Why IVF Isn’t Fixing the Fertility Crisis (and What Actually Will) | Dr. Ann Shippy

9:25Dr. Ann Shippy:I went on vacation. And when I came back, I couldn't find a doctor to help me. I couldn't absorb my food anymore, and I got so skinny, people thought that I had cancer. Like, I looked terrible and felt terrible, too. And so that's what made me start thinking about things outside of traditional medicine. I did all the workups, all the things through traditional medicine, but then I had to start changing my diet. I went and started found a naturopath and a nutritionist and started building my body back. And suddenly my body was healing and better after six to nine months of doing this additional work.

10:06Dr. Ann Shippy:And I got so inspired with how my body healed that during the night one night, I think my decision was made. I wanted to change careers and go to medical school so I could do medicine differently at 32. and I've never taken a biology class.

10:24Dr. Mark Hyman:Yeah, no, me neither. I studied Buddhism and I didn't, it was sort of an afterthought. And I think that there's a whole bunch of us out there who have been, you could say fortunately, unfortunately, have been sick and we've gone into medicine or we've been in medicine and we got sick and we had to wake up to something different, to a different way of thinking about the body, about health. And we had to question our training, the paradigm we were exposed to, and we had to think about doing medicine quite differently. And you're also, like me, a functional medicine practitioner. We've known each other a long time.

10:58Dr. Mark Hyman:Your work really is around this particular area is so inspiring because you really break it down for people in terms of the way to think about handling all the things you need to handle to create a healthy baby. And it's not like you start when you get pregnant. The book is called the preconception revolution, meaning before you get pregnant, and it's not just like a day before or a week before, you're talking anywhere from three months to 36 months, three years, that you have to start thinking about what it takes to prepare yourself to have a healthy baby. And I was just reading an article, maybe you're aware of some of this data, but there was a really interesting article about rapamycin and fertility and egg preservation in women, which this is a kind of a longevity drug.

11:41Dr. Mark Hyman:It modulates immune function, has a lot of interesting effects. But, you know, I think we're seeing, we're seeing increasing ways of how do we, how do we preserve, increase, improve fertility and healthy pregnancies.

11:52Dr. Ann Shippy:And especially as it applies to women, there's, um, there's a study that just came out on, uh, the mitochondrial DNA being preserved more than any other cell in the body that they could test. And so that was one of the things that I think really gives me hope. And what I see happening with patients is that even for women in their mid to late 40s, if they've really taken care of their bodies and they've done these steps that I've described, even if they've had infertility issues where they've gone an IVF brute in the past, that they can actually improve their ovarian function and have healthy babies while into their mid and maybe even late 40s.

12:34Dr. Ann Shippy:My oldest patient right now is 47. And I just got pregnant naturally on the first try. She had had a couple kids. They're about 10. And she met the love of her life and decided that they decided they wanted to have a child together. She knew about my work. So she came in right as she was turning 47. We found some things. I was like, wait, let's test you and make sure it's a good idea. So we found her microbiome was off. She had some environmental toxins we needed to clear out, some inflammatory markers. We worked really hard for three months. And then she was supposed to come back and retest some of these things, but they had one night where they weren't careful and got pregnant.

13:19Dr. Ann Shippy:And now she's doing about six weeks. And she looks and feels amazing, Super happy, easy pregnancy, super, everything's going very, very well. And she's actually going to be 48 by the time that the baby's born. And then I just, right before I left the office to come talk to you today, had follow up with a patient of mine who's 44. And we had kind of decided maybe they shouldn't have another baby. She had done, she came to see me about a year ago. She had done IVF to get her three-year-old. And the IVF was really, really hard on her body. She had endometrius that just went rampant and she actually ended up losing a kidney from it.

13:58Dr. Ann Shippy:So she's down to one kidney. It triggered autoimmunity. So she ended up with autoimmune hepatitis. And we were like, okay, maybe one is good. She's six weeks pregnant right now, not trying at 44.

14:12Dr. Mark Hyman:Yeah, I mean, you know, we talk in medicine about geriatric pregnancy, which means if you're 35 and older, you're a, quote, geriatric pregnancy. and I think you know historically you know women had babies and they're you know teenagers and early 20s and but now you know women are delaying it and and there's a there's sort of I think some challenges with that and that's why we're seeing a lot of women struggling but but you're also talking about this idea that it's not your chronological age but it's your biological age that matters and talk more about that I'm starting to think about the ovaries as

14:45Dr. Ann Shippy:they're like little sensors in the body, like continuously monitoring. Is it a good time? Is it a good time? Because we're basically built to keep the species going, right? So if the body senses it's not a good time, the check engine light comes on and it's like, nope, we're not doing this right now because you might not be safe and it might not be a good time to have a baby for them as well. And so I'm really thinking about infertility as just the body sensing it's not a good time. The male side of things is a little bit different because we're continuously producing sperm, so it's more about the sperm quality.

15:22Dr. Ann Shippy:But that's another thing I see too. We see when there's environmental exposures, when there's nutritional deficiencies, weight and blood sugar abnormalities, that the body's not producing healthy sperm. And so a lot of times what I'll see is even a patient who has issues with their sperm quality or quantity, when we do these same things for the man, they get an increase in sperm count and quality and also resume to be super fertile.

