Inspired with Nika Lawrie

Optimizing Pre-Pregnancy Health: Insights from Alexandria DeVito on Fertility and Wellness

September 03, 2024 • Alexandria DeVito • Season 2024 • Episode 90

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Ever wondered what it takes to prepare your body for pregnancy? My special guest, Alexandria DeVito, a functional nutritionist specializing in fertility, joins us to share her journey from corporate life to becoming a champion for fertility health. By the end of this episode, you’ll understand the five key areas of pre-pregnancy wellness—blood, hormone, immune, metabolic, and nutrient status—and how addressing these can significantly boost your chances of conception and ensure a healthier pregnancy.

Discover the shocking prevalence of nutrient deficiencies among reproductive-age women and learn how to tackle common deficiencies like iron, vitamin D, and omega-3. Alexandria opens up about the rising incidence of autoimmune conditions in women and the critical importance of dietary changes, stress management, and identifying underlying causes. Plus, you'll get an inside look at Alexandria's company, Poplin's testing process, designed to help you better prepare your body for pregnancy by identifying and addressing vitamin deficiencies, inflammation, and hormonal dysfunctions.

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Nika Lawrie:

Welcome to the Inspired with Nika Larie podcast. Alexandria DeVito. Welcome to the show. I'm so happy to have you here today.

Alexandria DeVito:

Thank you so much for having me. I'm excited to be here with you.

Nika Lawrie:

Yeah, definitely. So we are going to talk about really preparing our bodies for pregnancy, but before we get into that, I want to hear a little bit of your backstory. So you're a functional nutrition or nutritionist. I too am a functional nutrition counselor, so we definitely relate there. But you really specialize in fertility and like pre-pregnancy health. Can you give me a little bit of your background? How did you get into that? What inspired you to specialize in that? It was not a straight line.

Alexandria DeVito:

I'll start with that. It never is Right. So I started my career on the corporate side. So I was an investment banker and then I was a consultant. But when I was in consulting I was doing healthcare consulting and that was my first introduction into the health and wellness world. And after spending about a decade in the corporate world, I decided to go back to school and I got my MBA from Harvard and then I also did a part-time master's in nutrition on the side Wow, impressive, thank you. It was not the most traditional move at the time. And then, once I finished both of those master's degrees, I left the corporate world to see clients one-on-one as a clinical nutritionist.

Alexandria DeVito:

And then I continued on and did training in functional medicine, and that was really when things shifted into the fertility space. And I couldn't have predicted that because essentially, I ended up having a lot of clients that were struggling to conceive, that were coming to me as nutritionists, and friends who also were coming to me asking for my advice and guidance and feeling like there weren't great resources, there weren't great answers, they weren't getting the results that they wanted, and I was really struck by this and motivated to be helpful right, because they were asking, do you have any suggestions, like what do you got? And at the time I was really struck by this and motivated to be helpful, right, because they were asking, do you have any suggestions, like what do you got? And at the time I was like, please hold, stay tuned, I'll get back to you. And I went really deep into the clinical literature and I was inspired a lot by what I was learning in functional medicine about kind of root cause analysis, and so I ended up running these really broad panels of tests on my clients based on what I saw in the clinical literature that could potentially interfere with fertility.

Alexandria DeVito:

All of a sudden, a bunch of things were flagging on their test results that their providers had never even looked at, even in a year, two years, three years of struggling to conceive. And once we were able to address the things that were flagged largely through diet, lifestyle supplementation, sometimes medications and procedures in collaboration with their doctor, they were able to get pregnant, either naturally or on the next round of assisted reproductive fertility cycles. And so I was like, okay, wait a minute, there's something here. And it occurred to me why are we waiting until someone is deep into a fertility struggle to even look at what's going on with their underlying physiology right? What if we prepare to get pregnant gasp right Like we prepare for a wedding in advance?

Nika Lawrie:

right, it's probably the biggest decision we'll make in our lives. Yeah.

Alexandria DeVito:

And I got obsessed with this idea, and so again I dove into clinical literature and I realized there actually have been preconception guidelines for decades, but nobody knows about them, nobody's using them. And then I went back and looked even further and there's all sorts of preconception rituals in ancient tribal cultures. And so I was just so fascinated by this stage of life and I realized that there was an opportunity to rewrite the dialogue and to really give people a different opportunity to engage with this period of time to prepare to get pregnant, like we prepare for any other major milestone right, usually at least a year in advance, and, again with support, to be able to be in optimal health as you're moving into conception and pregnancy and beyond.

