The Preconception Revolution: A Science-Backed Approach to Fertility With Dr. Ann Shippy

Episode Highlights From Ann

• Why she decided to write this book on preconception health
• Surprising thing she’s found in her work as a functional medicine doctor 
• Decline in fertility isn’t just about age, there are some major biological and lifestyle factors behind the fertility decline 
• Top nutrients for building a healthy baby and for fertility 
• How the buildup of environmental toxins affects both fertility and children’s health long-term
• What we now know about epigenetics and how we can positively impact our children by dialing these things in before conception and during pregnancy 
• The way toxins can have a dramatic impact on the health of a baby and their future fertility 
• How plastic affects kids dramatically and why avoiding them is so helpful
• Sneaky sources of plastic exposure that can add up really quickly 
• Hidden sources of PFAS to watch out for 
• How we can optimize our mitochondrial function and why this piece is so important

Resources Mentioned

• The Preconception Revolution book
• Her website
• Follow Ann on Facebook or Instagram
• My posts on plastic dangers and alternatives
• Xtrema cookware

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Transcript

1059: The Preconception Revolution: A Science-Backed Approach to Fertility With Dr. Ann Shippy


Child: Welcome to my mommy’s podcast!
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Katie:  Hello and welcome to the Wellness Mama Podcast. I'm Katie from wellnessmama.com, and I'm so excited to be here with someone who I absolutely adore in real life. This is Dr. Ann Shippy, and I have followed her work for a very, very long time. Huge fan of her approach, and I love her new topic that she is bringing into the world, which is the topic of the preconception revolution and an extremely clinically and science backed approach to fertility where she routinely sees women in their forties who were told they were infertile, conceiving naturally, and having healthy pregnancies. 
And she is a phenomenal researcher. She brings decades of clinical experience and an incredible research mind to this topic, and I'll link to her book in the show notes as well as her website, but she's a board certified internal medicine physician, functional medicine practitioner, and she is now a leading voice in the this emerging preconception movement, which I think is really important as we hear more and more about this kind of looming fertility crisis.
Her new book is called The Preconception Revolution, which is a science backed path to fertility and generational health. I'll link to that in the show notes. And her expertise has been featured everywhere. She's helped so many couples with this. She's also absolutely brilliant as a functional medicine doctor in many areas. And we get to cover a lot of that today. So let's join her now. 
Dr. Ann Shippy, welcome. Thank you so much for being here. It is always an absolute pleasure to see your face, and to hear your voice, and to learn from you. I'm so grateful you're here.
Ann: Oh, thanks so much for having me. I just adore you so much.
Katie: Oh, well that's so, so mutual and I'm so excited about today's topic because we hear in the media actually quite often now about kind of this rise in infertility and this massive fertility crisis that we are going to seemingly face and are already facing in a lot of places. And I feel like we get a lot of the dire statistics around this without a lot of insight into what power do people actually have to shift this? Like what can change what is within our control? And I talk a lot about, on this podcast, how we're each our own primary healthcare provider. And I think that of course extends to our fertility as well. But I feel like there's so much nuance here that I'm very excited to dive deep and glean your wisdom from this today.
So you just wrote a new book called The Preconception Revolution, which I love because I also feel like we don't talk about before pregnancy. There's a lot of talk about what to do during pregnancy, but as you explained so beautifully, like potentially before is even more important and more critical. So maybe walk us into this broad topic of why did you decide to write the preconception revolution and what are some of those kind of core things to understand about that preconception window?
Ann: So we, this is just the perfect time to have this conversation because we are seeing such a drop in birth rate globally and this, one in five or one in six, depending on who's counting, couples dealing with infertility. And then we have this children's health epidemic, the increase in autism, autoimmunity, mental health, cancer.
So it's no accident that the things that we're seeing that are causing the infertility are also driving the children's health issues. And so what I've, what I started seeing in my practice over 20 years ago is that by focusing on this period before people start to get pregnant, or even start to try to get pregnant, they improve their fertility. So overcome these challenges that a lot of people are having and then go on to have really healthy children. So, I'm a functional medicine doc and I get to do a lot of testing on my patients. So I, and I, I'm constantly learning from my patients, like a patient, around 20 years ago actually planted the seed.