15:57Dr. Mark Hyman:As we head into a new year, a lot of us feel that natural pull to reset, to feel lighter, clearer, and more energized. And it makes sense. Our detox pathways take a hit this time of year from stress, disrupted routines, and environmental exposures. The truth is, sometimes eating well isn't enough to fully support that reset. That's why in my 10-day detox, one of my favorite tools I always talk about is infrared sauna therapy. A high-quality infrared sauna helps your body eliminate toxins more efficiently by boosting circulation, supporting lymphatic flow, and creating a deep, productive sweat at a lower, more comfortable temperature.

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17:44Dr. Mark Hyman:Yeah, it's so important. You talk about like this sort of problem in fertility as sort of a, not like a moral failing or some terrible thing wrong with you, but like as a check engine light. Like if something's going on with fertility, it means it's not just about fertility. It's kind of a clue that there's some biological disturbances that are upsetting your hormonal regulation and ovarian function and sperm health and production and quality. All those things are modifiable. And we don't think about them. We don't address them in traditional medicine. We don't think about how to look at it.

18:18Dr. Ann Shippy:Well, and unfortunately, there's this narrative. There are more and more books coming out by reproductive endocrinologists that are just making IVF to be expected, right?

18:28Dr. Mark Hyman:You know, like in order to get pregnant, you have to go to the doctor.

18:30Dr. Ann Shippy:You have to go to the doctor. So the way that I'm thinking about IVF these days is the check engine lights on, the body's saying, hey, there's something going on. And then women are encouraged to do IVF. And that's like taking a car that has the check engine light on and trying to drive it at 200 miles an hour across the country. It's like it's putting the body through super physiological efforts rather than being like, wait, what's going on? Why is it something simple like we're a little low in some nutrients or is there some inflammation because there's a low grade infection or is there a mold exposure or what's going on that's causing the body to put the engine light on?

19:14Dr. Mark Hyman:Exactly. you know and i've seen this so much in my practice at the ultra wellness center and i've helped so many women get pregnant by just addressing the fundamental like terrain it's like if you're going to plant you know a vegetable in the garden you want healthy soil and so how do you create metaphorically healthy soil in a human body both for the man and the woman and this is something that most of us know how to do and there's ways of measuring testing evaluating and learning about what's going on in ways that are not done in traditional medicine and that yet are extremely effective and that I think are increasingly being thought of by some fertility specialists.

19:50It's like hard to ignore.

19:51Dr. Mark Hyman:You know, like I think I just had Michael Eisenberg, who's from Stanford, who's a urologist, specializes in fertility and men and so forth. And he's talking about these issues. So I'm like, okay, you know, there's people in academic centers starting to think about, you know, toxins, about nutrition, about stress, about the microbiome and how all those play a role in infecting the basic hormonal systems and important sort of regulatory pathways that allow us to have a healthy baby. How do you start to think about like evaluating someone and how do you start to think about like when someone comes in and say, well, I'm having trouble getting pregnant or I want to get pregnant.

20:27Like, what do I do?

20:28Dr. Mark Hyman:How do I, how do I start? You know, maybe I'm not having trouble, but I want to clean house and get myself ready. Or maybe I am having a problem. What do I do? So let's start with like, just as a general idea that preconception time matters and what should we be looking at what should we measuring what should be testing and what are the kinds of things that people should be doing to actually improve their health so that their eggs and their sperm are as healthy as they can be

20:55Dr. Ann Shippy:at the time of conception that's such a great question so i know not everybody can do the testing. Like that's ideal to take inventory. So, you know, I wrote the book so that somebody could pick up the book and understand what the testing is, see how much they can actually go get done. But if they can't, start to lay a really solid foundation. So the first thing is to get the diet dialed in. So you and I find, we've had so many of our patients feel by just changing their diet, right? So I would start there by taking out the highly processed foods and add in the most nutrient-dense foods that we can.

21:41Dr. Ann Shippy:So I really like a paleo or Mediterranean diet where people are already taking out the gluten and the dairy that can be so inflammatory, depending on the person, see if they can take out the grains, but mostly put the really high quality good things in and get out the process.

21:58Dr. Mark Hyman:The truth is that sugar and starch is a huge driver of infertility. Walter Willett wrote a book called The Fertility Diet and was all about the phenomena of insulin resistance, driving infertility.

22:09Dr. Ann Shippy:And that leads to one of the things that really led me to write this book that I want to segue on for just a minute, and that's epigenetics. So how we dial our genes up and down. We can't change what genes we actually give to our child, but we can have a dramatic change on how those genes are being dialed up and dialed down. So then where our metabolic state is when we get pregnant actually gets passed on to the baby. What our toxin levels are, especially for men, can have a huge impact on how those genes are being dialed up and dialed down. Even can determine is it a successful and healthy pregnancy once you get pregnant.

22:49Dr. Ann Shippy:But then there's intergenerational studies now, and that's why I called it the, you know, for generational health, because the state of the nutrition in the body, the state of the toxins, the microbiome, the sperm is like a time capsule. So I really want to inspire men to be not just thinking about their own health, but do as much as they possibly can in this 3, 6, 12 months. It takes about 74 to 86 days to make a sperm, so get things really dialed in around 3 months before you're starting to try to conceive with as many of these factors that are going to influence the health of your baby. So hopefully that's going to really inspire men to prioritize their own health and make these changes, you know, eating super healthy and getting their weight at a good place, eliminating the toxins, doing a detox period where they are getting the toxins out.

23:47Dr. Ann Shippy:one of the interesting studies that came out actually after the book was written, so I didn't get to include it, was they took men and they gave them highly processed foods for three weeks. And another group that they gave just mostly whole foods like healthy meat, healthy vegetables, and then they looked at sperm quality and hormone levels. In just three weeks, they could see a change in sperm quality and hormone levels. Then they flipped the groups and they saw the same thing. So when they took the men who had their sperm looked pretty healthy, their hormone levels were good. They did a little washout period and then started filling them, feeding them highly processed foods and saw the same kind of decline in as little as three weeks.