Nika Lawrie:

Yeah, absolutely. It's such a needed thing. I think, you know, especially with the prevalency of infertility just increasing, you know, globally really, but especially here in the United States, and I think there are so many factors that play into that that can be addressed. You know, just in your own home Like you can address a lot of those factors that are that are playing a role in potential infertility. So I just commend you for doing this. I think it's such a needed service and I'm excited to hear more about what you're doing, definitely.

Alexandria DeVito:

Thank you so much. It's been an incredible journey and I'm inspired by all the people that I get to work with and learn from.

Nika Lawrie:

Yeah, so explain to me what are the basics of pre-pregnancy wellness, what are things that people would consider pregnant and that state of health affects your ability to conceive and the health of a future pregnancy and baby.

Alexandria DeVito:

And so when we think about pre-pregnancy wellness, I think about five different categories. So that's your blood status, your hormone status, your immune status, your metabolic status and your nutrient status, and essentially what this is is it underlies the premise that fertility is an extension of your overall health, rather than fertility just being about your hormones or just being about your reproductive organs. It is about those things, but it's not just about those things. So by looking at all of these different categories and understanding what's going on in these different categories, you can figure out are there any yellow or red flags that could potentially interfere with my ability to get pregnant or have a healthy pregnancy and baby? So fertility doesn't have to be this black box anymore.

Alexandria DeVito:

And understanding your pre-pregnancy wellness is important because healthier parents give birth to healthier babies. Right, and this may sound obvious, but a lot of times we may think that we're healthy, but how do we actually know if we're healthy right? And so, because preconception is such an important time period, it's this time period that is so powerful, because it's the time period where you can optimize your health and your reproductive partner's health so that it increases the probability of having a healthy baby and it also sets the lifelong trajectory of health for your baby. So what you're doing in the preconception period affects pregnancy, it affects postpartum, it affects early childhood development and so on. So it's a really important time period, and the one other thing I'll say on pre-pregnancy wellness is that it is relevant whether this is a first pregnancy or a fifth pregnancy. It's relevant before and between pregnancies, so for each pregnancy, and it is relevant regardless of your age. So whether you're 23, 33, or 43, preconception health and pre-pregnancy wellness really matters.

Nika Lawrie:

Absolutely. Yeah, I remember, you know, when I had my daughter, the nurse that came in that was coming to discharge us, she specifically said to me she's like I do not want to see you back here in the next two years. And she, you know, and it wasn't to be rude, it was like you need that long to rebuild. You know the nutrients in your body to let your body kind of reset and you know the the. She says that she saw a lot of women coming in. You know, basically, nine, 10 months later, you know, like right away, and and I think your body really needs that time to heal and reset and get ready for the next baby. So yeah, I think that's an important factor. Definitely. What are some of the things that individuals can do to measure their pre-pregnancy wellness? Like how do I know if I'm ready or not?

Alexandria DeVito:

Yeah, so it's a big, it's a big question. I think there's a couple of things that we can look at. So, first, if we're talking about females, you can use, certainly, signs and symptoms, and then you can also use your menstrual cycle as a guide, right? So the things that you? Essentially, your cycle is a good barometer for your fertility. And when I say your cycle, this means your cycle, not on any sort of hormonal birth control, right, this is your natural cycle. That's going to give you information about the health of your hormones in many cases and the health of your body. And so, having a regular cycle, having a cycle that is not highly symptomatic, right so, minimal symptoms, minimal discomfort, that's lasting, that's not too heavy, not too light right, it's a Goldilocks principle with a lot of these things, right, so that's going to be a really good indicator. And so, if you're having profound period symptoms, extreme cramps or heavy clotting, or very late periods, or you're missing periods, right, these are all suggestions of underlying hormonal imbalances that can interfere with your ability to get pregnant. So I think, just starting with menstrual cycle health can be a great starting place. Now another thing and you know, again, as someone who runs a testing company.

Alexandria DeVito:

I'm biased on this topic. I am a really big fan of pre-pregnancy wellness testing, where you can do blood and urine testing to actually understand what's going on in your unique body. Because what happens right now in a lot of fertility care, even in a lot of medical care, is we treat all 30-year-olds as equal, all 40-year-olds as equal and cellularly. That's just not true, right? The way that we live our life affects our health, and we know this practically. We all have the idea of someone who's 30 years old and they look like they're 50, or someone who's 50 and they look like they're 30. And so we see this practically on the outside, but on the inside, the rates of aging are different as well, and so that impacts our fertility.