She was 41 and she had gotten married late and was just wanting to start her family, but she had an intuition that she should come see me and see if it was really, if her body was ready and see if she, if it was safe. And so we did a thorough workup on her and we found that she had some nutritional deficiencies, even though she eats really healthy and she had some heavy metals and some other toxins in her body, even though she had been kind of paying attention to those things, and her microbiome was off. So in about six months we got her all tuned up and she went on to have a beautiful, healthy baby boy. So that was really my first experience to see, oh wow, you can have really healthy babies into your forties.
Katie: Which I love that, and I love that you bring the data to that because I know many women here, kind of like if you're over 35, it's like high risk. They know they use the term like geriatric pregnancy, I think even in that time, and I feel like they put a lot of fear on women, but is there actually any data to show that something dramatic happens to a woman's body after age 35, where she actually is like much more at risk in pregnancy?
Or is this like kind of attributed to some of these factors that women maybe don't know to address?
Ann: Exactly. So, yes, the, I mean, and unfortunately there's a lot of conversation even with women in their twenties starting to think about, okay, you need to start putting your eggs on ice if you ever wanna have a baby. And so there's this, because of the drop in fertility and because things can change as we age, there's just so much fear around it, but what's really going on is that the eggs are just not as in a healthy an environment as they need to be, to have, I think about the egg and the sperm both as being like a time capsule. And so what's happening over time because people don't realize that their nutrients are dropping and that their toxins are building up and the stress is taking a toll on all these things. That it can impact how healthy the eggs are and how fertile they are. 
But the thing that's so exciting is that I see these situations getting reversed well into the forties. So I have a patient who is pregnant right now at 47. So again, she just, she had the wisdom. She had heard about me and wanted to come in and she was on second relationship, had had some children earlier, but really wanted to have another child with her new partner. And she was, rather than rushing into it, rather than listening to this narrative that is out there, well, if you're gonna do it, you just have to get going and go do IVF right away. She came in and we found some things for her to work on. She spent about three months and got pregnant on the first try.
Katie: That's amazing, especially like you said. I know we're hearing from so many women even in their twenties who are now trying IVF, which I feel like there's so much hope in the message of your book of like how much more is in our control than we actually think or like our ability to affect change. And I know you've said that the fertility crisis actually isn't about age, which lines up with these statistics of women in their twenties even having trouble now.
So I'd love to like dive a little deeper of like what are some of the big drivers of what's going on with this fertility crisis? And if it's not just age, what are the like biological factors, lifestyle factors that contribute the most to this like seemingly massive fertility decline we're seeing?
Ann: Yeah. Thanks for that because, and this is really important. Not just people who are starting your family, but also between pregnancies too. So, if, I think a lot of women don't know, it's a really important time to do a little tuneup, a little bit of reset, because, you know, it's so hard to get enough nutrients into our body to actually build another human these days.
Because our food supply is just getting so depleted. Almost everybody is low in magnesium and antioxidants and other nutrients. So in my book, I talk a lot about what supplements, what to eat, like what a really good low inflammation, high nutrient diet is, but then also what supplements to be taking that can really help protect your fertility and really enhance the egg quality. It can make a huge, huge difference. So, you know, there's this idea about like what's just adequate and then what's optimal. A lot of the tests and things that are done don't tell you what's optimal. They just tell you like, are you at least the base amount of nutrients? So, really getting your body filled with the really important nutrients for fertility and building a healthy baby. 
One of my favorite ones to talk about is called phosphatidylcholine and it's so important for the egg quality, but then also once you get pregnant to build a healthy baby. Because it's what makes up cell membranes. And of course you're produce, the baby's producing so many new cells in such a short period of time. And then one of the biggest things that we're seeing is this buildup of environmental toxins. You know, it's really hard to get food that doesn't have some level of glyphosate or heavy metals, other pesticides in it.
So most people, in addition to helping their environment be healthier by filtering water and buying organic and using air filters at night, those kinds of things that I discuss in the book. It's also really important to do a little bit of a detox before you get pregnant. And there's so much, there's crazy information about what a good detox is out there. So I really walk people through that in the book. So things like taking a methylation supplement, taking liposomal glutathione, taking a healthy binder and some liver support can vary effectively and quickly help the body to detoxify what's built up over time. 
Katie: I feel like that's such an important reminder. I feel like often in like at least these like trendy cleanses I see floating around on social media for detoxing, I feel like we lose, we forget the idea that the body is inherently designed to be able to detox efficiently. So it's really more about how do we support the body and what it already knows how to do, versus like some external thing we do to ourselves.