24:31Dr. Ann Shippy:So trinkies and

24:31Dr. Mark Hyman:pop tarts are bad for your sperm.

24:33Dr. Ann Shippy:Well, exactly. And I think it's somewhat to the containers that these highly processed foods are like the takeout, I think is really not good for men's sperm health, right? The PFAS and the plastics that get leached into the food from the takeout containers and the frozen containers that the highly processed food in is in as part of the story here on what's going to actually move the needle to have men have healthier sperm.

25:03Dr. Mark Hyman:It's important that you're talking about this because I remember a book I read a long time ago called Our Stolen Future by Theo Colburn, which is sort of like our Rachel Carson Sound Spring book about the role of these environmental chemicals and pesticides and plastics and PFAS and fiber chemicals and their role as endocrine disruptors and how they were affecting fertility. And she went deep into the animal kind of research around this. And I think, you know, we don't realize that that's all affecting us. So the toxins do affect both women and men in terms of both their...

25:39Dr. Ann Shippy:It's just easier to study it in men because we have this quick turnaround. It's harder to know what's going on with ovaries, but I'm sure it's the same thing as with the men with the ovaries. It's part of why the ovaries are saying, check engine light, there's a problem here.

25:52Dr. Mark Hyman:So how do you start to think about just, let's just sort of dive into the whole preparation of how do we like clean house, right? Because health is just about removing the things that are causing a problem and also adding things that make you healthy. But it's the overload of things over time that tend to cause problems.

26:11Dr. Ann Shippy:So most people, when I do their toxin testing, they think they're doing everything right. And then we'll test and find out that they're high in atrazine or high in BPA or heavy metals or all these things. So for the people that can test, great. And if they can't, starting to minimize the exposures by using things like environmental working group and looking for where the chemicals are, eating the healthy foods that actually support the detox pathways. But then I think most people really benefit from doing some liposomal glutathione and some liver support and some binders for at least three months.

26:52Dr. Ann Shippy:And I describe a lot of that in the book.

26:54Dr. Mark Hyman:So what you're talking about, Anna, is basically a systematic way to help upregulate your body's own detoxification pathways through specific foods, certain supplements, certain lifestyle practices, saunas, all kinds of things that binders to bind the toxins. And there's a method to it. And it's not something we learn in medical school, but it's something that I think I've used personally when I had mercury poisoning and other various kinds of toxic stuff.

27:18Dr. Ann Shippy:Me too, when I had toxic mold.

27:20Dr. Mark Hyman:Yeah. And so, you know, it works. And it's something that requires some level of education, awareness, and specificity, but it actually can help you reduce your total body burden quite significantly. And I think there are even more advanced protocols, like intravenous protocols of IVs and things like phosphatidylcholine, but those are harder to access and they're more expensive. But honestly, in a perfect world, I would put everybody through a six-month detox program, get their metals out, get their pesticides out, put them on an aggressive detox program, IVs, saunas, gut binders.

27:56Dr. Ann Shippy:I think that's the next thing we do is we just open these centers that have this level for people that need to. But what I see with my patients, because not everybody can do that, and what I wrote the book for is so that people know how to do it safely. And, you know, I'm starting to even think about how I'm thinking about this because so many young women that I'm running into, they're like 28 or 30. They haven't met their person yet or they're deep into starting their career and they want to wait. And they're seeing everything on social media and what's happened with friends that are a little older.

28:31Dr. Ann Shippy:And so I also think that rather than going and putting your eggs on ice kind of thing, if you do take some of these steps, you can preserve your fertility based on what I'm seeing in my mid-40-year-olds. Sure.

28:43Dr. Mark Hyman:I mean, sure. I mean, the body has this incredible capacity to kind of repair, heal, and to renew. But also, you know, I think it's important not to wait too long.

28:54Dr. Ann Shippy:Yeah. No, I mean.

28:55Dr. Mark Hyman:I think a lot of people struggle and they wait and then they end up, you know, just.

28:59Dr. Ann Shippy:It's a lot less stressful. Yeah. If you do it in your, if you have your kids in your late 20s or early 30s. Yeah. But I don't want people to feel like there's this pressure, like save for IVF or, you know, make sure you get your eggs harvested. And I want to change that conversation. I'd rather people are actually putting their efforts into lowering inflammation and toxins in their body and, you know, really supporting their fertility with some of those supplements. You talked about the repomyosin. And I think some of the supplements that work on some of those same pathways, like CoQ10 and NAD and some of these supplements that are so reasonably priced and very available for most people, can do a lot of those same things without the level of risk.

29:48Dr. Mark Hyman:Yeah, I mean, Michael Eisenberg, the standard professor, is involved with a company called Swim Club, which is basically about supplements that help male fertility and sperm health.

29:57Dr. Ann Shippy:Because there's so much good data around this now. Like there really are supplements. So we talked about getting the diet dialed in, making sure the toxins are taken care of. And then there's, yeah, there's so many good nutrients for enhancing.

30:13Dr. Mark Hyman:Are they different for men and women? Or like, how do you think about it? And how do you think about testing? And how do you think about evaluating what people need and what the things that are most evidence-based that are out there?