Alexandria DeVito:

So you can do testing to understand across those five categories that I was talking about earlier. Are there any flags that could potentially interfere with my ability to conceive? Um, and so this is what I was mentioning earlier all the things that I've seen in the clinical literature that are pretty well validated that they can increase time to pregnancy, they can impair sperm quality, they can, you know, impair potentially implantation, they can impair egg quality or egg health, right, so we have some decent metrics around those and so it's meant to be a screening test to say, okay, you know, are any of these things at play for me? And all of them are modifiable through largely through lifestyle, sometimes medications and procedures, as I was saying earlier, but most of the time it's diet, lifestyle supplementation.

Nika Lawrie:

What are some of the most common like maybe, symptoms that you see specifically women, but also, I know, men play a big role in healthy babies too, and we'll get into that a little bit. But for women right now, what are some of the kind of key symptoms that you see for maybe, um, not being uh in the healthiest spot for fertility?

Alexandria DeVito:

Yeah, so what's interesting about symptoms is that they're fairly late in the disease process that they show up, and so a lot of times, people either people with abnormal preconception labs, which is almost everyone that we're running either don't have any symptoms or they think the symptoms they're experiencing are normal.

Alexandria DeVito:

Okay, right, so symptoms can be a lagging indicator of what's going on. Right, they're not a leading indicator, and so what I would say is the things that we're seeing on testing that are dysregulations that people could potentially keep in mind are inflammation. We're seeing tons and tons of inflammation. So over half the time, we're seeing some sort of inflammatory process going on, and that's probably not surprising, since we tend to be leading inflammatory lives. A lot of people are eating inflammatory foods, right, stress is very inflammatory. We have environmental chemicals that are very inflammatory, so we see that a lot. Over half the time, we see some sort of hormonal imbalance, and that's either hormones are too high or too low for optimal, and certainly that can mess with cycles and ability to conceive. We're seeing nutrient deficiencies in over 80% of people.

Nika Lawrie:

Yeah, it doesn't surprise me at all.

Alexandria DeVito:

It's wild and you know this is like. You know I looked at a lot of the surveys on nutrients and the surveys say that you know the vast majority of reproductive age women are micronutrient deficient. I've been surprised that we're confirming that data, you know, in our own data sets and that it's as high as it is. So you know that's another. You know really big one, and so you know people might experience fatigue, like a lot of these symptoms can be nonspecific so it can be hard to figure out kind of why. So you can experience fatigue.

Alexandria DeVito:

We see tons of iron deficiency, so you can experience fatigue if you're iron deficient. We see a lot of vitamin D deficiency. We see a lot of omega-3 deficiency, so you know those are big ones, and so with vitamin D deficiency you could experience impaired immunity. You know that's a big one, so those are. You know big themes that we see. And then we're also seeing a decent amount of indicators of autoimmune processes, and autoimmune conditions are on the rise. They're disproportionately present in the female population and so we screen for them and it's not diagnostic you still have to do follow-up testing to confirm but we're seeing a lot of suggestions of potential autoimmune processes and so those are. You know, depending on the tissue that's being attacked by the body, the symptoms can be very different.

Nika Lawrie:

Yeah, yeah. So walk me through the process of you know, let's say I'm a 29 year old woman, I'm, you know, wanting to have my first child and I come to see. What does that? What does that look like? Like you know, maybe I have no symptoms, but I want to prepare my body and get ready to have the kid. What does that process look like?

Alexandria DeVito:

First of all, I would say kudos to you, like way to be on it, and you're starting this journey early, right? You're giving yourself the gift of time, and so the process on the Poplin side with the testing would be that you would come in, you would order a test panel on our website. A lot of people are coming and doing testing with their reproductive partner on our website. A lot of people are coming and doing testing with their reproductive partner because, as you mentioned, we'll get into this, but biology doesn't care about our cultural construct that fertility is a female problem. Right, it's a 50-50 biological equation. So you would order your testing.

Alexandria DeVito:

Then you would either go to a local lab or have a lab tech come to you and do a blood draw. Because we're testing so many biomarkers, it needs to be through a blood draw and then you would receive your results through our app and whatever is flagged. You can then go in and say, okay, what is this marker? And then what are the implications for fertility? And then you can have a call with one of our pre-pregnancy educators to talk about the results a bit more and to start to come up with a game plan, and so this whole process is just designed to put you in the driver's seat, whereas before, right fertility is a black box and we have no idea until we try. Now you have a lot more indications of things that could potentially interfere and you can start to take action. You don't have to take action right. Once you get the information. That's totally on you to decide what makes sense, the pace at which you go, but you at least have the information to do with what you decide.