I think there's a lot of like, an important paradigm shift in that like befriending what the body already knows how to do versus trying to make the body do something. And I also love that you talk about that adequate versus optimal. And I know probably many people listening have had the experience of being told labs were quote normal and still feeling like something was off.
And then I know that was part of my journey, getting to go through the experimentation of learning my own kind of end of one study and what actually helped my body thrive, not just look normal on labs. And I know you get so detailed of this in the book and you talk about how the few months to up to a couple years even before conception is so powerful and can actually like really shape a child's lifelong health.
So I'd love to dive into what's happening during that time period that a lot of people don't realize and or maybe touch on a little bit 'cause I always wanna sort of like release mom guilt anytime it exists for people who already have their babies outside their body. I would guess there are still some corollaries we can learn on supporting our children nutritionally as well.
So like certainly all is not lost if we didn't know to do this ahead of time.
Ann: Exactly, and that's actually, it's been so fun to have this conversation with parents as they're thinking about their children growing up and how to protect their fertility as well as potential future grandparents are also really interested in this. So It started writing this book in 2016 and then it got shelved to work on some other projects. But it's kind of perfect timing that it's coming out now because this field of epigenetics has just exploded. So the data that I was able to tap into to really show to back up what I believe on this important period of time has just really accelerated. So the, so epigenetics is how genes are being dialed up and dialed down, and we're constantly fluctuated from minute to minute on what our genes are doing.
Like, if you get exposed to the flu, it, you know, the body picks that up as a measurement and it changes so much of what it's doing to start ramping up the immune system. So our bodies do that around whether we're gonna get or how nourished we are. So there are things that happen when there's gonna be, when there's starvation, when babies are conceived around that period of time, the gene, the thrifty genes that help them to use the most outta the nutrients.
And then they end up having some issues with being overweight and diabetes. There, there are epigenetics that happen when your blood sugar isn't great. So if you're having diabetes or pre-diabetes, that information gets passed on to the baby. But the really alarming thing, and the thing that I am most excited about, the impact that this book can have is how toxins that you're exposed to around the time that the egg and the sperm are being produced or what's accumulated in your body over time can have a dramatic impact on the health of the baby. Even their future fertility can be impacted by things like BPA. So I think it's just, you know, just a super important, valuable time to really be able to know the factors that can help you to have the healthier baby and to have at least three months. But if you've got a year or longer, or if you have children that are younger, you wanna start thinking about really keeping the nutrient levels up, keeping the toxins down, and managing as many of these lifestyle factors as you can.
Katie: And I feel like the encouraging part of this that seemingly epigenetics research is pointing to as well is like this doesn't require perfect adherence or a hundred percent clean of everything, or getting everything exactly right for this to work. Like the body is so incredible and adaptable and they have, from what I understand, have seen even just removing the majority of like, for instance, glyphosate exposure in the diet, the blood levels drop relatively quickly. 
Like our body is amazing at trying to get back to a healthy baseline when we just make these small kind of changes that support it and what it already does so beautifully. And you really outline these so well in the book. And I'd love to, I know this gets a little bit controversial, but kind of go deeper into specifically some of these toxicants, because I know that a lot of them are actually pretty easy to remove from our home environment when we understand where they are and why to remove them, and how a lot of these things are linked to potentially some of these major issues we're seeing in young children even now. Things that didn't even used to exist in childhood populations.
Ann: Yeah, and I know that your audience is probably already addressing a lot of these things for all kinds of reasons. Right. But one of the big ones that can really impact the future health of the baby are the plastics. So, you know, there was this push for several years where you just wanted to get the BPA and BPB out and switch to BPS.
Well, it turns out BPS is just as dangerous or more dangerous than the BPA and the BPP that are used to make the plastics. So I think that's one of the most important things that we can be doing. And it's so challenging when it comes to our food, right? Because it's the, a lot of the foods are packaged in plastics, but if we can just start there and try to buy things in glass or buy things fresh, that can make a huge difference as to how much the body actually has to get rid of. And then, of course not store food in plastic. So having glass containers and then being aware of our skincare. And I know you've been such a huge champion for skin and haircare not having the phthalates and other chemicals in it, because they again, can make a huge, huge epigenetic imprint for the baby. And then even air pollution, right? So we can't necessarily affect where we live, where most of us are kind of not able to move someplace where, like move to Colorado to get to cleaner air. So just even using an air filter at night can make a huge difference because the particles in the air have a huge impact on fertility and the epigenetics. Those are some of my favorites.