30:23Dr. Ann Shippy:So I really feel like this area is evolving. Like as I was writing this book, there were a number of studies that came out to look at this. And there was actually another one even on ashwagandha that came out recently for sperm health. So it's such an evolving area and the quality of the studies can be mixed. But I really find that there's so much good research around the mitochondrial function. So most of the nutrients that support mitochondrial function, the little organelles in the cells, I'm sure your audience is very, I've heard about mitochondria ad nauseam, but yeah, there are a few people that might be listening that don't know what mitochondria are.

31:08Dr. Ann Shippy:They're the little energy makers and they quelch certain types of inflammation in the body. Pretty much everything that supports mitochondria supports fertility. So CoQ10, B vitamins, NAD. You and I both have had such a dramatic assistance from the supplement phosphatidylcholine in our bodies. It turns out there's a lot of really good data behind phosphatidylcholine being good for both men and women's fertility. Like if I could just beam out supplement to everybody who wants to protect their fertility or enhance their fertility, everybody would get phosphatidylcholine.

31:48Dr. Mark Hyman:And that's basically like a fatty substance that's part of your cell membranes that helps both your regular cells and the mitochondrial membrane, right? So you've got, it's basically providing the infrastructure, like the building blocks, the bricks for your cells to work.

32:02Dr. Ann Shippy:For cells and the mitochondrial membranes. And that's such a fun area to be able to measure and see the difference in how the cells and the mitochondrial are performing. So, you know, you and I have both seen such turnarounds from our patients that are super sick with autoimmune disease and neurological diseases and all the things. Yeah. And then, of course, it works for healthy babies and fertility, too.

32:29Dr. Mark Hyman:Yeah, well, energy is everything, right? If you don't have energy, you can't do anything in the body. And if your energy system isn't working, then, you know, it's tough. So I think it's really important that people understand that this is not like a passive process, that it really requires some thought and planning and preparation. And it's not to guilt your people or to have a moral judgment. but you know having a healthy baby is unusual today i mean one getting pregnant is hard and two having a healthy baby so it's not just about the conception part it's also about you know what you mentioned a little earlier which was epigenetics and i want to sort of double click on that a little bit because you know people may not really understand the implications of that everything we do washes over our genes every thought we have every right of food we have every our sleep, exercise, environmental toxins, emotions, all of it is communicating in real time with our genes in ways that program them for health or disease.

33:32And so the good news is

33:34Dr. Mark Hyman:it's changeable. The bad news is if you don't do anything about it, it can be a problem.

33:40Dr. Ann Shippy:It can be devastating. Yeah.

33:41Dr. Mark Hyman:And you mentioned generational effects. I think, you know, when you've talked about generational health as a subtitle of your book, I wanted you to talk about that.

33:48Dr. Ann Shippy:Yeah, you're making me think of a really powerful patient example. So you and I both love taking care of families in multiple generations. So as you were talking about that, you made me think about this couple that brought me their children like 10 years ago when they had one child with autism. It was about four and fairly severe verbal. but, you know, lots of issues. And then another one who was a year and a half and had developed pretty severe autoimmune encephalitis, so PANS pandas. We found that they were in toxic mold and had, you know, methylation. So, you know, some genetic predispositions to not clearing toxins very well, some glutathione.

34:36Dr. Ann Shippy:We found a lot of things with them, and we got them out of that dilemma, right? So now this little girl is, she's like leading her class kind of thing, and the little boy doesn't have any signs of autoimmunity. But in the meantime, then I got to help the parents. And they had had to go through some IVF to get these kids, but we got the parents tuned up. And so then at 42, they ended up with the surprise number three. Oops. That they weren't expecting because they had gone through infertility with the first two. And then also, you know, it was a little alarming. Like, were we going to get a healthy baby at 42?

35:11Dr. Ann Shippy:Well, this little girl, she's five now, and she is so unbelievably healthy. Wow.

35:22Dr. Mark Hyman:Because you kind of got them healthy.

35:24Dr. Ann Shippy:Because they got healthy. So they were some of my teachers and what's important when I was writing the book among many of my patients. But it's so inspiring because infertility issues, like children get their bodies tuned up and they accidentally get pregnant. Yeah, I see that a lot. I see it a lot.

35:42Dr. Mark Hyman:People don't think about how they have to get themselves healthy first. But it's a great story because I think it sort of speaks to the reversibility of a lot of these problems.

35:51Dr. Ann Shippy:Well, and I think so many couples, they're going into this seeing, you know, either their siblings having children with health issues or their family or their friends having infertility or problems. So they go in already thinking, oh, we might fail. And so that's why I love sharing these stories, because just having that hope that if you put this effort in and actually press the pause button, take the time, don't rush into getting pregnant. Take the 3, 6, 12 months to really prepare your body. It can really make a difference between what you have to go through with your kids, because it's so hard to have a child with the neurodevelopmental delays or the autoimmunity.

36:36Dr. Mark Hyman:and it's it's a little disturbing i mean one in six kids now has some type of neurodevelopmental problem whether it's learning disabilities or asperger's or add or autism or anywhere in that

36:49Dr. Ann Shippy:whole spectrum it's escalating i i think without this kind of effort and that's why i really i called this book the revolution because i want people to really start like it's non-negotiable to think about this period of time so that we can start to see the autism decline the autoimmunity the cancer rates that we're seeing in the kids. Like, have you seen the studies on the numbers that came out on colon cancer, you know, really going up in 20 and 30 year olds? Yeah, it's frightening.

