EP 290 The Ultimate Pre-Pregnancy Checklist |Alexandria Devito

Alexandria DeVito, MS, CNS, is a functional nutritionist who specializes in fertility and preconception health. She is the author of 9 Months Is Not Enough: The Ultimate Pre-pregnancy Checklist to Create a Baby-Ready Body and Build Generational Health. She is also the founder and CEO of Poplin, the first pre-pregnancy wellness company. Prior to founding Poplin, Alexandria worked in management consulting at McKinsey & Company. She holds an MBA from Harvard Business School. She also has a master’s degree in nutrition; extensive training as a doula, yoga teacher, and personal trainer; and is an Institute for Functional Medicine Certified Practitioner, all of which inform her approach to pre-pregnancy wellness.

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Summary of this episode:

Alexandria DeVito shares her journey from working in the corporate world to becoming a fertility health advocate. She obtained an MBA from Harvard and a master's degree in nutrition while working in healthcare. She then trained in functional medicine and started seeing clients as a nutritionist. Many of her clients were struggling to conceive, which led her to focus on fertility health. The conversation explores the challenges of fertility struggles and the lack of preconception health guidelines in clinical practice. It highlights the emotional, physical, and financial toll of fertility struggles and the need for better preparation and support. The conversation discusses the importance of preconception care and the impact it can have on the health of both parents and future generations. It highlights the challenges faced by females in accessing comprehensive medical care, which often focuses on contraception rather than preconception care. The conversation emphasizes that there is no such thing as starting preconception care too early or too late. Our bodies were designed to conceive, but our modern environments create a mismatch. Factors such as nutrition, supplements, and stress can affect fertility. 

Transcript:

Michelle (00:00)

Welcome to the podcast, Alexandria.

Alexandria DeVito (00:03)

Thank you so much for having me.

Michelle (00:05)

So we just had a really great pre-talk and we definitely are on the same page on so many things. And what I love about you is that you are here really to empower couples on the fertility journey. I got to look at your book. I was very excited because I feel like I really resonate with the

And I just love the fact that you really approach it from such an empowering perspective. Absolutely love that. But for the listeners, I would love for you to share your background, how you got into the work that you do.

Alexandria DeVito (00:38)

Hmm, you got it.

Yes, I mean, I think there's a lot of alignment philosophically about, you know, just how much more agency we have over our reproductive health and all the different ways that we can prepare to conceive, which I'm sure we will talk all about. So I came into the world of fertility actually, initially through the corporate world. So I was doing corporate consulting and was working in healthcare, largely with pharmaceutical companies and medical device companies. So I kind of learned the healthcare landscape from that lens.

enjoyed working in healthcare. I thought it was just such an incredibly impactful field. And at some point I decided that I wanted to switch from what I felt was operating in a more reactive model of healthcare to a more proactive one. And so that was the impetus for me to go back to school. I went back and got my MBA from Harvard and then I also did a part-time Masters in nutrition on the side.

while I was doing my MBA. And that was my way of adding more tools into my toolkit that were more holistic in nature. And then I finished both of my master's degrees, and I did training and functional medicine, and started seeing clients one-on-one as a nutritionist. And basically what ended up happening was I had a lot of clients that were struggling to conceive, and they had been on fairly long journeys, sometimes a year, two years, three years, and they were being

ping-ponged between different providers and they still weren't getting the answers that they so deeply desired and they were not getting pregnant. And it really struck me, why was this happening? And so you know initially they were saying like do you have any other suggestions? Can you tell me what I should be doing? And this was also happening with friends. Friends of mine were also struggling coming to me not in a professional capacity but in a personal capacity asking for my advice and guidance.

And initially I was really perplexed, right? This seems like an important problem. This seems like a solvable problem. What the heck is going on here? And so inspired by my functional medicine training, I started running these really broad panels of tests that.

essentially were screening mechanisms. I looked at the clinical literature and saw all the reasons that could potentially interfere with someone's ability to get pregnant. And once I started running these broad screening tests, a whole bunch of things started flagging that my clients, other providers, had never even tested in the first place.

And that was what really inspired me to say, wait a minute, like, why are we waiting until someone is several years into a fertility struggle? It is emotionally, physically, financially draining in most cases. Why are we waiting to find out these things that we could have found out before they even started their journey? And so that really inspired my exploration of preconception health, which is essentially the preparation period before and between pregnancy is, which we can talk more about.