Nika Lawrie:

Yeah. So you know, say I get the test results and I'm pretty good, but there's some tweaks. What are some of the things and I know this is kind of a generic question here, but like, what are some of the things that I can do to start optimizing my body in pre-pregnancy?

Alexandria DeVito:

So if we go back to some of the more common themes that we're seeing and usually it's not one thing Usually these things cluster together. And so, let's say, you have vitamin deficiencies. So vitamin deficiencies can be addressed through diet or through supplementation and, depending on the nutrient, some are easier to address through diet and some are easier to address through supplementation. And, depending on the nutrient, some are easier to address through diet and some are easier to address through supplementation. So that's a fairly straightforward one. Inflammation it's often a sense of figuring out, okay, well, what is driving the inflammation? So the more common causes of inflammation that we see are certainly around blood sugar dysfunction or metabolic dysfunction, and that can largely be impacted by dietary changes. And then also, as I was mentioning, stress can be incredibly inflammatory. So that's something to be aware of. And then sometimes underlying infections that people aren't aware of, that may require a little bit more digging to figure out what's going on there. So that's some big ones.

Alexandria DeVito:

Hormonal dysfunction I think it depends.

Alexandria DeVito:

So what's really cool about the testing that we're doing is a lot of other fertility tests are looking at just your hormones, so it's like four to seven markers, which is a fine start, but it doesn't give you the full picture, and if you find out that your sex hormones are dysregulated, you have no idea why, and so we're looking at your sex hormones. But we're also looking at your thyroid hormones, and we're also looking at your adrenals, your adrenal function, which is your stress hormones, and so we have a much better picture of what might be driving that sex hormone dysfunction and therefore where to intervene. Because I'll give one example, which is the way that you would proceed with addressing the underlying problem is different if you're having a hormone production problem versus a problem with binding globulins that are blocking the action of your hormones. So sometimes people will have adequate let's just say testosterone, but it's being bound by sex hormone binding globulin, and so it feels like they don't have enough testosterone, and that's a different problem than if someone just isn't producing enough exactly testosterone.

Nika Lawrie:

So I want to talk. You mentioned kind of the stress hormone side of things or the stress side of things and cortisol. I know, I hear, you know I've heard so many stories over the years of women that try to have babies, try to have babies and couldn't do it, you know, kept either not being able to get pregnant or had miscarriages, and then they finally give in and they adopt and then they have a baby and they have this baby and then all of a sudden they get pregnant on their own right, without even trying. And I think so often what happens is the stress of wanting that baby and having that baby and getting pregnant. Is my body good enough, right? All of that builds up. But then once you have the baby from adoption, that stress goes away because you've, you know you have your baby and then it's much easier to get pregnant. So there's just like one example. No-transcript.

Alexandria DeVito:

Yeah. So I think that we are seeing the incidence of what I call reproductive anxiety on the rise and that's anxiousness about ability to get pregnant and sustain that pregnancy and have a healthy baby. And I think it's a function of a bunch of things. Certainly one is infertility is rising and we are surrounded by more people friends, family, colleagues who have struggled to conceive and there's more public discourse about it. So in our awareness, more, I think. I think a second thing is that we're having children later in life and we've been told that once we turn I don't know 35, we turn into a pumpkin. Too bad, so sad for us.

Nika Lawrie:

You're like a senior pregnancy or something there's a name for it Geriatric pregnancy. Geriatric. Thank you, yes.

Alexandria DeVito:

I really do not like that term, insane to me.

Alexandria DeVito:

Yeah, I mean this stuff, just it needs a rebrand. It's nonsensical and it's very, very, very disempowering. So you have all of this nonsense flying around, and so it would make sense that people are anxious, and I think, in particular, what happens with the situation with reproductive anxiety is anxiety is often a function of situations where there's a gap between how much importance the thing has and how much control we have over the thing. So getting pregnant is a high importance, but we've been told a low control state. So anytime you have high importance, low control, it creates anxiety because you feel like you can't do anything about it.