37:15Dr. Mark Hyman:We're basically threatening our whole future generation if we don't address this. And I think this is one of the most consequential books because of that, because nobody's really talking about this. We're talking about the rise in autism. What's the cause and what's going on? We know, like, it's not like a freaking mystery. Like, it's not that hard. I mean, we might not know everything about everything, but we know a lot of the foundational principles about how to create a healthy human. And that means, you know, dealing with nutrition, dealing with stress, dealing with environmental

37:46Dr. Ann Shippy:toxins, dealing with the microbiome, dealing with mitochondrial dysfunction, all the things

37:51Dr. Mark Hyman:that you talk about in your book, they're like foundational for everybody's health in general, not just sperm and egg health. Because like you said, it's just like a check engine light. It means everything else is not good too.

38:01Dr. Ann Shippy:And I think by doing this work before starting or growing your family, you also change the trajectory for your own longevity, right? I think you're less likely to get cancer, to get autoimmune diseases, to have all these things that are also looming for people.

38:20Dr. Mark Hyman:Yeah, right. It's not like you're doing this just to have a baby. You're actually getting yourself healthier and there is benefits to that. You're going to feel better. You're going to have less chronic disease.

38:28Dr. Ann Shippy:Well, and the other thing that I've seen is that when couples do this, the women are less likely to have the postpartum issues. Like, they just sail through the postpartum period. I still like to do some testing and make sure they're getting tuned up. And, you know, after the first month or two, we're replacing nutritional deficiencies and double checking to see what all the hormones did to their microbiome and things like that. But it just, it actually helps people to be in a place where they can enjoy their families more and be present and have, you know, delight in growing their family.

39:04Dr. Mark Hyman:Yeah. I mean, if you're not healthy, it's hard to show up for your kids, right?

39:06Dr. Ann Shippy:Exactly.

39:07Dr. Mark Hyman:And just kind of looping back a little bit to the epigenetic stuff, I think I want to kind of emphasize it because it's generational. And what you do now actually could affect your grandchildren.

39:18Dr. Ann Shippy:I think that the PFAS testing is one of the biggest things. I think you offer it through Function Health. Yeah, Function Health.

39:25Dr. Mark Hyman:We do add Function Health.

39:26Dr. Ann Shippy:Yeah, I think that's one of the most interesting pieces of epigenetic data for generational health that's out there now. We know that the PFAS can dramatically, like just exposure to the sperm and the egg, can dramatically affect the possibility that the child's going to have to deal with obesity. Yeah.

39:47Dr. Mark Hyman:Those are forever chemicals, right? And they're obesogens.

39:50Dr. Ann Shippy:So, and probably for future generations, like it's looking like those epigenetic switches that get passed on at conception can impact not just the baby, but their children as well. So the best analogy that I can think of are the DES children, right? The children that were exposed to the DES chemical in utero. It's a similar thing where, you know, I just had a new patient the other day where her grandmother had had the exposure. And now we're like, oh, well, let's kind of look at how this might affect your fertility. So she's just starting to think about having babies. So we're going to delve into that.

40:31Dr. Ann Shippy:We see that.

40:31Dr. Mark Hyman:I mean, we see this in animal studies because, you know, it's hard to poison a human on purpose. But we're all poisoned anyway, but on purpose. And they do this with animals, like with mice. And they see that there's transgenerational effects. If the grandmother mouse had glyphosate or a weed killer or Roundup, their grand little baby mice are affected. Their risk of hormonal dysfunction, of cancers, of kidney issues. It's kind of disturbing. And we're not really addressing this as a medical profession, as a society. And we have to, because if we don't, we're going to see a very sorry generation coming up.

41:11Dr. Ann Shippy:So you and I both love data. We're so nerdy, so we love to test. But I know not everybody has access to that. So if you can at least follow the checklist of things. I mentioned the packaged foods, but it's in the clothing. It's in our sofas or carpeting, all those kinds of just nonstick surfaces. I'm not sure that any nonstick pan is healthy. Don't feel safe with them. I think we need to be using— I use cast iron. Yes. Or stainless steel. So eliminating the exposures that we can figure out and then helping our bodies to detoxify. like that three, six, 12 months before and between pregnancies, I think is going to give people a much lower likelihood of passing on those epigenetic changes.

42:05Dr. Mark Hyman:And there are ways that people are thinking about, okay, what are the tests that we need to do? What are the biomarkers we need to do? Because, you know, at Functional Health, we create a panel of biomarkers that includes a lot of the foundational things that you need to know, like a lot of the core nutritional things that are important, a lot of the hormonal factors that affect fertility, the immune factors, checking for inflammation, And also we can look at PFAS, you can look at BPA, you can look at heavy metals. Should people be doing that?

42:30Dr. Ann Shippy:Absolutely. Every test they can possibly do, as well as looking at their microbiome, as well as if they can do mitochondrial function so they know if they need to do something there. Autoimmunity. There's so many people that have the autoimmune process going on, but they don't have any

42:48Dr. Mark Hyman:low grade disease yet.

42:50Dr. Ann Shippy:So I really like people to do a detailed autoimmune panel.

42:53Dr. Mark Hyman:It's incredible. I don't know if I told you this, Anne, but in function, we've got 400 ,000 members go through it. And a good third of people have some degree of autoimmune disease or pre-autoimmune disease. It takes years for enough tissue damage to happen.

43:10Dr. Ann Shippy:I pretty much screen every patient because it's usually fat dysfunction. It's the immune system just being confused. And as it's working on something, a low-grade infection or these environmental toxins that are building up, and then it gets confused and attacks itself like the thyroid or the DNA. You know, I had a run-in with Sjogren's after I had my second baby. Totally gone now, along with basically antiphospholipid syndrome. Also completely gone now.