And I realized that there have been preconception guidelines over 40 years at this point, but they're not being implemented in clinical practice. And then certainly, if we think about ancient practices, which this is your specialty, these have been around for thousands and thousands of years. But we're not implementing them.

And so I just felt that there was an opportunity to rewrite the dialogue and to really give people so many more tools to prepare to get pregnant like they prepare for any other major milestone, a wedding, a career, right? Even buying a house today has more infrastructure and support. And so that's really been my journey and the impetus and really spreading the word around this concept of preconception health and all the things that you can do on both a macro level and a micro level.

to optimize it and build generational health.

Michelle (04:25)

I mean, I love this topic and I just, you know, it pains me that it's not mainstream, that this is just not information that people get. And I feel like they do get it after digging and finding. it would be so nice if people just knew this information because it's so important. And so let's go to that topic of really preparing the body.

Alexandria DeVito (04:33)

Mm-hmm.

Michelle (04:52)

because I think that is just something that most people don't even consider. Nobody really is told that. It's not something that anybody really has access to. I mean, the only access that you really have is like high school health education, where they tell you not to conceive and that anybody blinks and they get pregnant. And so just about your body and how it really works. And then,

Alexandria DeVito (05:07)

Hahaha

See you soon.

Michelle (05:20)

it's that like the red pill that we swallow and realize like what's really happening and what's the reality and it's so different than what we've been told. So let's talk about preconception care like why is it important and how long do people really need to consider preparing themselves before conception?

Alexandria DeVito (05:42)

You had so many important points in what you just said that I, you know, I think it's actually really helpful. I want to elaborate on them and, you know, and amplify what you said. First, right, I think it's true. We don't get updated sexual education information in most cases, right? The last time most people had any sort of sexual education, it may have been in middle school or in high school, where presumably the goal is to prevent teen pregnancies. So the message that we are giving people...

in that context is very different from the message that we might want to give to someone who's in their 20s, 30s, 40s, who's actively trying to conceive, right? But there aren't great mechanisms to update that information, right? And so I think that's one of the first challenges. I think the second challenge is that we are very bifurcated in our medical care for females, where we're either focused on contraception, so preventing pregnancy, or pregnancy.

right, managing a pregnancy that is already in process. But this intervening period, this preconception period, when once we are stopping contraception and pursuing pregnancy, is almost been forgotten about. And I think it deserves its own conversation. And that's why I'm so happy to be here today talking about it, is I didn't even know preconception was a thing before I started researching it. And proper preconception care has

big benefits. Number one is it makes it easier to get pregnant, and then number two, it increases the likelihood of having a healthy pregnancy and a baby. And it's certainly been known, been shown to reduce the complications of any sort of birth complications, pregnancy complications, and then also fertility challenges. And so this is relevant, whether it's your first pregnancy or your fifth pregnancy.

it's relevant whether you're 23 or 43, right? And sometimes it can be even more relevant for subsequent pregnancies because a female's body can be so depleted of nutrients in a previous pregnancy or hormones may be dysregulated. I'm sure this is something that you see a lot of the time as well, right? And so what you do in the preconception window is incredibly important because it's been shown to affect the lifelong trajectory of the health for your child through the epigenetic markers in egg.

and sperm. So it's just such a profoundly impactful time period where you're not only affecting your health and your reproductive partner's health, but that of your future child and even your child's children and beyond. It's wild.

Michelle (08:18)

Right. I know, isn't that crazy? The thought of that. Yeah. It's pretty wild. So how long would you say, generally speaking, how long do you think people should really consider pre-conception care, like before even conceiving?