Alexandria DeVito:

So I think that's a big piece of what's happening here, and so what I would say on the stress side specifically, is there's a bit of science that I think is important to understand. Once I understood this, I was really blown away and it really helped my understanding of one of the factors of fertility. So our body will always prioritize survival over procreation. It's adaptation at its best, and our sex hormones and stress hormones are in the same biochemical pathway, and when our bodies, our minds, are stressed, our bodies divert resources from making sex hormones to making stress hormones, so they keep going down that stress hormone pathway. So you literally don't have the raw materials oftentimes to get a cycle, nevermind get pregnant and sustain that pregnancy.

Alexandria DeVito:

So that really unhelpful advice that people give oh don't stress, don't worry about it is truly unhelpful and it also has a scientific basis to it. So what the heck do we do about this? Because stress is inevitable, it's part of life. The goal isn't to avoid it and we do need some stress. Stress allows us to evolve and advance and it's about finding the right level of stress. Too little stress is not great either, and too much about finding the right level of stress right. Too little stress is not great either, and too much right. This Goldilocks principle comes in again right.

Alexandria DeVito:

So what I generally recommend to people around stress is it's not actually about the acute stressors that are problematic. Our bodies were designed for that. So where you get very, very stressed out and then it dissipates like if you have a presentation for work, something like that, right, where it's short-term but then it goes away, those things are fine, right. It's the chronic low-level stressors, either psychological or physiological, that can really drain us. So that could be I really don't like my job, I really don't like where I live. Or it could be an underlying infection, mold that you aren't aware of in your living space. It could be overtraining for any sort of athletic races, overtraining for your body and everyone's different on that front. So any one of these things can chronically deplete our resources. And so what I say for those is for the things that you can eliminate that are chronic stressors. Eliminate them.

Alexandria DeVito:

But the things that you can't try to upgrade your relationship to them or your experience of them, right? So let's say you aren't in love with your current house, apartment, whatever living situation, is right. It may not be practical for you to up and move right. So what can you do within your surroundings to upgrade it just 10%, to make it just a little bit better. That alone will, you know, kind of oftentimes reduce the stress level that you're experiencing in that thing, in that environment. So those are the couple of guidelines that I give. People around stress and also try as much as possible not to allow yourself to get in the loop of getting stressed about getting stressed.

Nika Lawrie:

Huge, yeah, yeah. Yeah, I think you know one of the things that I've really seen in the last couple of years is women do so much cardio training to going back to the exercise piece and that can actually be really stressful on the body long term. And so, you know, starting to understand having the conversation around maybe strength training and walking opposed to hard running and hard exercise, and then giving your body enough space to actually recharge and recover after those exercises too, like people think, exercise is just naturally healthy, but it can be a real stressor on the body, and so learning what those balances are for your own body's unique needs too, I think is really key.

Alexandria DeVito:

Yeah, absolutely. I mean, we see this a lot in athletes, right? So there's tons of instances where female athletes are losing their cycles as a result of, you know, either overtraining, overtraining and under eating that combination. So you know this can happen in people who are training for marathons, you know, as an example, and not appropriately fueling their body, not appropriately recovering, and so, you know, what I tell people is that I mean, I'm a huge fan of exercise and movement and also it's really important to listen to your body and what your body can sustain may be different from someone else's body, but looking at your cycles and looking at your energy and your recovery rates, and sometimes testing, can be really helpful feedback mechanisms to understand whether you're pushing it, because, especially if you've been pushing it for a long time, you may not even know it, it may not feel like that to you, but your body is physiologically responding.

Nika Lawrie:

Yeah, absolutely so. I have one question and I want to kind of talk about the men's side a little bit. One of the things that I actually teach on a lot or work with clients or have done courses on is environmental toxins, and I think you know they play such a massive role in hormone function. You know they're so often you see them as a serious issue when it comes to fertility. Do you guys look at that when you're looking at you know, planning for pregnancy with your clients? Do you test for that? What are your thoughts around environmental toxins?

Alexandria DeVito:

Oh my thoughts on environmental toxins, yeah. So I'm so glad you're doing this work because I think it's incredibly important and I agree it's a major factor when it comes to fertility, it's a factor when it comes to precocious puberty, it's a factor when it comes to sperm counts dropping and testosterone drop. I mean, it's very multifactorial, multifactorial. So I think that anything that we can be doing to reduce our exposure is a wonderful thing for overall health. So we're not directly measured. There's some tests out there that actually is directly looking for a lot of environmental toxins. We're not doing that. We are looking at things that could be flagged as the result of environmental toxin load. So that can contribute to metabolic dysfunction, it can contribute to inflammation. So we'll pick up on those things and a lot of times we'll be asking questions around someone's exposure levels.

Alexandria DeVito:

And we have looked at we're always looking at our testing and looking at adding additional markers, especially as the science evolves. So we have been looking at our testing and looking at adding additional markers, especially as the science evolves. So we have been looking at adding potentially some more detox markers if that's something that might make sense. But I think it's an incredibly important thing to factor in and what I generally guide people to is to focus on decrease what's coming in and increase what's going out, and there's different ways that you can do that and everyone has a different load and a different starting point. So you can, and also the process of finding products that work for you is a trial and error process, so what may work for me is maybe very different than what works for you. I mean, like the number of I joke about this but like the number of deodorants that I had to try before I found one that you know worked, uh, right and and so, um, it's a, it's a journey, Um, and you know I'm I'm so glad that that, um, there are.

Nika Lawrie:

Yeah, and you know what I see so often with people is that you start to tell them where the potential exposures are and it's literally everything and everywhere, right, so it gets like really overwhelming.

Nika Lawrie:

So then you have to kind of like pull people back in and and like calm them down and be like, okay, the idea here is to kind of understand the landscape of where potential exposures are and then pick different areas to start making small changes, right, and so reducing that exposure over time. So a big thing would be like looking at the cosmetics or personal care items that you're using or, you know, having your water tested or looking at your air quality condition either outside or in your house different things like that and then slowly but surely reducing your exposure over time. And then, like you were saying, you know it's about how much is coming in versus how much is going out, really helping people understand the detox systems throughout the body and really helping them improve how those systems work, whether that's sweating or the liver or the kidneys or whatever. It is really making sure those are functioning well for the individual.

Alexandria DeVito:

I think it's so important and I hear you, I mean, I think it can be overwhelming, and that's one of the reasons I mean I talk about this in the book as well, where, you know, I recommend starting earlier because this stuff can take time and, you know, even if you just go room by room, it's an undertaking and want to give yourself grace and patience as you go through this process.

Alexandria DeVito:

It can also be a financial investment to switch over to different products, and so spacing that out over time is also, I think, helpful. So there's a lot of elements here, and what I also tell people is someone was asking you recently have you just had to recommend one thing to people like around detoxification? Right, and you may be surprised by my response to this because I was but it's like make sure you're having a daily bowel movement, like let's just start actually with basics, right, because we can change all the things we want, but if things are staying in our bodies and we're recirculating them over and over and over again, then they certainly have more time to do harm. So I think that this is a two-pronged approach, which is reduce what's coming in and increase what's going out, but there are some basic blocking and tackling that majority of people are constipated and they don't even know that they're constipated, and so you know that's a really basic thing that making sure that that's working will certainly amplify any of the other efforts that you're making.

Nika Lawrie:

Yeah, I think understanding the color of your urine as well is a huge thing. Like the darker usually the more dehydrated you are, versus the lighter usually the better off you are. So it's important little things like that that you can just look at kind of gross, but look at day to day and and really have a better understanding of how your body is functioning on the inside. Definitely. So let's I want to talk a little bit about the man, the male side of this cause.

Nika Lawrie:

I know it plays a big role and it's so often overlooked. Like you mentioned, you know, kind of societal norms is fertility is a women's issue, but you know, male fertility or infertility is massively on the rise right now and I think it's really really key that we speak to that and make sure that both partners are getting the care and support that they need in order to create that healthy child. What are some of the things that you're seeing with men and some of the struggles and maybe a couple of things that they could do as well to support their overall preparedness for conception?

Alexandria DeVito:

Yeah Well, I'm going to start with the last thing first, which is that essentially the same things that females can do to improve their fertility, males can do as well. So I mean, that's the great thing is that if you're going to be parenting together, generally I recommend people to be preparing together, and it becomes a lot easier when you have two people working on making these changes and supporting each other and making these changes, rather than you know one person who's doing it on their own. And we know that you know is just you know true of any sort of health behavior. So I think you know what I would say on the male side is yes, what you're saying is absolutely true, and just for some statistics, because I, you know, I don't know why this is in the headline news, so, like, I try to share it as much as I can so people understand the magnitude, which is that sperm counts have dropped 60% globally in the last 40 years. It's six zero Insane.

Alexandria DeVito:

Yeah, and, as you said, this is a global problem, it's not just a US problem. So this is happening on a macro stage, and testosterone has also meaningfully declined and I really want to dig into this a lot more. But there are suggestions that it's declined so much, actually, that reference ranges have actually shifted from our grandparents' generation as an example.