Katie: That makes sense to me. And I've kind of thought of it as almost like when I had to prioritize based on budget and just time when I was making some of these initial shifts, kind of tried to address it from like a triage perspective of realizing we breathe much more in a day than we drink and we drink, hopefully, more than we eat.
So in that order of addressing can we address air quality, water quality, and food quality? And air quality I feel like is so important. Because that takes into account our cleaning products that we're using. And if there's kind of toxic air fresheners that are just contributing to the air burden. And that could be things like you said, like air filters or even just how indoor air is often more polluted than outdoor air.
It can be as simple as opening our windows once a day and actually just letting the house air reset. And then some simple, simple shifts like switching to natural cleaning products, which now there are so many options that are more eco-friendly, that are about the same price point. I feel like we've come so far in the last 20 years as far as options for some of these things. But some little switches make a huge difference. And then from there, addressing water filters if we need it in our house or our area. And then also, of course, our diet, which I feel like gets the most talk when sometimes these shifts in like air and water quality can make a huge difference really, really quickly because we breathe so often and drink water so often.
And I love your line where you talk about, you say our bodies aren't broken, our environment is, and you've definitely touched on some of the common things affecting fertility today, but are there any other surprising ones that maybe people don't even realize? Like I'm thinking of, I've read like touching receipts for instance can be a massive source of BPA exposure that a lot of people may not even think about.
Like are there other kind of hidden, sneaky sources that we're exposed to?
Ann: Yes. So the, I love that you brought up the receipts because that, people just don't even think about that generally as being a source of toxins. But that particular plastic really leeches into the skin very easily. It's just been warmed up and it actually changes consistency by, with warmth.
So touching it will activate that. One of the things that has really become, so I get, a lot of times I get to check these levels in my patients because they think that everything's gonna be okay, but they wanna really confirm. So we check the levels and some of the surprising things lately are people that actually think that they're doing everything right with the plastics, but then they're still having a high BPA. So, that really reflects to the takeout food containers. So the putting warm food into plastics and doing the takeout. So I'm really asking people to, if they're going to eat out, just go to the restaurant. Don't try to take, do the takeout or take your own glass containers and ask them to put the food in it.
Because most of the takeout containers are either full of PFAS, the non-stick chemicals or the plastics. And then the other thing that I'm just seeing so much of is the PFAS, so the non-stick plastic, I haven't really found a non-stick pan that I think is, really, even though it says they’re not toxic, I'm not sure I believe it. They have to use something. And so I really recommend people just, especially in this period around conception, just use the stainless steel or ceramic pans because I see the PFAS in their levels. And then I'm seeing a lot of mercury in anybody who's eating a fair amount of fish.
So even when you think you're buying the healthiest fish, like just getting the wild caught salmon, I’m seeing both mercury and arsenic high. And then I'm also seeing a lot of lead. So the, even though there's been a big push in the last 20, 30 years to get lead outta gasoline, lead outta paint, I'm seeing a fairly big exposure and a lot of times it's actually in the kitchen. With plates or cookware that has lead in it so you can get home lead test kits and just double check your kitchen and make sure that your glasses and plates and things don't have the lead in it.
Katie: That's a good point. I feel like people maybe have heard of the non-stick issue in cookware, but perhaps haven't thought of like even dishes can be a source depending on the glaze of things like lead. And I feel like the Mercury one is big as well and I feel like at least during pregnancy women get warned about sword fish and salmon and some of the bigger fish.
What about smaller fish in moderation like sardines? I ask mainly because I'm a huge fan of them personally, but I like, I wonder if pregnant women need to be careful about those.
Ann: I think the sardines are okay, but other than that, I'm not sure that it's actually safe to have fish more than, you know, once a week. And maybe not even that in the preconception period. Just because of the accumulation issues. Sardines would be the safest bet.
Katie: Okay, good to know. I know the general maxim is like if the littler the fish, the safer. So in general, I've always kind of gravitated towards sardines and anchovies and used them only a few times a week. But it's like that balance of, they're so high in omega threes and calcium and so many good things as well.
Ann: So the other thing that's probably safe is the caviar. I think that that's such a great source of the Omega-3 oils. So if you like caviar and you can get it fairly inexpensively and you don't need more than a tablespoon or two every couple of days, but that could be a really great source for omegas.