Alexandria DeVito (08:34)

Yes. So what I generally say is, look, there's no such thing as too early. So if you're an overachiever and you want to start this early and you're thinking about pregnancy even in a couple of years, no such thing as too early. There's also no such thing as too late. Even if you've already struggled to conceive and or are about to pursue an assisted reproductive cycle, you can still be making these changes. Your body is incredibly, incredibly resilient. That being said, generally speaking,

what I recommend is usually about a year, right? So kind of what you're doing in the three, six, 12 months prior to conceiving is the timeframe that your body is gonna be most susceptible, either positively or negatively, to what's going on in and around your life cycle. And that is true on the female reproductive side, where the last stage of egg maturation is around three to four months and kind of their susceptibility to what you're eating.

environmental toxins and you're stress-loaded in that period of time, and sometimes we need multiple of those cycles. And the same thing for male sperm development. That's around three months, so again we may need multiple cycles depending on our starting point. But it actually takes about a year, the current literature is saying, for an egg to kind of move from its you know essentially sleeping beauty like state all the way through to ovulation. So that's just the time periods when we're thinking biologically what we want to keep in mind.

Michelle (09:58)

And so what are the things that you would suggest or what are some of the things that you would say people should look at? I mean, I know there's so and I know nutrition's a huge part in certain supplements, but I'd love to get your, your thoughts on that.

Alexandria DeVito (10:12)

Absolutely. Yeah, so here's what I would generally say. Our bodies were designed to conceive, but our modern environments were not. Right? And so there's a mismatch now between our genes and our environment.

and our environment today is communicating to our bodies that we are in a reso unsafe environment on a pretty regular basis. And when we are in a reso unsafe environment, our body down-regulates reproductive function because it says, wait a minute, probably not the best environment into which to bring a child, so let's put it on pause right now. And so when I think about what are the factors that are driving

as auspicious to conceiving. There's the macro level and then you know kind of what's going on for most of us, and then there's the micro level. So I'll split it into those two. On the macro level, you certainly alluded to several of these, right? We're eating a lot of food and we're getting not very much nutrition, right? So we're eating more food-like substances, less food, less nutrient density of food, less balanced.

Michelle (11:13)

Mm-hmm.

Alexandria DeVito (11:20)

diets, more blood sugar imbalanced diets, right? So these sorts of things are not conducive to fertility, and that's become the norm, not lately. A second big one is environmental chemicals that are coming at us through our food, our water, our air, our personal care products, our home care products, and I think particularly for females who are using, tend to use more personal care products than our male counterparts. You know, if

One of your products has these endocrine disrupting chemicals in them, probably not that big of a deal, but when it's kind of like our shampoos and our conditioners and our makeup and you know our lipstick and our soaps and right, you know, it starts to add up and our bodies were just not designed to deal with this level of toxic load. Our bodies can naturally detoxify, but when it's all day every day, it becomes much, much harder for our body to excrete these compounds that we're not meant to be dealing with. So environmental toxins are another one.

Stress levels, I think are another important one. We are more stressed and stretched than ever before. The data suggests this. We are sleeping less soundly and less cumulatively. And what happens there is our sex hormones and our stress hormones are in the same biochemical pathway. And our bodies will always prioritize survival over procreation. So kind of what, to what I was saying earlier, if your body thinks, oh, this is, we're in war basically, or we're in an unsafe environment,

it's going to down-regulate reproductive function and switch from making your sex hormones to making your stress hormones because it thinks it's adaptive, it thinks it's protecting you. And what happens then is you don't have the raw materials, A, to get a regular menstrual cycle and ovulate, but then B, to carry a baby, right? So that's a big one that I see. And then the last kind of big one that I'll touch on is just movement. We've...

significantly increase the sedentary-ness of our jobs even, and we you know we don't have to walk more than five feet if we don't want to right there's planes, trains, automobiles, right even scooters can kind of get us from point to point, and so when we think about movement the important thing about movement is that when we are moving we are getting you know this is very much in your realm right we don't have stagnation right so

whenever we have good blood flow, that means we're moving oxygen, we're moving nutrients throughout our body. When we're sitting for long periods of time, we're essentially compressing our reproductive organs and creating stagnation, which is not great for kind of getting the things to go where they need to go. So those are the big ones on the macro level that I see, and I'll just briefly touch on the micro, which is that part of what was the impetus for me building the pre-pregnancy testing company that I now run, Poplin, is that

know, it was inspired by what I saw working as a nutritionist, that there's all these things that we can test in advance to understand what's going on for you uniquely. Right now in fertility we treat in many cases all 25 year olds as equal, all 35 year olds as equal, and that's cellularly just not true. So if we can understand what's going on in your unique body, then we can have a much better intervention plan rather than kind of doing all the things you can do, the specific things that are relevant to you and your physiology.