43:43Dr. Mark Hyman:This is important. What everybody should pay attention to is what Anna is saying is she had a whole bunch of auto antibodies. And by the way, so did I. And we're trained in medicine that once you have them, they never go away. But that ain't true.

43:58Dr. Ann Shippy:Well, so what we're trained in medicine to do. So I, you know, I'm two years into my internal medicine practice. I can't have a conversation without having some piece of gum or mint in my mouth. And my eyes are so dry, I couldn't wear contacts anymore. And so I did an autoimmune workup on myself. And I found I had those antibodies along with the antiphospholipid antibodies, which means I was at increased risk for having a heart attack, stroke kind of thing. Right. And so I, you know, I've had my training and I know I still go see the specialist, the rheumatologist and get the answer I expected.

44:40Dr. Ann Shippy:Like the only thing to do is to put you on immunosuppressants and then go away. Right. So that was actually perfect because I had had a baby in med school, a baby in residency in my 30s. And I was kind of had a one year old and a five year old when I was done. So I went into standard internal medicine practice. I was off my path. I hadn't found functional medicine yet. So it was perfect because I was like, oh, wait, I've got to solve this. So that was right around the time that IFM started being a little bit more visible. Found them, went and did my first course. It was all they offered at the time.

45:15Dr. Ann Shippy:It was just the one week. When was that? About 21 years ago, I guess. Wow. So then I started implementing everything I learned and reversed my autoimmune markers, which was great because then I could hold that from my patients, right? Just because you have Hashimoto's thyroiditis or just because you have lupus doesn't mean that you should just bandage your system with the immunosuppressants. We need to figure out why your immune system's confused and help your body get your immune system back into balance. So it's been really fun. and then every once in a while I'll just double check myself because I know I don't have to have symptoms, right?

45:52Dr. Ann Shippy:And my autoimmune markers are perfect.

45:55Dr. Mark Hyman:It's true, it's important. Like the diagnostic workup to make sure you're okay before you have a kid is important. And that's why with Function Health, we do include autoimmune biomarkers, which are not typically part of your checkup because I think they should be screened because there is a phenomenon of pre-automunus. It's like pre-diabetes or pre-hypertension. And it's not that they're really pre-anything, they're just...

46:16Dr. Ann Shippy:They just don't have full-blown disease yet.

46:19Dr. Mark Hyman:Something's going on. It doesn't mean it's normal. And most doctors will dismiss and say, well, you don't have any other symptoms. It's nothing. It doesn't mean anything. It's not true. It's so not true.

46:28Dr. Ann Shippy:It means your immune system's confused and attacking itself.

46:30Dr. Mark Hyman:It's like if your blood sugar is 99, but 100 is prediabetes. Like, is 99 actually okay? No.

46:37Dr. Ann Shippy:And it is one of the things that can be the trigger for infertility.

46:43Dr. Mark Hyman:Yeah.

46:43Dr. Ann Shippy:And I think it's also letting us know that there's epigenetic markers that are not going to be great for the baby. So I've had a number of patients now where I'm thinking about one in particular where she had failed IVF so many times that they told her don't do it anymore. and she came in, we worked her up. She had an undiagnosed autoimmune thyroid situation along with some shifts in her microbiome, some toxins, you know, worked up the whole thing. She ended up getting pregnant naturally and then she was nursing that baby and ended up getting pregnant with twins. Didn't learn the lesson. pregnant with number four.

47:32Dr. Ann Shippy:So she ended up with four children under the age of four after failing IVF. I hope you talked to her about birth control. Her husband finally, they decided four was good.

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49:48Dr. Ann Shippy:That really taught me about how important the autoimmune piece was in the infertility and then how incredibly fertile, because, right, you're not supposed to be that fertile while you're still nursing. But, yeah, I have several of them. I have actually had two of those patients right now that are... We did a little tune-up postpartum, you know, looking at your nutrient status and got them really dialed in with their nutrients. And then they were quite ready for the next one.

50:21Dr. Mark Hyman:It happens, right? The healthier you get, the more fertile you are. more fertile you are. That's the whole message here. If you want to be fertile, you have to be healthy. Infertility is not a disease. It's just a sign that something else is going on in your body that you can address. And it's not directly treating your hormones, which is basically what happens with IVF treatment. They just plow all these hormones into you. They overpower your system. They cause all kinds of havoc. Often women have long lasting consequences from that. I'm not saying IVF is bad because, you know, people really want to have a baby and they can't otherwise, is okay, but like there's so much.

50:52Dr. Ann Shippy:But do this first because if you do end up needing IVF, you'll have a healthier baby and you'll have better chances at the IVF working. So it should be like prep for IVF because a lot of times then you don't even need it. I just, a new patient last week, they had failed IVF. I've just seen her for the first time and our husband came and they had been reading the book and learning about him. And so he had done a traditional sperm test for them when they were doing the IVF piece, and it looked okay. So they were just pointing the finger at her. Well, then they did this. Have you heard about the sperm QT test yet?

51:31Dr. Ann Shippy:Yeah. So he did sperm QT. It's terrible. And so now they're both patients, and we're going to get them both tuned up because the sperm QT looks at the epigenetics of the sperm and can detect deeper problems than what a traditional sperm test is. And what is it measuring? what it's measuring um epigenetic markers so methylation and histone markers of the sperm um and i i this is another thing that i hope just becomes really common as part of this um probably the longevity conversation like is your can we use sperm as a biomarker for men okay all

52:07Dr. Mark Hyman:right i i actually have a true confession here i wanted to figure that out and i did that sperm QT test. You did? I did. And I got excellent. So I was happy to see that at 66 years old. And that's unusual.