Nika Lawrie:

So that's a big deal, yeah, and we need to understand why. I know there's lots of factors that are playing into it and lots we don't know so far, but it's, yeah. People need to be really aware of this for sure.

Alexandria DeVito:

Yeah, and I think that, like there is the, I think it's really important that we share this information, and I would also say our bodies are incredibly resilient. New sperm is being made all the time, and so you can have really fast feedback loops. Sperm development cycles are about three months, so if you're really paying attention to this, you can theoretically make huge improvements in a relatively short period of time, and you may need several sperm development cycles to get to a point where you're in an optimal state, where the count is appropriate, the quality is appropriate, such that you want to pass that state of health onto your future child. Because that's what you're doing In egg and sperm. You're passing not only DNA, which is your genetic code, which cannot be changed, but you're passing epigenetics, which is a predisposition towards or away from health for the lifelong trajectory of that child's health.

Alexandria DeVito:

So I think it's important to understand this that we are passing health predispositions onto our children through egg and sperm at the point of conception. So what you're doing in the three, six, 12-ish months beforehand is incredibly important, and it has impacts not only on your health but also the health of your future family, and so, I think, for the male reproductive partners. Just knowing that alone is incredibly important, I think. Males I've had a lot of conversation with male reproductive partners and they want a seat at the table. You know, I think, that they have been excluded from this conversation and they want to do and then also acknowledging the importance of their role is, you know, I think, two really, really important steps on the journey.

Nika Lawrie:

I think men get such a you know you kind of mentioned it before. I think you know men are expected to just donate their sperm and then, you know, show up in the delivery room, right, and like that's kind of the whole game for them. And I think it's so, so key to really respect and care for the male side of things and and to really support them in the process too and kind of, you know, it's almost like a bonding thing bringing them in, like preparing for the child, preparing to conceive, preparing throughout the pregnancy as well, to, you know, help them connect and bond with the mother and the child through the whole process for sure.

Alexandria DeVito:

Yeah, that's a beautiful way of talking about it. Yes, I mean, I think you can allow this experience to be really transformative, you know, for you and your reproductive partner. You can use it as an opportunity to talk about a lot. You know a lot of the things your hopes, your dreams, your ambitions in, you know, this preconception phase and to join forces to, you know, really set the stage for the family life that you want to have in the future. And, yeah, being able to invite your male partner into that conversation, if that's the reproductive construct that you have, it's a beautiful, beautiful thing.

Nika Lawrie:

Yeah, yeah, definitely. You mentioned earlier to start as early as possible. When, ideally, if you had the perfect patient, perfect client, when would you like them to come in and see you before getting pregnant? What does that look like?

Alexandria DeVito:

I usually recommend at least a year. I think that I can't remember if I mentioned this, but I did some research on average engagement and it's 15 months in the US and so I feel like that's a good proxy right. People prepared for their weddings for about 15 months, so I think about a year is a good timeframe. It's a good timeframe because it allows for several egg and sperm development cycles and it's enough time to make meaningful change and it doesn't feel too long and too far away that it's hard to have agency over yourself. So I think this one-year timeframe can be a good period of time and, generally speaking, what I tell people is that you can spend more time preparing or you could spend more time trying. Usually, people prefer to prepare than to try, and it doesn't always work perfectly like that, but often it does.

Nika Lawrie:

I'd say a lot less emotionally draining and stressful as well.

Alexandria DeVito:

Yeah, yes, there's something less pressure inducing about preparing.

Nika Lawrie:

I always try to teach you know, bring the good in opposed to cutting the bad out, because the more good, like you know, the more healthy good stuff that you bring in and you start to love it and appreciate it and you feel good when you eat it or whatever. It is right, and it's a whole lot harder to cut out the bad stuff. But when you start to love the good things and you feel good about it, it's easier to let go of the bad stuff, right. And so it's the same kind of thing Instead of battling with the infertility, bring in the good stuff, heal the body, feel good about it and then go into the pregnancy or the conception phase feeling good and feeling happy and healthy, right.

Alexandria DeVito:

Yes, I like the sound of that.

Nika Lawrie:

So I have one more question for you, but before I guess I have two more questions for you. So before we get into the final question, can you tell me you have a book? Nine Months Is Not Enough. Can you talk a little bit about some of the takeaways in the book and then share? Where can we find the book? Where can we connect with you? How can we get all your great information? Oh well, thank you so much for asking.

Alexandria DeVito:

So the book is at nine months is not enough the number nine, and it's also available wherever books are sold, so wherever your favorite bookstore is. And so the book is. It split into a couple of different parts. The whole first part is about busting a lot of myths around fertility, because I find that in health in particular, and certainly for fertility, a lot of times we have to unlearn before we can learn, and so there's a lot of stuff in there around how age is not the only factor that matters when it comes to getting pregnant, how period symptoms are telling you something, and even though they're common, they're not normal, ie the way that your body was designed to operate.

Alexandria DeVito:

So a lot of the things that we've touched on. And so that's the first part. And then the second part talks about why preconception health is important and its impact on both fertility but the health of your future child. And then the last part of the book is the checklist to prepare to conceive, and it talks about the micro factors and the macro factors. So the micro is getting testing, if you so choose, having a preconception visit with your doctor, and then the macro factors are all of the things that kind of everyone who's living right now is exposed to and how you might start to address them. So that's things like nutrition and movement and stress and environmental chemicals, and so it tries to give you the background but then also be practical in how do you move through these different areas, and so it's really meant to be a guide to help you optimize your health and your reproductive partner's health prior to conceiving.

Nika Lawrie:

That's amazing. I wish I had had that book going into pregnancy. I remember having what's the book everybody gets I can't think of the name right now Like what you Need to Know, or something.

Alexandria DeVito:

Oh, what to Expect when You're Expecting, yeah, what to.

Nika Lawrie:

Expect when you're expecting? Yeah, what to expect when you're expecting? Yeah, I took that book. I threw it away because I was like this is the scariest thing I've ever read. I stopped reading it like halfway through. I was like I don't want to know anything else because all I could think about was like the horrible things that could potentially be happening to my baby while pregnant. I was like that's the last thing that I need to be thinking about through this process and so I wish I'd had your book going into it and preparing and understanding and everything. I think it's so key. So that's phenomenal. Thank you for writing that and sharing that information with the world. Really.

Alexandria DeVito:

Well, I really hope it's of service to many people.

Nika Lawrie:

Yeah, definitely. Where can we connect with you online Social websites, those kind of things?

Alexandria DeVito:

So for the book it's nine months is not enough. If anyone's interested in testing or has questions about the testing, that's at getpoplincom and on social at getpoplin as well.

Nika Lawrie:

Perfect. I'll link to all in the show notes as well. So definitely so. My last question for you today what is something that's been game changing for you, that you've either learned or experienced that you would like to pass on to others, to inspire them?

Alexandria DeVito:

So I think there's, you know, probably so many answers to this question, yeah, but I think the one that I'm going to go with is actually very simple, which is I found some of the most profound healing help perspectives from walking outside in nature, and the reason I love it is that it's essentially habit stacking, but also value stacking, and so what I'm able to do is that I'm relatively type A, as we've talked about, like I like to be efficient, and so you know walking is movement.

Alexandria DeVito:

You know I brainstorm a lot when I'm walking, and I get to be outside, I get to be in the sunshine, and so you get to layer a whole bunch of things on top of one another, and so one unit of time allows me to move, and then a lot of times I'll listen to podcasts like yours and get ideas. I could speak to friends while I'm moving, so you can stack a lot of your values on top of one unit of time, and so that's one example that I give, but I think there's a lot of other examples, which is how do you take one unit of time and value stack the things that are important to you, whether that's community or health or education, or you know, whatever it is. That's one of the things that I found allows me to be really efficient, but then also fulfilled.

Nika Lawrie:

I love that. I literally just wrote down value stacking. So you always hear about habit stacking and it doesn't sound nearly as fun or or um, inspiring or motivational. But value stacking to think about, you know, a simple walk, in that it's because I did the same thing. You know I go outside take my dog for a walk. It's when I think, it's when I, you know, um kind of envision things for the future and game plan those kind of things. So thinking about it in such a beneficial way of value stacking, I love that. It's really beautiful. So thank you for sharing that.

Alexandria DeVito:

Thank you for asking the question. That's a good one.

Nika Lawrie:

Yeah, definitely so. Thank you so much for coming on the show. I'm so grateful that you took the time to share all this knowledge with us and just your expertise, and once again, I commend you for the work you're doing. I think it's so, so important and so timely, so needed in the world and environment that we're living in now. So thank you.

Alexandria DeVito:

Thank you so much, Nika. It's my pleasure.

Nika Lawrie:

Absolutely.

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Nika Lawrie

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