Katie: That's a great point too. I hadn't thought about that one. What about, I know you also talk in the book about factors like gut health, inflammation, and I feel like mitochondrial function is a really trending topic right now, and I'm so glad we're talking about this because I've been thinking for years kind of like an electrical first approach to the body, realizing we're electromagnetic beings. And so to me that brings in the question of mitochondria, minerals, is our body electrically communicating optimally? And you touch on all of these in the book, but maybe kinda give us a primer on understanding those categories and how they relate specifically to fertility and healthy pregnancy.
Ann: Yeah, so mitochondria are the little organelles inside our cell that make energy and that's just been such a big topic in all areas of my practice, whether I'm working with somebody with early onset dementia or an autoimmune disorder we're working on reversing or really anything. So I've been studying what happens, you know, how we can best optimize our mitochondrial function. 
And it turns out for this fertility piece, the mitochondria are crucial for creating healthy eggs. What's really fun for me, the science nerd, is that we can measure mitochondrial function in great detail now. So we used to just have these markers where we looked at different parts of the pathway of the mitochondria and tried to interpret whether there were things that weren't working great and rebuild it with the nutrients in that step. Well, now we can measure what's going on with the mitochondria in a whole lot of detail, like electrical charge type of detail. So it's super fun. And then we can run little mini experiments to see for that individual person what will actually help their mitochondria work more optimally so that we have better resilience and it just applies to really every area of health and longevity to have powerhouses for our mitochondria. 
So what I found is that there are certain nutrients that really can make a difference. So there's special forms of CoQ10, like MitoQ there's carnitine, there's D-ribose. The phosphatidylcholine plays a role in this part of the body as well because it helps you to have healthy membranes so that that whole electron transport chain can be healthy. So we have a lot of tools in the toolbox to help us with that. And one of the enemies of the mitochondria is when our bodies have inflammation. So we can have inflammation because of food allergies or toxic buildup in our body. The toxins building up, low grade infections, stress having fought off an infection.
And some of us genetically are more predisposed than others. That would be part of my journey and my health is that my body's really great at creating inflammation from a lot of different things. So the mitochondria are like partners in the body to help clear inflammation, but then they can get damaged when there's too much inflammation. So that's one of the things that I really like people to do in this preconception period is take a look and see if there's higher amounts of inflammation. And we can measure a lot of that as well. But a lot of times you just kind of even know, like, you feel more inflamed. So then you wanna go looking for those things that might be, that your body might be responding to appropriately, but aren't the best for fertility and for long-term health and longevity.
Katie: I’m a huge fan of phosphatidylcholine as well. And that was actually one thing I realized in my own journey I had, I've spoken about this before, but I used to have Hashimoto's and at one point I had a lot of food intolerances, so I hadn't eaten eggs for a really long time. And I realized I was getting basically no dietary choline at all.
And when I started supplementing with that, it was like a light turned on in my brain. It was like I heard angels singing. It made such a big difference. And so I'm a huge fan of that one. And also, just to like back up what you're saying, anecdotally I got to see in real case in my life with my six kids of as I changed some of these things and learn more about health through each pregnancy, like pregnancy got easier, they, I mean, none of them had major health problems to begin with, but they had, they were thriving in childhood and I got to see this really make an impact in real time. And got to see the anecdotal kind of proof of what you talk about in this book. 
And I know we're gonna get to do another conversation to go deeper on the male fertility side, which we haven't gotten to really dive into yet, as well as kind of future proofing fertility. But before we wrap up this episode, are there any other things you wish couples understood about this preconception period, especially that they might not be told by their doctor or by conventional medicine?
Ann: Yeah, I really want the, this narrative on preparing for pregnancy to change from a one of fear to one of hope. And that by putting some effort into this preconception period that 3, 6, 12, or even longer periods before and between pregnancies, really is the greatest gift you can give your child because you're actually creating an environment where they can have better health and longevity.
Katie: I will link to the book in the show notes. I know it's available everywhere books are sold. As well as I'll link to your website and your social media. Where can people find you and find the book and keep learning? I feel like this is such an important topic and I love that you're tackling it.
Ann: It’s thepreconceptionrevolution.com or annshippymd.com, and we do a lot on Instagram, on the Ann Shippy MD Instagram to just keep information flowing.
Amazing. Well, like I said, we get to have a follow-up conversation, so you guys stay tuned for that one. But for today's conversation, thank you so much. It is always an absolute joy to get to have a conversation with you. I love that we got to record this one. I am so grateful for you, for your work and that you agreed to be here. Thank you so much.
Ann: Thank you.
Katie: And thank you for listening, and I hope you will join me again on the next episode of the Wellness Mama Podcast.