Michelle (14:24)

Right. Yeah.

Oh my God. Yeah, for sure. And a lot of people are not really getting the tests, even if they are available mainstream. I'm always like surprised when people get there just the TSH and very high and nobody looks to see is it antibodies that's causing that. Like, there's no antibody testing. And I've even had patients go to their doctors and ask for it. And they're like, I don't know why you need it.

Alexandria DeVito (14:57)

Mm-hmm.

Michelle (15:05)

And I'm like, really? Like just, it boggles my mind. So it's again, a shame that people have to really search it and seek it, but if you are able to, I definitely highly suggest that. I think it's a game changer to be able to really see what's going on and to do the functional testing. Cause functional testing is a lot more detailed than what we'll see in just like a doctor's office or So I think it's huge.

Alexandria DeVito (15:32)

I agree and I'm obviously hugely biased here so you know everyone has to take you know my opinion with a grain of salt but I've just seen you know because we're testing such a wide array of markers like I've never seen a test come back without something that you know someone could be working on and I've never had someone say you know I wish I didn't do that testing right

Michelle (15:50)

Yeah.

Alexandria DeVito (15:50)

it's really empowering. I think sometimes we can get scared and say, well, what if we find something out? And, you know, I don't want to know. But the things about the testing that we do, at least, is that everything on the test, except for blood type, is modifiable, which means you can do something about it. It's not some test result where you then are just, you know, sitting there, twiddling your thumbs, wondering, you know, what to do. You can modify it through diet, lifestyle, supplementation.

Michelle (16:05)

Right.

Alexandria DeVito (16:19)

Alternative therapies like the work that you do, right? Enhancing blood flow, managing stress levels, all of these things can really improve these biomarkers and you can see it in black and white, right? You can take the test, you can make lifestyle interventions and then you can take it again and you can watch your progress.

Michelle (16:19)

Mm-hmm.

Yeah.

Not only that.

I feel like people feel a certain way or they feel sluggish and they think it's them or something's wrong with them. And when people get that confirmation, and this is kind of like, I mean, it's obviously related because everything's related to fertility. Because you were saying what you said was so true. And I say the same thing. It's your body's going to want to survive. And if it doesn't have the means, regardless of the fact that it's going to also influence reproductive health, but it also influences your quality of life.

Alexandria DeVito (16:44)

Hmm

Michelle (17:06)

people actually see that and they realize, oh my God, this is what explains it. Because I think there's nothing more frustrating than getting that unexplained diagnosis. And when you actually see beneath the surface what's really happening and it gives you an explanation, I feel like that by itself is so empowering.

Alexandria DeVito (17:14)

Very funny.

Michelle (17:26)

And I agree a lot of times with functional medicine, yes, we can change diet, we can address what's going on. We can see the inflammation. And then let's talk about gut health, because I know that that's like a big thing. A lot of people hear about gut health. And at first, I think when people start the fertility journey, they think it's just, let's focus just on fertility. But then you don't realize, like, there are so many different factors that come into play.

Alexandria DeVito (17:36)

Yeah.

Michelle (17:51)

And there are different systems and all the systems come together to create the whole of you. And gut health is incredibly important, even in Chinese medicine, you know, the clean stomach or the center, really the center that makes the blood, supports your body's processes and energy. So I wanted to get your perspective on gut health and also to explain it to people who are first hearing about it. Like why does gut health

matter so much when it comes to fertility health.

Alexandria DeVito (18:22)

And I want to hear more from your perspective too, because I think this is where it's so beautiful to hear that the different modalities and how they're looking at things differently. And in a lot of ways, there's just this underlying similarity between the philosophies too. So I think, you know, what you said is spot on, right? Fertility is an extension of our overall health.

A lot of times we treat fertility as this below the waist conversation, or we treat it as solely a function of your hormones. And it is those things. It does involve your reproductive organs, and it does involve your hormones. But if we're just looking at those things, we're just kind of like looking through, you know, at-

20-30% of the equation, we're missing all of the other stuff going on in your body. And that's why when we look at testing, we're looking at your blood status, your hormone status, your metabolic status, your nutrient status, your immune status, all of these things affect your fertility. And you're talking about gut health, incredibly important.

thing. When we think about gut health, just to give a few examples with my nutritionist hat on, just because you're eating, let's say, a quote unquote healthy diet does not mean you are digesting and assimilating those nutrients. So if we're eating in a stressed state, if we're eating while we're standing up, if we are judging the food that we are eating, all of these things actually decrease the amount of nutrition that we can extract from that meal. So that's just

Michelle (19:30)

Right.