52:23Dr. Ann Shippy:I mean, I think that's going to be one of the mixed blessings of what you've gone through the last two years, right? Because it got you to even dial in your health even more.

52:32Dr. Mark Hyman:Yeah.

52:32Dr. Ann Shippy:Wouldn't you say in some ways you're healthier now than ever?

52:36Dr. Mark Hyman:Yeah, for sure.

52:37Dr. Ann Shippy:And so that's so great that you can see that in that biomarker.

52:40Dr. Mark Hyman:Yeah, because I understand that it's a biomarker. Even if you're not wanting to have a kid or not planning to have children, you know, it's like checking your blood pressure. Checking your sperm health is a way to see if you're otherwise healthy or not. And actually, Michael Eisenberg from Stanford on the podcast, he talked about exactly this issue. He said, you know, it's a biomarker of your health. It's like a vital sign.

53:01Dr. Ann Shippy:It's like a vital sign. It may be an easier way to even know, is there a toxin we need to go look for? Is there a disruption in your microbiome? Do you have a low-grade infection someplace? Do you have some autoimmunity brewing? I think it's kind of an easy way to see what's going on.

53:18Dr. Mark Hyman:Yeah, I mean, I'd encourage everybody to listen to that podcast with Michael Eisenberg, but I think your message is very much the same. It's like, don't just look at the woman. The guys have the problem. And often the woman gets all the hassle and the blame.

53:30Dr. Ann Shippy:And have the opportunity for this preconception period, right? It's like part of how we have a healthy pregnancy, how we have a healthy baby. It's like such an untapped potential for couples to help them actually have a healthy family.

53:47Dr. Mark Hyman:Yeah. It's so true.

53:49Dr. Ann Shippy:That's so great, Mark. I love hanging out with you. I love that you did that.

53:55Dr. Mark Hyman:Oh yeah, whatever. I'll try everything. I want to know everything. I want to test everything because I'm just curious and it's what my job is anyway. So I want to learn about tests. I want to do for my patients. So I always do it myself and I learn a lot and, you know, I see areas that are problematic. You mentioned something earlier I want to kind of come back to and see if you can dive in a little bit on the research on this. We've heard a lot about NMN, NR, NAD as this longevity supplement. David Sinclair has done a lot of research on this and I heard him once talking about this and I read about it in his book, Lifespan, where he basically talked about these female mice who he gave NMN to, which is a precursor of NAD, which helps mitochondrial function and DNA repair and inflammation and blood sugar regulation and a whole bunch of stuff.

54:44Dr. Mark Hyman:And he said these mice reversed menopause, or he called it mausopause. But what is the data on these?

54:52Dr. Ann Shippy:Of course, I'm not doing anything in isolation. I don't have the mice that I can look at and just see what NAD does. But so many of my patients for so many different things, I use the best form of oral NAD that I can. And for the patients that are willing to come and do the NAD IVs, I found a source for that, that I get just such great results. And then I combine it with phosphatidylcholine, orally and IV if we can, really good forms of CoQ10, the B vitamins, all the things that really support the mitochondria. And I think this is part of why I'm seeing such good success because the mitochondria are such an important piece of the sperm itself.

55:38Dr. Ann Shippy:I'm doing an online course for, you know, kind of the people between me, the people that want more of me than what they can get just from reading the book. And yet they can't come see me as a patient. So I've just started this and, you know, showing them the picture of the sperm that have all the little mitochondria lined up after the head so they can, you know, be inspired to support their mitochondria. And then the ovaries, like the ovaries just need such good mitochondrial support. And then I just see this. Like I had a patient today who's 55 and she's doing all the mitochondrial support. You know, she's taking the MitoQ, the CoQ10, the NAD, and she's 55 and she's still having regular periods like every 28 days.

56:28Dr. Ann Shippy:And I think it's because we've really, you know, she had some family history for things that we wanted to really get ahead of with some dementia and heart disease and those kinds of things. So I'm like, OK, let's really have your mitochondria be some of the focus. So I think the NAD is really, really a powerful piece of this. and then there's a study that came out where they did the NAD IVs you know like a 10 pack of them and showed that it did help significantly with fertility and again I don't want people to feel like they have to do the NADs but if you're in a situation you know you're 40 and you want to have a baby next year then think about doing the NAD IVs.

57:11Dr. Mark Hyman:Yeah all such important information you know the importance of nutrition the role of toxins your microbiome mitochondria but You know, there's another piece to this, which is this stress of trying to have a baby when you can't have a baby. And I've seen this over and over again. And as soon as couples give up, they get pregnant. Like as soon as they deal with it. Because it's such a stressful process.

57:35Dr. Ann Shippy:I personally, in one of those babies, my mom had the papers to sign for adoption. And then she got pregnant at 32.

57:42Dr. Mark Hyman:Yeah. And I think, you know, I remember before I even, back in the early 90s.

57:49Dr. Ann Shippy:i i took a course at harvard that was a mindfulness one yeah with herbert benson and he had a he had

57:56Dr. Mark Hyman:a woman come and speak who was a harvard professor her name was ali domar and she wrote a book about this and it was really this mindfulness-based stress reduction essentially meditation group for 12 weeks where they learned about stress management stress reduction and their results in terms of pregnancy were the same as IVF, like, or better than IVF. So basically, I thought that was fascinating. And I'd love you to sort of speak a little bit about that piece of it, because I think families, couples, women especially get very, very burdened by this feeling of not being able to conceive, and it actually makes it all a lot worse.

