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Optimizing Fertility: What Actually Moves the Needle—Rachel Swanson Explains

On this episode of The Empowering Neurologist, I sit down with one of the most influential voices in modern nutrition and women’s health, Rachel Swanson, MS, RD, LDN. Her new book, Trying! A Science-Based Plan to Optimize Your Fertility, is poised to reshape how we think about fertility, moving it out of the narrow confines of hormone-focused conversations and into the broader landscape of systems biology, metabolism, environmental exposure, and cellular health.

Swanson’s work begins with a powerful premise: fertility is not a mystery, and it’s certainly not something women should feel powerless about. Instead, she argues, fertility is a measurable, improvable expression of whole-body health. And her book provides the first integrated blueprint to understand and support that health.

The conversation starts with the microbiome, which Swanson calls the “mission control headquarters” of fertility. Who knew that our gut bacteria were playing an important role in determining fertility? Drawing from her book, she describes how the gut, vaginal, and even oral microbiomes create the biochemical environment that influences hormone balance, inflammation, implantation, egg quality, and partner’s sperm health. A balanced vaginal microbiome, particularly one dominated by protective Lactobacillus species, has been linked to shorter times to conception and better IVF outcomes.

Next, we explore metabolic function, a chapter that reveals how profoundly energy management influences reproductive potential. As Swanson writes, metabolic health acts as the body’s “internal energy economy,” directing how energy is stored, utilized, and prioritized. Blood sugar regulation, distribution of body fat, nutrient timing, movement, sleep, and stress resilience all become key tools, not only for general health, but for improving the probability of conception.Swanson also takes us into the world of methylation, micro- and nanoplastics, and mitochondrial optimization, pillars often overlooked in traditional fertility advice. These chapters uncover how nutrient-driven biochemical pathways, environmental toxicants, and mitochondrial energy production shape egg health, sperm integrity, and early embryo development.

What makes this book, and this podcast episode, so compelling and empowering is Rachel’s rare combination of scientific precision and heartfelt dedication to women’s autonomy. She refuses to oversimplify fertility into quick fixes or fad-driven advice. Instead, she offers deeply practical strategies rooted in peer-reviewed research and years of high-level clinical practice.

Whether you’re actively trying to conceive, planning for the future, or simply interested in how factors like metabolism, gut health, mitochondrial function, and environmental toxins influence human biology, this episode is a must-listen. Rachel’s framework empowers women with understanding, agency, and tools that can truly move the needle, often far more than conventional advice suggests.

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RACHEL SWANSON, MS, RD, LDN, is a registered dietitian and one of America’s most sought-after nutritionists, known for optimizing human performance through science-backed, personalized care. Her clients include celebrities, professional athletes, and Fortune 500 executives who trust her expertise in concierge medicine and private practice. Rachel is a highly principled, intellectually rigorous, and passionately empowering expert, whose communication and sentiment are consistently driven by a profound conviction in her book’s unique, holistic framework as the transformative solution to outdated and fragmented fertility advice, reflecting a deep commitment to women’s health and autonomy. Rachel’s most profound strength is her unique ability to fuse rigorous scientific research with practical clinical experience, providing a holistic and actionable framework, sourced from her extensive dedication to both academic inquiry and real-world patient care.

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