Alexandria DeVito (19:46)

first really important principle.

The second one is if you have happened to have been on hormonal birth control for any period of time, the literature is fairly clear that hormonal birth control can disrupt our microbiome. And so if we're not taking compensatory action to address that, then you're likely to be dealing with a disrupted microbiome. And then again, right, that may feed certain cravings. It may mean you're not, again, extracting nutrients as effectively from the foods that

eating. It may mean that you're dealing with symptomology like bloating and gas and discomfort after meals that are certainly...

not very pleasant right? And so you have kind of all of these different components when we think about gut health and if you just think about it from like a nutrient perspective, our gut is the way that our body helps us digest and assimilate. So if we're eating all these foods and we're not actually getting the benefit of the foods that we're eating, we're more likely to be in a nutrient deficient state. And nutrient deficiencies can delay time to pregnancy and they can also affect

And so what we're kind of consuming in the three to four months prior to conceiving is what you actually have to offer to that baby in that first trimester. So ensuring that your nutrient stores are replete before that period of time is incredibly important.

Michelle (21:12)

Oh yeah, absolutely. Chinese medicine, It actually is what extracts into blood and blood is really important for women, uterine lining, but it also feeds the ovaries. So yeah, and it's amazing how now we're starting to find out a lot of things with research. And I love that. And it's also interesting because people do go on the birth

not only impacts the gut microbiome, but also impacts your nutrients in your body, depletes certain nutrients. So for people who have been on the birth control pill for many years, I think that that's one of the things in mainstream they'll say, oh, you could be on the birth control pill for many years. And then the second you stop, you could just go ahead and get pregnant. So what

has been your experience for people who have been on birth control pill and some people for over 10 years. And what are some of the things that you would look at and want to address to regulate and prepare people for conception? Yeah.

Alexandria DeVito (22:16)

Such a great question. So I mean, I think there's the talking about birth control can be such a.

an important and also sensitive topic because I think it's, you know, I have such reverence for the freedoms that it has afforded myself for many years and also many, many women to pursue their lives as they deem fit, pursue their careers. And at the same time, I think we now have a generation of women who have been on hormonal birth control, as you said, from very early reproductive years, and we now have more information about the side effects.

you know, I'm a big believer in this concept of informed consent, which means you get to decide what is best for you, and the only way you can decide what is best for you is if you're given all of the information to evaluate the pros and cons of this. And for, you know, many women, even understanding some of the things that we're about to talk about, they still may make the same decision, but that is not the point of informed consent. The point of informed consent is that you get to know all of this information and then decide what is best for you. And so what I think

about hormonal birth control. Certainly what was not communicated to me is that, as you said, there are very well established nutrient depletions. And we've known this, you know, for almost 50 years now, by the way. So like the nutrient depletion side of this has been very clear. So nutrient depletions in many B vitamins, vitamin C, vitamin E, and then also in certain of the minerals, so like magnesium, selenium, and zinc.

And so what I would say there is you have a couple options, but number one is supplementing alongside hormonal birth control if you're still on hormonal birth control and are thinking about getting pregnant, not imminently, but in the future. And also if you go off of birth control, making sure that you're repleting those nutrients, because those are nutrients that are incredibly important for fertility and pregnancy.

Michelle (23:58)

Right.

Alexandria DeVito (24:11)

So I would say that as one piece, right? Certainly around the microbiome, we talked about that. And so giving your gut additional support might be helpful, right? Eating.

probiotic foods, eating prebiotic foods, sometimes adding additional supplementation may be necessary. And you can understand if you're experiencing any sort of digestive upset, that may suggest that there's something going on with your gut. So a lot of yeast infections can sometimes indicate, okay, there's an imbalance in what's going on in your gut.

Michelle (24:41)

Mm-hmm.