58:37Dr. Mark Hyman:And how do you help them think through that?

58:39Dr. Ann Shippy:I think this is important for everybody listening, not just for people that want to start to grow their family. Like it's such an important driver for health. So, and it's something that I really do address in the book, but, you know, we have something called the cortisol steel, where when we're stressed, we make more cortisol and it basically slurps up the estrogen, progesterone, testosterone, and uses the precursors for making our hormones into cortisol. And so one of the best things that we can do is to meditate. It was so funny because I was just having a conversation with one of my office staff today when we were both grabbing a cup of tea about the importance of meditation.

59:24Dr. Ann Shippy:And she's like, but I can't do it. I'm not good at it. I start stressing out about whether I'm doing it right. And I reassured her that just the intention of meditating will start to change your biology. And just letting your body know that it can be for a moment without doing will start to change the brainwaves that you make.

59:47Dr. Mark Hyman:Even thinking that you could do meditation, not meditating, or actually meditating.

59:52Dr. Ann Shippy:Actually meditating. But, you know, it's so normal for your brain to get distracted and start solving a problem or making a grocery list or reflecting on a previous conversation. But that's okay. That is normal. If you just, when you notice that you're in a little different place if you just gently bring yourself back to the meditation, whatever. And it doesn't really matter whether you're doing mindfulness, centering prayer, Joe Dispenza, any kind of meditation has really good research behind it. So it's a matter of just finding a type of meditation that you like and actually doing it. And it doesn't even have to be long.

1:00:31Dr. Ann Shippy:Even five minutes will start to change your biology. Ideally, it's 20 minutes once or twice a day and then for people that really want to get more nerdy about it you could um you can do neurofeedback i i personally find neurofeedback fascinating and have invested a lot of time and money and equipment and you know going and doing um week-long neurofeedback great four years of four years and i've done four or five times um and i have a muse a um a sensei which is one of the newer feedback devices. I have the equipment that you spend 20 grand on because I find it so impactful.

1:01:14Dr. Mark Hyman:Wow.

1:01:15Dr. Ann Shippy:I think, you know, sometimes when we go through these health crises are like almost dying, like both of us have done multiple times, that our brains can really get stuck in something called limbic state where we can't like we're just stuck in high beta and can't get into the alpha theta brain states very easily um one of the best things that we can do is go and do some neurofeedback to help our our bodies know that we're not running from the tiger anymore we're not needing to be hyper vigilant and we can actually start relaxing and enjoying our lives again It's so important for fertility, healthy pregnancies to find something that you really enjoy.

1:02:02Dr. Ann Shippy:It can just be a guided meditation. It can be a prayer, a mantra, something that gives your body a few minutes every day to relax.

1:02:12Dr. Mark Hyman:It's just such a hopeful conversation. Just the simple idea that there's actually something you can do rather than just going to a fertility doctor, crossing your fingers and going through tens of thousands of dollars of the treatment with all kinds of pokes and prods and injections and it's like wait stop like let's try something else first not that we can't use IVF as a last resort but it shouldn't be the first step and I think in your book really lays out very carefully how to think about all the different things that you can address from fundamental lifestyle factors to detoxification to addressing mitochondrial function to identifying all those pieces in a very simple way that people can use so and i thank you for writing this book where where can people find out more about you about your work about the online

1:03:01Dr. Ann Shippy:course like tell us tell us more uh so my website is andshipemd.com uh the book is available any place that books are sold. It's easiest probably to get on Amazon. And we're just constantly putting information on Instagram and any place that I'm found. So thanks so much for having me. What about this course for people listening?

1:03:23Dr. Mark Hyman:Like, I can't see you.

1:03:25Dr. Ann Shippy:Oh, the course is, we've started a separate website called Every Baby Well, because that's That's my dream is that all babies are born healthy. I was pregnant with my first son. Oh, gosh, this makes me feel really emotional. This is what I wish I had known before I got pregnant. I was in medical school. I was doing my first rotation, third year of medical school, eight months pregnant at Herman Hospital in Houston. And it was devastating to see these children suffering when the hormones were just flowing through me. Like, this is what I wish I had known and what I want every parent to know before they get pregnant on what to do.

1:04:08Dr. Mark Hyman:So everybabywell.com. Everybabywell.com.

1:04:11Dr. Ann Shippy:You can find information about the course. And so I'm loving it so much. I love seeing patients individually, but what's really interesting is how the people in the course are wanting to help each other already and be encouraging of each other. So I really feel like we're going to build this community of parents-to-be or people that are growing their family that all want to really be implementing this healthy lifestyle, have these tools in their toolbox so they can have healthy families.

1:04:42Dr. Mark Hyman:Well, thank you, Anne. Thanks for your dedication and all the work you do and the book and everybody definitely get a copy. Thanks for being on the podcast.

1:04:50Dr. Ann Shippy:Thanks, Mark. Thanks so much for supporting this mission of healthy babies.

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1:06:03Dr. Mark Hyman:If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Dr. Mark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to The Dr. Hyman Show wherever you get your podcasts. And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on The Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic and Function Health, where I am Chief Medical Officer.

1:06:34Dr. Mark Hyman:This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness Center at ultrawellnesscenter.com and request to become a patient.

1:07:07Dr. Mark Hyman:It's important to have someone in your corner who is a trained, licensed healthcare practitioner and can help you make changes, especially when it comes to your health. This podcast is free as part of my mission to bring practical ways of improving health to the public. So I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening.