affiliate faculty member at the Fellowship in Integrative Medicine through the University of Arizona School of Medicine. You are a prolific writer and lecturer and educator who speaks globally on women's health and regularly publishes in peer reviewed medical journals. And you are also the bestselling author of the PCOS SOS series, which I love. That title and your latest book, Menopause: 50 Things You Need to Know. It is such an honor to have you here.

Dr. Felice, welcome. Well thank you. It's a pleasure to join you. And I just love what you're doing as well. Thank you so much, Dr. Felice. It's incredible. I have so many things that I want to ask you. I'm really excited to be able to highlight your expertise in PCOS and your expertise in the day to day care of women with PCOS. And so I have so many things that I want to ask you. We are going to limit ourselves to 30 minutes, which I know will be really difficult because I know we'll have a really engaged conversation.

And one of the things that I like to do is really make sure that our listeners and that the women listening to our voices right now who are searching for answers, leave each interview with very concrete steps that they can take. So I want to save the very best for last. In terms of the one thing that you hope every person will take away

Fertility Decline and PCOS Trends 2:36

to better their fertility, to better the health of their future family. But to start out, I would love to ask you if you were taking a look at the fertility landscape today in 2024 and you were looking at the fertility trends, what would you say are the best and the worst of the fertility trends that you're seeing in 2024? Well, the worst of it is the severe decline in fertility for both males and females. Way back in the day, when I was a medical student. It was the highly touted that a normal male sperm count would be 60 million.

And then now it's down to normal is 20 million. So you can say that that is erosion of what is considered normalcy. And that is horrible. So the male sperm counts have been declining along with quality of sperm motility, morphology, the whole thing. On the other side, the female issues of fertility are also on the upswing. And my personal investment in the most common cause of female infertility, polycystic ovary syndrome. PCOS is just skyrocketing. And it is, I call it the poster child of the deterioration of health of the modern American woman, because basically everything that's wrong in our society is contributing to the infertility of women with PCOS, the environment, total toxicants, the pollution, the endocrine disruptors, the circadian rhythm dysregulation.

And, you know, women with PCOS are like living in multiple time zones on a regular basis. The deterioration of the quality of food, the diet, the diversity, the lack of sleep, the pervasive light, you know, the blue light and the the stress degree that people now are enduring the sedentary lifestyles. I mean, all of these things come into play in a woman with PCOS. And so she's having problems in so many different landscapes involving her fertility. And when you combine that, we're just going to see more and more fertility centers popping up.

But even there, women with PCOS have the lowest success rate when they do get into things like IVF, IVF treatments. So it's it's not all doom and gloom, but I think understanding the problem is always the first step in then solving the problem. So, you know, I'm glad you brought that up. It's very disturbing what's happening to you? Humanity. As far as fertility, I know we have overpopulation, but we're going to have individuals suffering on a huge level. When couples can't achieve their desires to have families.

Dr. Felice, when I listen to you, I got so emotional and I can't fully explain or describe what I felt. But you said that what we're seeing is erosion of what is considered normalcy. And this is something that I talk about constantly at FPI and in my work, that we have this incredible mismatch between the world that our reproductive biology evolved to function and thrive in, and the world that we are living in today. And we are struggling so hard to close that gap as a society. And what you said is that, first of all, PCOS is the leading cause of infertility in women today.

And I put that in quotes for a specific reason, because we know most people aren't truly sterile or truly infertile, yet they're struggling deeply with their fertility. So that's why I put it in quotes. And that that struggle of PCOS is the I think your words were the poster child for everything that is going wrong in our society today. And I really felt that, you know, in my heart and at my very core, and there's so many things, so many places I want to go in response to what you just said to us.

But I'm trying to put myself in the shoes of the woman who's listening to us right now, and she's desperate for answers. And maybe she heard she has PCOS and she's been diagnosed with it. Or maybe she doesn't know what's going on with her fertility yet, but she just knows it isn't working the way that she always believed it would, and the way that society always said a woman's body would work when it was time to have children. And when I put myself in her shoes, I. The question I want to ask are.