Alexandria DeVito (24:45)

If you're having immune challenges, a lot of times that can actually be linked to what's going on in your gut. Issues with digestion or motility, a lot of people don't even realize that the daily bowel movements are normal, and so if you're not having daily bowel movements, that actually means you're constipated, and so many people are walking around constipated and not even realizing it. So all of these things can be manifestations of, you know, A, our lifestyle, and then also can be a function of long-term

hormonal birth control use. So just understanding that. And what I generally say is that coming off of hormonal birth control, if you've been on it for many years, is an active rather than a passive process. So if you are just aware of some of these side effects of being on hormonal birth control, you can be a much more empowered user to take compensatory actions to address them.

Michelle (25:36)

That's such a good point because I think in many cases people don't really feel like they have an option, but they need to still learn about what they can do in order to empower themselves. It's definitely such a good point to bring up. I was going to ask you just kind of a side note, what are your thoughts? Because I'm reading a lot about it as of late, systemic enzymes, enzymes are really, really important, but I'm reading a lot about how

Alexandria DeVito (26:04)

Hmm.

Michelle (26:06)

amazing it is for the body, for inflammation.

Alexandria DeVito (26:11)

bit about them too. I haven't done the requisite deep dive that I would need to give a really thorough opinion here. It does seem to be showing some promise and you know I think there are some potentially interesting applications out there, but you'll have to stay tuned on that one because I need to research them a little bit more before I get into thinking about kind of what are the best suggestions for folks and kind of what are the specific instances that I think they can be.

Michelle (26:27)

Yeah.

Alexandria DeVito (26:37)

used in? What do you think is the most intriguing application so far?

Michelle (26:41)

It's incredible. So for example, wobe enzyme, which as of late, it's been out of stock for so many, but there are a lot of different places that do offer systemic enzymes. And basically what they do is they really break apart fibrin and you know, even plaque in our circulation system and our veins and arteries. And

it could really help lower inflammation. There's been a lot of research on specifically whoope enzyme and they've even researched it for recurrent miscarriages which I find really interesting. it can also help in certain cases of autoimmune conditions has been shown to help with Hashimoto's. There's so many things that I'm reading about it and I'm really fascinated. So I'm starting to dig in a little bit more.

and finding it to be a really amazing thing. And I think what happens is as we get older, we decrease the amount of enzymes our bodies have and enzymes are so brilliant, your body's so brilliant. It knows what to basically clean out and it will never affect your tissues. So it's really fascinating stuff.

Alexandria DeVito (27:50)

It is. The autoimmune conditions are the ones that I've seen some applications for. And it is really interesting to think about because certainly we're seeing autoimmune conditions on the rise and pretty precipitously. And autoimmune conditions are disproportionately present in the female population. So it's something that's important to be aware of. I think it's 80% of autoimmune diagnoses are in females. And on average, it takes about

immune diagnosis. So it's just, it's wild. It's wild to think about that. And a lot of times, autoimmune conditions can have non-specific symptoms, which is why sometimes it can be hard to address. We do autoimmune screening, testing it at Poplin, and one of the reasons that we do it is because there's been such a precipitous rise in autoimmune conditions, and we're seeing a lot of people flagging for indications of autoimmune conditions. And it's not a diagnosis. You have

Michelle (28:21)

Isn't that crazy? Yeah.

Mm-hmm.

Alexandria DeVito (28:50)

diagnostic testing to get an autoimmune diagnosis, but it's a first step to say, okay, might there be some autoimmune processes going on? And a lot of times that will initiate people into conversations around family history that they, you know, weren't aware of but that they then become aware of around autoimmune conditions. And, you know, there are certainly plenty of things once you know that you're dealing with it that you can start to do to manage it in collaboration with your doctor.

Michelle (28:51)

Mm-hmm.

Alexandria DeVito (29:16)

So I think that's an area that's certainly right for a lot more research. And I'm excited to see that there are potential other alternative therapies as well.

Michelle (29:23)

Yeah, it's pretty fascinating and really looping back to the gut health, there's such a connection with gut health and autoimmune conditions. And right now we know that so many of the ingredients that we find in processed foods impact our gut health. I mean, some of the medications we take. So it's kind of like you were saying earlier, even just environmental.

Alexandria DeVito (29:28)

Yes.

Michelle (29:45)

It impacts our gut. it's not something that we can avoid, which makes sense to why so many people are experiencing that. You also have to be proactive in, like you said, like the environment. We're not living in a very fertile friendly environment. So you have to be proactive in looking into it and researching it and then figuring out what's going on with your specific body and then what you can do about it.

Alexandria DeVito (30:10)

Absolutely, I think it's true. You know, I wish it weren't the case. I wish we had, you know, better regulations in this in this area. And I wish that we could play in a safer sandbox, I guess, is the is the way I would say it, you know, but you know, unfortunately, until regulations catch up, or, you know, until we are in a place where these, these chemicals aren't around us in such a profound way, we have to take a lot more personal responsibility. And so, you know,

Michelle (30:22)

Yeah.

Alexandria DeVito (30:38)

it can sometimes feel overwhelming because there's a lot to learn around, you know, trying to understand, okay, well, what are the things that I want to be keeping in and around me? What are the things that I don't want to be keeping in and around me? And I just, you know, generally encourage people to be gentle with themselves as they maybe go kind of room by room, starting to look at the different things that are coming in, identifying potentially major sources or things that you're using frequently to start to minimize all these assaults that we have on our system, right? Because our body

as I was saying earlier, and it was designed to regenerate and heal. And so it's really our job to figure out kind of what are the fertility blockers in our environment, right? And to remove those, because once you remove those, the body heals itself, right? It's miraculous. And so it's, you know, systematically finding, okay, where are these things in and around my environment that are not so consistent with my goals right now?

Michelle (31:21)

Mm-hmm. It does.

It's so funny. I feel like we're like mentally related because a lot of things that you're saying are things that I felt for forever. I mean, I really like relate and I say it over and over again, because it is really true. It's just that hope that knowing that your body's incredible. It's so intelligent. It's beyond intelligent. And it's just a matter of really finding things and anything's possible. Truly, if you put your mind to it.

And for just for people to hear about, I would love, and I would love to know also, what does poplin offer? Like what are some of the things that people can get tested?

Alexandria DeVito (32:13)

Mmm.

So Poplin's designed a pre-pregnancy test for females and for males, and the idea is that we look at a vast array of biomarkers that are like 70 plus. So the idea is essentially that we're looking across five different categories of health. So I mentioned them earlier, blood status, your hormone status, your immune status, metabolic status, and nutrient status. And within each of those categories, I'll just talk briefly about some of the most common things that we see, but the idea is to identify things that could be red flags or yellow flags,

with your ability to get pregnant or sustain a healthy pregnancy and have a healthy baby. So in blood status, this is where we're looking at the health of your blood cells, red blood cells, white blood cells. And so a lot of times there, we'll also look at iron storage, so your ferritin levels. And in your world, I'm guessing you see this manifested in a slightly different way, but we see a ton of iron deficiency. And a lot of times people are just coming in and

Michelle (33:09)

Mm-hmm.

Alexandria DeVito (33:14)

requisite iron is going to be really hard to, you know, to get pregnant and to sustain a pregnancy. It's a really important nutrient. So that's one that we see really commonly when we think about hormone status. That's the category that most people think about when they think about fertility. We're looking at a lot of different hormones there. As you, as you mentioned earlier, we look at TSH. We also look at seven other.

thyroid function markers, right? So we are looking at thyroid antibodies, but then we're also wanting to look at what else is going on with your conversion of thyroid hormone, and sometimes your TSH is not as sensitive of a marker as some of the others, and so it will change later in the disease process, and so using markers that are a bit more sensitive to catch things earlier is important.

Michelle (33:37)

Mm-hmm.

Mm-hmm.

Alexandria DeVito (33:59)

When I think about metabolic function, we look at blood sugar in that category. We also look at cholesterol. So a lot of times blood sugar function can interfere with regular ovulation. So we wanna understand what might be going on there that could interrupt.

ovulation or even egg quality. I know this is something that you've covered before, right? Our blood sugar is intimately related to certainly our hormone function, but also egg quality and sperm quality. And then nutrients we've talked a lot about, but I'm still consistently seeing low vitamin D, low omega-3s. So these are things that are fairly easily addressable if you know that they're present. And so those are ones that we are seeing commonly. And our, you know,

Michelle (34:33)

Mm-hmm.

Alexandria DeVito (34:44)

choose to address that, in some cases through diet and in some cases through additional supplementation.

Michelle (34:51)

And are people able to just go on and do it for themselves or do they need a provider to access the tests?

Alexandria DeVito (34:58)

people can access it directly themselves. That's exactly what we're designed for. I think what I realized when I was working as a nutritionist and I was trying to get some of these tests like have other providers run the testing was that a lot of providers wouldn't run the testing. They wouldn't run as comprehensive of a panel as I thought was necessary. And it's really not their fault. It's because in most cases, insurance is driving care. Care is not driving what is reimbursed through insurance. And so providers are stuck even if they wanted to run it,

they don't have the codes to be able to do it. So it is, you know, offered out of pocket. You can use HSA or FSA dollars for it. But the idea is that you know exactly what you're getting, you know exactly what you're paying, and then you can have this information. And most of the time, even though most doctors will not necessarily run the tests up front, once you get the results, you can bring those tests to your doctor and they...

will engage with you and can help you address what might be going on, whether or not that's chronic disease management, medication, or further conversations about the patterns that are being seen. And with the purchase of your test, you also get a call with one of our pre-pregnancy educators, so you can talk about next steps as well to make sure that you're equipped for what would be most helpful.

Michelle (36:14)

Okay, so that you'll have somebody to explain to you really what the test means.

Alexandria DeVito (36:19)

Yes, and it's also explained in our app as well. So for each item, it says kind of what is this and what is the implication on fertility as well. So the idea is to just give you some context for what you're looking at, and then you could also speak with someone to ask additional questions about if there's anything that's still confusing.

Michelle (36:41)

Awesome. I mean, I think that's great. I think it's great for people to be able to do it for themselves if they don't, if they're not working with somebody and, have that accessible for so many people because going through this could be so daunting and then just not really understanding. And then just getting, you know, doors closed, like, no, you can't continue looking into this, or it's just unexplained. So like, what else is going on?

Alexandria DeVito (37:06)

That's so well said. I mean, I think I'm consistently surprised at how dismissive sometimes people can be about getting information about your own body. And I really do believe, like, don't let any, if you desire information about your body, don't let anyone tell you that you don't have a right to that. I think that is, you know, just not true.

And so everyone has a different relationship with data. For some people, they feel it is empowering. Most people, I find, feel it is empowering to understand what is going on for yourself. And if that's you, if you feel like you want to understand, okay, what is my baseline? What is my pre-pregnancy wellness? What am I working with? Then I'd invite you to look into that because I think it's so much more impactful to have that information and then have paths to follow than be dealing with this kind of black box, right?

Michelle (37:46)

Mm-hmm.

Alexandria DeVito (37:59)

to be a black box, though we often treat it as such. There's so many indicators that our body is giving us through our menstrual cycles, through our symptoms, and then through, you know, physiologic testing like blood testing and urine testing. There's so much information that our body is giving us about what's going on that we can use to understand earlier indicators of fertility than just getting pregnant.

Michelle (38:21)

Absolutely. So for people who want to find out more about you, and do you work with people one on one still what do you offer?

Alexandria DeVito (38:32)

Yeah, absolutely. So if people are interested in the book, that's...

at 9mon the number nine, and that has all the information about kind of how to prepare to get pregnant and many of the factors that I talked about. I also talk about testing in the book as well. If people are excited about getting tested and are interested in getting tested, that's through Poplin, and the website for that is getpoplin.com, G-E-T-P-O-P-L-I-N. I'm not working with clients one-on-one anymore. It's only through Poplin these days, so if that's something that you're interested in,

encourage you to come join us. We have an incredible set of pre-pregnancy educators as well who are deeply passionate about the space just like you and I are, Michelle. And so if you want to get a little bit more insight into what's going on with your body or your reproductive partner's body, that's what we're here for.

Michelle (39:24)

Awesome. Well, Alexandria, I feel like we're on such similar pages on our approach to fertility And I love the fact that you're all about empowerment and education and getting people to really understand.

that their body is incredible and so intelligent and so powerful and that you can actually do something about it. So I had such a great conversation with you today and thank you so much for coming on.

Alexandria DeVito (39:52)

Thank you so much for having me. It's such a pleasure. And please keep doing what you're doing. It's absolutely incredible spreading the word and serving in this space. It's beautiful.