The thing I want to say is it's so unfair that there are some women we're in the modern world. We are all exposed to the same things.

Coping With Fertility Struggles 7:48

And for some women, it takes such an incredible toll that it impacts their fertility. And for other women, it doesn't. And it feels so unjust and unfair. And the reality of the situation is that we all are suffering, and we all will suffer for this combination of conditions that you just mentioned. We all have our own unique physiological, genetic, psychological, social vulnerabilities where these problems will show up for us, right? And for some people that's in PCOS and in their fertility and more and more people it is that.

But what would you say to the woman who's feeling like I didn't create this modern world, and it's so unfair that my fertility is suffering because of it? When there are people all over who still get to go on and and have children with so much ease, even people who maybe don't mean to have children. Well, I think the number one thing is stop doing comparators. You know, just look at yourself. You know, we know that when people look at social media, there's so much jealousy. It's like, oh my gosh, their house is nicer, their home is nicer, their food is nicer, their kids look neat and clean.

You know, their grades are better. You know, we can't live in this world of comparisons. Just take stock of yourself and what are your goals? And then decide. Number one, it's always good to have a gratitude journal to look at what you do have, instead of always looking at the negatives, because that is a terrible way to go through life is just thinking of all the things you don't have. And then when you don't have something and it is on your list, you know you want to have kids, then you got to be proactive.

So what can you do? And that's what this is all about. This whole, you know, putting all these people together, the speakers and so on, so that people have actionable data and information because it's first you define the problem. Okay. So we know that say this, this individual we're talking about is very depressed, discouraged, seeing her friends getting pregnant. And she is suffering and she is not successful. So we need to then define what is wrong with her. And every person like you mentioned is very unique in their their nutritional status, their genetics and their background and so on.

So every person needs to be evaluated individually and there are things that you can do on your own, and there are things that you do need a health care professional to work with. So in terms of what you do on your own, there's a lot you can look at your lifestyle like do you go to bed? Do you go to bed at a reasonable time? Are you getting enough sunlight? Are you eating the right foods? Are you getting lots of plant based antioxidants and polyphenols and vitamins and minerals? Are you snacking all day long?

Are you eating late at night? are you getting physical exercise? Are you taking time to deal with stress? You have a mind body practice. You have relationships. Do you have love in your life and purpose? You need to look at your self like taking inventory of what you can control yourself, which is a lot. You know, you can still make tremendous changes in your body just by harnessing your innate abilities to heal, by taking in the proper foods and and exercise and sleep and stress reduction. And are you eating out of plastic?

Are you getting processed food? Are you buying from farmers markets trying to get find individual growers? Are you you know, or if you can't get to a farmer's market, are you buying the best food you can in the market that you have? Maybe you could buy things online now you can have things shipped to you. If you live in a food desert, you know where you can get optimal organic produce and so on. If you can't, you can buy frozen organic produce. I mean, there are things that you can do to get those vital nutrients and polyphenols and so on into your body.

And you know, what about your relationship? You know, you can't make a baby without, you know, if you're a female, you have to have sperm. Assuming you have a partner, what is your partner doing to contribute to the health of the couple? This isn't a solo enterprise, guys. You know, I mean, so you've got to work together as a team to support each other emotionally and spiritually and get everybody's health in an optimal way. And no matter what, try to keep fun in your life. Don't. If you obsess incessantly about fertility, then your life loses its joy.

You have to, like, take a break, you know, and just have some fun and be optimistic. I always say, if you believe it, you can make it happen. If you believe you will fail, you will fail in almost every case. That's why they take people who are striving to become Olympic gold medalists, and they have them visualize themselves standing, getting the gold medal put around their neck and so on. You have to visualize those, the little sperm getting up and, and and fertilizing your eggs.

Disruptive Approach to PCOS and Fertility 13:24

And you have to really I mean, positive thinking is not woowoo medicine. It's real. You can change the inflammatory status of your body through positive thinking. So, you know, don't compare yourself to your friends. Be happy for them because you want them to be happy for you when you are successful. And just focus on making the best out of your life. And there's so much you can do. And I mentioned the things you can do yourself, you may need to have fertility drugs. You need a health care professional.

You need someone to order labs on. You may be imaging tests. You need to work with, someone who you can trust and who is really interested in this subject. Right? You don't want someone who's marginally interested in you or your your state of health. So find your health care partner so that you can go through this journey of infertility and into fertility. Because this is not not for the weak of heart. You know, you really have to be strong. You have to be determined, and you have to believe you can do it.

Like you said, that's why I loved when you said in quotes, because the vet has majority. I mean, the absolute best majority of my patients who come in with infertility ultimately walk out with a beautiful baby in their arms. So exact clean is doable. You're not sterile. And it breaks my heart when I see patients who tell me they were diagnosed sometimes recently, sometimes a few years back and they were told, you have PCOS, you'll probably never get pregnant and have a baby. It's like, what a thing to say to a.

To somebody, oh. My. But this happens all the time. All the time. Oh my gosh, that is not the right message. That's a messaging bad message. Exactly. And and it was it's like you said what we what we believe in has so much power. It's like the brain rehearsing for its future. And it has neurochemical underpinning biochemical underpinnings, like you were saying, inflammatory markers, so many other things. And yet when a doctor says this isn't going to be possible for you, that's like rehearsing for a future that nobody wants.

That is so not helpful. And I always say to our Prime minister mamas at the Fertility and Pregnancy Institute, I don't know if faith and belief are sufficient conditions every single time for being successful, but I know that they are necessary conditions, meaning that if we don't have them, we could go through all of the steps that science says will get us to where we want to go, and it will be very unlikely that we will get there. We've got to have the faith and the belief as the foundation for the steps that we're taking.

And I know that that's not always easy. So I feel like one of the most powerful parts about working with someone is that you can borrow their faith and belief when yours are wavering, and we can't underestimate the power of that support. In fact, we know from the scientific data that when we have support, especially as women, but all humans, we're more likely to be successful in every domain of life, including fertility and pregnancy and the families that we want to have. So I just want to thank you so, so much for that.

And also the reminder that fertility and having a healthy pregnancy and having healthy children is not a solo enterprise, that the person providing sperm is at least 50% of the equation. And we need everybody to be contributing to the family before the family's even created. So thank you so much for that. Doctor Felice, what would you say is the most disruptive thing that you do in your and I mean disruptive in the best way possible? Because I don't know about you, but I'm getting so tired of all of the same old fertility party lines about what is and is impossible.

And you know what you should and shouldn't do. I mean, we just want real solutions that work and that work efficiently, that our the straightest line from where someone standing today to getting to their their super baby, as we call them FPI, what would you say is the most disruptive in the best way possible thing that you do in your practice is to help women and couples with fertility, whether it's in in the area of PCOS specifically or more broadly. Well, I would say it is focusing on for women, not so much for the men and women.

It's just lower inflammation, lower inflammation, get their nutrient status up and keep the heat down in their, yes, local area. So those would be the main things there for women. It's getting it's it's a similar thing. It's getting inflammation down and optimizing ovarian function. So that sounds so simple. But it's not as simple always in reality to do it with women with PCOS. It's really understanding what is the underlying issue which is not broadly understood, which is their ovaries are not optimizing the production of estradiol.

And without that, you're not going to end up with that beautiful spike of estrogen that precedes the LH spike. And then obviously, and then the production of progesterone. So you end up with ovarian malfunction, essentially. And with estradiol not being produced optimally for all the different areas of the body that rely on estradiol, which is basically every area in order to optimally function are going to be suboptimal if functioning. That includes the immune system, which becomes more like, we'll say, trigger happy to produce their inflammatory products and distribute inflammation throughout the body.

You get altered gut microbiome, you get altered circadian rhythm. Because the master clock in the brain relies on estradiol to keep its proper beat. You don't have proper function of the neurological system, which involves the autonomic nervous system. So women with PCOS have more stress, more dysregulation of their enteric or their intestinal, peristalsis, their whole neurological system there. And so on. So and then when you have the circadian rhythm dysfunction, the autonomic dysfunction, you don't have proper sleep.

So you don't make enough melatonin. And melatonin is a potent antioxidant which reduces inflammation. And there are receptors on the ovaries for melatonin. So without adequate sleep then that is just like fuel to the fire literally, of not having the ovaries work properly, of not having proper rhythms involved in the ovaries, and then more inflammation in the ovaries. And so there it's just this incredible dynamic. And it really starts, in my opinion, with my disruptive, you know, sort of approach to PCOS is that it really is about the ovary, about ovarian function, and about its ability to produce estradiol.

And when it's not adequately producing estradiol, the brain says, what the heck, give me more estradiol. So it puts out more LH, the luteinizing hormone, which causes the ovary to make more testosterone. Totally different skill set to make testosterone. so you end up with this really obvious dysregulation where you have too much testosterone, not enough estradiol, you're not ovulating regularly, you're not there for making the progesterone. And you have obviously infertility. But this once you understand that which is not widely understood, I.

Think. I my gosh, then you have to take proactive steps to heal the body first. You can't you don't want to get people pregnant, like through artificial trickery when they're not even healthy.

Preconception Health and Healthy Outcomes 22:00

You got to first be healthy. So that not only will you be successful with conception, but you will not have miscarriages galore. Which women with PCOS have very high rates or pregnancy complications? Which women with PCOS and women in general now are having so many pregnancy. Related complications and then. Babies are born not healthy. So then you have challenges with your offspring. So this all has to be addressed like proactively before conception. And so my disruption is you got to get women healthy first and men to you know, you got to get Greek conceptual health understanding the underlying foundational problem allows you to take a real, you know, we'll say, specific approach to it.

You're not just throwing fertility drugs at someone and hoping, you know, it'll work, but, you know, tricking the body into ovulating when the body is not healthy and then keeping the body healthy through the whole pregnancy so you don't end up with all those problems that women with PCOS and just in general, like I said, women that we're having now with pregnancy. So it's really be proactive. Pre-Conception understand the underlying problem. That's what functional, you know. So I'm integrative and functional.

It means you are mechanistically oriented. You look at the etiology of the problem. You don't just to throw a blanket over something and hope something is, you know, right. You want to pinpoint the specific cellular organ, structural functional problems and then address them very specifically taking into consideration the uniqueness of every individual and literally solving the underlying problem. Maybe not curing, but we'll say solving it so that you really improve every aspect of health and really be truly successful, not just counting heads, but counting healthy heads.

That's right, I love that. That's thank you so much for that. Because when we talk about, you know, did this did this treatment result in a live birth? Well, there's a lot more to it. Like you said, not just counting heads but counting healthy heads. And in a world where for the same reasons that fertility is declining and PCOS and other, indicators or issues with fertility are on the rise, all those same things are contributing to this situation where almost one out of every two children has a chronic mental or physical health condition, and, you know, I don't know how to say this gently, so I'm just going to say it.

The stress of not getting pregnant. Couldn't couldn't, could never be anything like the stress if something were not right with your child. I mean that the stress of taking care of a child who's not okay, I cannot imagine it. I mean, I have I have seen women, I have studied women. It is the greatest pain a woman could face. And so if there are steps that can be taken, and you and I both know there are, I mean, that's what we do in the Prime Minister. That's what we do in the Prime Minister protocol.

And that's exactly what you were just describing. That can help reduce the likelihood of of those kinds of outcomes, not just infertility, not just pregnancy complications, but also in improving childhood health and life span, health. Then we have to take those steps, even if we don't have PCOS, and even if we don't have expectations of having fertility challenges, we we want to be proactive. And so I really thank you so much for for saying that, Doctor Felice. And I feel like you and I are a match made in heaven.

It's it shouldn't surprise me. Our science backgrounds, our publication backgrounds, our, our research backgrounds. I feel like, you know, we, the Prime Minister protocol would love to team up with you and the women you're helping. and I just thank you so much for for everything that you've shared here. I would love to ask you, Doctor Felice, as we come toward the end of our conversation, if you could tell the woman listening, the couple listening, the human being listening of any gender one just one thing that you hope that they'll take away from the time they've spent here today about taking care of their fertility and their future children's health.

What would that one thing be? Well, I think it's what we've said throughout this whole session, which is an attitude of positivity, that it can be beyond overwhelming. But when you break it down, it turns out that all the different problems may have a single underlying thread that sort of, you know, weaves its way through everything, that when you get basic hormones balanced, when you get your nutritional status and your stress and all of that controlled, you can have a massive turnaround. So positivity, understanding and believing in the power of your body to heal is really foundational to fertility success.

Thank you so much for that, Dr. Felice. So believing in your ability, your bodies and your fertility ability to heal are foundational for your success. And it can be we. I think that both Dr. Felice and I both acknowledge through having walked with, I'm sure, thousands of women and families each, that it can be hard sometimes to maintain that positivity. But if that can be the home base that that you come back to, even when you have moments of feeling like it's hard to come back to that and having the right supports around you to help you stay connected to that home base, that that's really, really a powerful stance from which to move forward.

And I think that's so very beautiful. Dr. Felice, one last question for you.

Positivity, Fertility, and Vital Signs of Health 28:36

What is the feeling of Super Fertility to you when you hear the term Super Fertility? What what does it make you feel? Well, I always say time and time again, fertility is a vital sign of female health and male health. And we spend so much of our life as women trying to eradicate our fertility. And I, I it makes me want to just hug anyone who says super fertility, because it's acknowledging the vital, integrative role that fertility plays in female health that we need to embrace fertility, have kids when we want to, so on.

And I am the ultimate feminist and say we should be able to time when and if we want to have babies 100%. But understanding that fertility is a vital sign of health, ancient civilization. Nations worshiped fertility gods because they understood thousands of years ago that fertility meant health and vitality. And we need to get back to that, to basically a sense of revering fertility and understanding that fertility is vital to health and that the female body evolved to be fertile and reproduction, whether we want it or not, is the prime directive of life.

So embrace the fact that you are fertile. Strive for fertility even when you don't want to have kids. And then of course, when and if you do, your body will do what it was totally evolved to do. And that we also recognize that along with fertility being a vital sign that so to the menstrual cycle is a vital sign, and that when the menstrual cycle is not right in any form, whether it's irregular or painful or too heavy, or there's PMS that that is a red flag, that this woman should be addressed medically to find out why is this vital sign not right, not just cover it up with some fake hormones like.

Yes, perceptive. That exactly. Super Fertility means recognizing the prime directive of life. Fertility is a vital sign, and that we should strive to be optimally fertile. Because that is what health is in a female and a male. I love that so much. Thank you, thank you, thank you Dr. Felice, you have blessed us all today with your wisdom. Thank you for the work that you do in the world. Thank you for being part of the Super Fertility Summit, and I look forward to so much more collaboration because our approaches share so much overlap and the spirit with which and soul with which we do our work also share so much overlap.

Thank you Dr. Felice. I look forward to a beautiful future together. Thank you and for everyone out there. Yes, absolutely. To each each mama listening. We look forward to a beautiful future for you and your beautiful family. Thank you, Dr. Felice.