Ep 162: Sperm Health and Family Planning with Deb Valentin of Sage Wellness (Part 1)
Fertility Forward Episode 162 :
What if the key to unlocking fertility lies in addressing both partners equally? Today on Fertility Forward, we’re joined by Deb Valentin, a renowned integrative acupuncturist, herbalist, fertility specialist, and founder of Sage Wellness in Manhattan, to shed light on the often-overlooked role of male fertility in family planning. With over 20 years of experience, Deb combines Eastern wisdom with modern techniques for a holistic approach to fertility that addresses both male and female factors. We explore how lifestyle factors like stress, sleep, diet, and habits like smoking and alcohol consumption can significantly impact sperm quality and overall fertility. Deb shares small, sustainable changes that can make a big difference in fertility outcomes and emphasizes the importance of early intervention for both men and women, stressing that fertility should be a shared responsibility in family planning. To learn why progress, not perfection, is key to improving fertility and why addressing male fertility is essential for anyone on the journey to parenthood, tune in today!
Rena: Hi everyone. We are Rena and Dara, and welcome to Fertility Forward. We are part of the wellness team at RMA of New York, a fertility clinic affiliated with Mount Sinai Hospital in New York City. Our Fertility Forward Podcast brings together advice from medical professionals, mental health specialists, wellness experts, and patients because knowledge is power and you are your own best advocate.
Dara: Today on our podcast we have Deb Valentin, who is a renowned integrative acupuncturist, herbalist, and fertility specialist with over 20 years of clinical expertise in women's health. As the founder of Sage Wellness, a holistic clinic in downtown Manhattan, she has treated countless individuals on their journey to build a family. She offers personalized whole body healing for both men and women. She blends Eastern wisdom and modern integration and she uses an intuitive approach and an unwavering commitment, which has established her as a trusted leader in fertility and family planning, inspiring lasting wellness, and nurturing dreams of thriving families. Deb, thanks so much for being here today. I appreciate you taking your time out of your busy schedule.
Deb: Well, thank you Dara, and thank you Rena. I appreciate you having me on the podcast. I'm really excited to talk to you about male factor fertility.
Rena: Yes, we are so excited to hear your perspective.
Deb: Yeah, so I've been in the field for over 20 years. A little about myself, which is interesting, which I probably haven't shared with you all, you know, back when I was in my late twenties, finished Chinese medical school, it took my husband and I forever to get married. It took us seven years. We were dating. And so at that point we were like, okay, we could start really trying while we were kind of, you know, looking into the wedding. And so we tried and probably a year went by and I was also planning my wedding, so kind of wasn't really focused on family planning, but as soon as we got married we're like, okay, you know, this has kind of been a year, maybe on and off, decided to get tested. I had really good fertility. My husband actually had some sperm issues and so we went to a natural fertility doctor and we did a lot of rounds of IUIs and you know, by the time - he had some low sperm morphology - and by the time we really got to the root cause of it, he had some varicocele issues from a urologist. He went through surgery and the urologist was really excited and said, okay, let's, you know, give it another year, great blood flow. I found, you know, like three kind of like varicoceles, which was kind of enlarged testes. There's, there's a stagnation of blood flow and so he was really optimistic, but at that point it had been three years since we were trying, and so we actually decided to, I decided to actually go and speak to a reproductive endocrinologist. We have, the story goes well, we have 13-year-old twins, very busy soccer mom. But with that, I found out a lot about the fertility journey, both on just a knowledgeable level, an emotional level, every level you can think of. And I also found the pitfalls of like where we had to kind of like piece things together. And so I wanted to devote a little bit of time to male factor fertility because I feel even in 2025 we're really still focused on female fertility and I think there's many factors to that. And I think, you know, I have a lot of patients that come in that are females that wanna do everything possible to get pregnant and checking off the box. But it's interesting because you know, when you really look back into, there's some really great studies and many of them, but a couple that are very predominant that have really showed within decades and we're talking probably about one study that did a study from 1973 to 2011, which was a while ago, but showed that sperm quality has gone down 50 to 60% and that is a huge amount. And then there was another study also that showed a decrease in sperm count. And these are studies that are done predominantly in, like, the North America region and Europe, Australia and New Zealand. But what I think the most important thing is, is to ask ourselves why is this happening? And I think that is where we are kind of as a society, not really paying attention. And so really as an acupuncturist, it's interesting to kind of go back and see, okay, we, why is this happening? And so if you kind of look before the, you know, industrialized society where before in the forties and fifties and sixties, there really weren't processed foods. If you think about it, men weren't working as much. You really had, you know, the mom at home cooking stress is such a relative thing. But I do feel like there was a lot more structure in the family, you know, life that led to kind of a healthier structure. And so then you came back into going into the seventies and eighties where you had more processed foods. And now we have highly processed foods. We have more stress. We have a lot more things going on that I believe is causing sperm quality to go down. And so when you look at sperm, first of all, I just wanna let the audience know, just like eggs, sperm has three months, it's called spermatogenesis, where there's a development of sperm. So it takes three months to actually develop sperm. And the beauty of it is, and I always tell women as well, when we're looking at eggs, like we do have a window of opportunity to really increase egg quality as well as sperm quality. And so it doesn't have to be this really sad story of, you know, bad sperm. And so going into sperm, I also wanna talk about what that means. And so in a sperm analysis, they analyze different aspects of sperm and one of them is the volume, another is a concentration, another is motility and morphology. And so the actual volume of the, of the sperm of the seminal fluids is there and then the actual count of the sperm. And then you actually have the swimming of the sperm. And then you actually have the structure of the sperm isn't normal. And so when you look into these parameters, if there's not enough, you know, sperm volume, there could be an issue, right? Another thing is when a man, a lot of the sperm die off and there's kind of dead sperm, which actually can reduce fertility. And so if you don't have enough of count, there could be an issue on top of that, the sperm that's alive, there's only a percentage that are swimming at a proper rate 'cause sperm has to swim and make it up the cervix and the fallopian tube for fertilization. Then there could be a problem on top of that if the structure of the sperm. So we look at the TED and the tail and other types of structures, if that's abnormal, that can be an issue. And so what I've seen actually in interviewing women and going over sperm analysis, there's quite a few, you know, a lot of times, I mean it's 50-50%, right? We need the egg as much as a sperm. A lot of times there is sperm issues. And so it could be circumvented through IVF through ICSI where you take, you know, one sperm and you fertilize the egg, really. But if you're looking at family planning and you're looking at even IVF, we do have a window opportunity to actually help to increase sperm health. And that's what I kind of want to talk about today because I think there's a lot out there to help a quality and really focus on females, but really are we focusing on males? And so there's a lot that can be done. And so, you know, when I look at any type of case, I always go back to basics. And I always feel like we don't have to make it this complicated. In modern day society, I think Google's great, but I think we overcomplicate things. And so really the parameters are sleep, stress, the gut, is the gut strengthened and is it taking in nutrients? You know, looking at factors, I think diet is actually one of the biggest factors when I really look at any type of health. Exercise - are people exercising? Are they doing the right types of exercise? And then you look at lifestyle stress. What kind of environment are they working in? You know, environmental factors, things in the home, mold, are they near construction? So really looking at the whole picture instead of just zooming in on one thing. And so if you go into sleep in general, sleep is, I think we, we don't really focus on the importance of sleep. You know, sleep is really a time where our body actually is able to heal. And so when we get reduced sleep for one thing is why are we getting reduced sleep? And so oftentimes I see there's stress involved where people having difficulty falling asleep or they're getting up in the middle of the night. And, and so when that happens, sleep has an effect because it's a circadian rhythm. We also have an ebb and flow of hormones, which is also circadian rhythm. So with reduced sleep, it has an effect on testosterone and other regulation of hormones. And so a lack of sleep can affect sperm. And so we have that. Then oftentimes it's like, okay, why is a person not sleeping and then looking into lifestyle issues? Oftentimes, I mean, it's in New York City, but I think it's kind of worldwide, there's a lot of stress. And so I find that, you know what stress does, it increases cortisol levels that can have an effect. It disregulates hormones and predominantly testosterone which is very important for the development of sperm. Also, low testosterone can also decrease libido. And so oftentimes when men are trying to, you know, when families are, or women and men are trying to get pregnant, there's also stress involved in that. And so if a man is having a low libido or difficulty sustaining an erection, that also leads to more stress. And so sleep, I feel is such a huge component of health that's kind of thrown out the door because we live in a society really where production's really important and work's really important and emails, and we focused our life really about producing and that line of, that boundary of, okay, work life and then also your life and rest and kind of that yin and yang is completely dysregulated.
Dara: Blurred, I feel like, don't you like, don't you feel like it gets a little bit blurred? The the sleep? Sometimes people work up until sleep and then they wonder why they're not sleeping well.
Deb: Yes! And you know, it's interesting because even with people that work from home, which is great because you know, I think it negates certain types of stress. But what I've seen also is that boundary between, okay, you go to work and then you, you go home and then there's kind of two different environments with, with boundaries has gotten skewed. And so with the use of technology, people are up at night Googling, they're checking their emails. Okay? So cortisol is kind of like you're sympathetic, your fight or flight system is activated much longer. And so it's difficult to fall asleep and stay asleep. And so that stress component is very damaging to the overall health of our body. And I wanna just also step back into saying, and I say this to women all the time, we kind of compartmentalize reproductive health, right? We're like hormones and AMH and FSH and the uterine lining and we kind of like, you know, just look at that as like something separate. And I always tell women fertility health is a reflection of overall health. And same with men, you know, male fertility health is always a reflection of overall health. And so when you look at these different components and then you look at diet. And so what I've seen, and we probably intuitively know, okay, you're coming from more whole foods based diet back, what, 40 years ago, 30 years ago, into more processed foods. Okay. And you know, why did you know you have processed foods? They are low in a, they have additives in them, they low nutrients, they're not nutrient dense. And so all of a sudden we're eating things that, first of all, we're not getting the right amount of nutrients and on top of that, there's all these different things and additives that can, that have an effect on sperm. Pesticides have gone up and so that's another factor that also can, you know, have an effect on sperm. And so you have the diet that's more processed. We're living a life that we're working harder and more that calls for, you have a lot of men and women that are, you know, working and so there's less time to cook. And I understand it, I have 13-year-old, you know, twins. I have a busy practice. And so trying to always problem solve this as well. So now we're getting takeout, we're eating more just processed foods. And so what that does is we're having less, less nutrients. And those nutrients are really, really essential. The macronutrients, the micronutrients, the prebiotics, the probiotics really important for overall health and for sperm health. And so now we're seeing, okay, sleep, we're seeing rest, we're seeing diet. And then on top of that we have other factors. We have alcohol, we have smoking, we have marijuana, we have other types of, it could be drugs, it could be medications as well that people are on. And so, you know, and alcohol, that's a really big one I think. And so, and I think that's another thing that's kind of discounted. I think a lot of women are like, oh, I'm quitting drinking and, but my husband still drinks a lot. And so drinking has, I mean I think there's a lot more coming out about alcohol. And when I say that I love my glass of wine, it's not like I'm, you know, completely this acupuncturist that doesn't like to eat or have a glass of wine. But within that there's moderation. And I think that, you know, when you go a little overboard, alcohol has a direct impact on sperm and for one, it's toxic to the testes and increases inflammation so it damages the DNA of the cell. I mean it does many different things. It decreases testosterone, again, so we're talking about, you know, forming sperm, it converts testosterone to estrogen and so it also produces inflammation. And so right then and there, if, if you know, a man is kind of a, a heavy drinker, we're looking at a lot of less sperm quality from that weight gain is another thing that's really not good for sperm. Weight in general, extra fat increases inflammation and inflammation is just the destruction of anything 'cause It reduces, you know, it damages our cells. Another thing kind of going back on diet, when you don't have diet that has an array of good whole foods, you're also depleting yourself of macronutrients and micronutrients and all these things that are essential for healthy sperm. It's also things that we don't have antioxidants and antioxidants are very important that kind of prevent cell damage. And so, and when I say cell damage, you know, the air we breathe in our everyday living can have an effect on the cells. Antioxidants go in and they kind of protect the damage of the cells. And so when you look at fertility, it really goes down to these basic cell functions, the quality of the cell, the mitochondria of the cell, the powerhouse of the cell. And so when I talk to women, it's both in eggs and in sperm and that goes into really our overall health that has a reflection on our fertility health. Then we look at smoking. I mean smoking's very toxic to the body as well as sperm health. Both smoking and alcohol can increase DNA fragmentation. But DNA fragmentation is, it's actually a, like an actual sperm can look normal, but the DNA is fragmented and so it's very, it can't really fertilize an egg. And so both of these disrupt, you know, they cause DNA fragmentation, they also disrupt hormones. And so they also decrease testosterone, they increase oxidative stress and damages the actual sperm cell. So alcohol and smoking have a really bad effect on sperm. So if you take a case and you take something like where, you know, a patient comes in and they show me their husband's, you know, sperm analysis and we go through all these different factors. And say you take a normal male, say in New York City where they're working long hours because of the stress, they're not sleeping properly because of the stress. They're drinking more, they're out a lot either with clients or they're eating more processed foods or they're just not paying attention to their health as much. You can kind of have in a nutshell, okay, this is, you know, a holistic viewpoint of their health that reflects in their sperm health. And so I think there's a lot that we can do to really target men in helping them increase their overall health and increase their sperm health.
Dara: I think that's great. I loved how you touched upon, of course nutrition, the nutrition component. And I think sleep sleep's one of those areas where I think it's not spoken about too much. And I like how you brought in the importance of trying to minimize cortisol and that connection. There's definitely that big connection between stress and quality of sleep and then also what we're doing working right before, watching tv, the lights are bright…so many different factors that really can, and I do think like that's the foundation. If we don't have good quality sleep, it doesn't necessarily matter what we eat doesn't necessarily matter our exercise routine, the sleep really is, I often say like, it's like the reboot, but you said something that was really great. Like it's the chance to to
Deb: To nourish and heal.
Dara: Nourish.
Deb: Yeah, yeah. Really important. I mean, you know, it's yin and yang. It's like we have that part of the day where we're, you know, pressing the gas pedal, right? And you know, we're working, we're, you know, delivering, we're doing all these things where we're really emoting energy, you know, we do have a circadian rhythm. There's a reason why our body is meant to shut down and, and sleep and not do anything and so that it can repair and build that energy in order it builds the gas in the gas tank in order to wake up and say, okay, we need to, you know, press the gas pedal, go. So, you know, and also sleep has an effect on the gut. It has an effect on our brain. I mean, so many different factors. And so sometimes people want to have this one quick, easy, take a pill or you know, do something to just kind of mediate everything. And oftentimes it's consulting with people and saying, okay, let's look at your life and your lifestyle. And you know, I, I must say when you look at, you know, even male factor or female factor fertility, you know, if someone's drinking a lot or they're eating certain, certain foods or not sleeping, I can also say, okay, why is that? And we can pinpoint it to the root cause being stress. So that's one of the things we really have to target in order to unravel everything else. And I always let people know nothing has to be perfect. Like the body wants to heal, the body wants to be in a good place. So sometimes it's little changes, sometimes it's major changes. But if we can tackle one thing and we can really tackle, say stress, and then that can help with sleep and it can help with, you know, other things like decreasing alcohol because you know, if they're not as stressed, they're not drinking as much. And then we can look at diet and all these factors. The beauty of it is, and the great thing of it is, is I always tell people, just like I tell women, your hormone panel is just a hormone panel at that moment. Your FSH can go down, your AMH can go up, your egg quality can go up. ,we do have an ability to increase our fertility health because we're increasing our overall health. And same with men. Like the beauty of it is we have an ability to move in a direction of getting healthier, which then will reflect on fertility health in men.
Rena: This is much amazing information and of course where my mind goes, you know, hearing all this is when I think to couples and you, you know, you really touched upon lifestyle and the smoking and the drinking and how many people I work with that get frustrated because a male partner won't modify their lifestyle. And so, I mean, I just think this is such a helpful episode to share. There really is so much efficacy that it matters and there's an impact. And you know, especially for those partners, you know, men who feel like they're quote unquote like not involved or they don't really matter, they just have to go give a sample. Well, you do matter how your living matters. Everything that you are eating, drinking, putting in your mouth, putting in your body matters to this process so much more than just, you know, providing a sample. And I think it's so important for people to understand that.
Deb: Yeah. And I think this is really what this episode is also about is it is 50/50 and I, I do feel like we're still in this kind of female focused, you know, problem solving, you know, field in women and you know, I think predominantly women are more ambitious and like getting help. And so if a male really wants to have a family, then it's really important to focus on his health and it's not just kind of on the female. And so even if, you know, I often get this too, well, we're going, you know, through IVF and we'll do ixy and you know, they'll take one sperm and and put in the egg and it kind of feels like, okay, I'm off. You know? But really the quality of that sperm, I mean, you know, it goes further beyond that. And it could be fun getting healthy. I mean it doesn't have to be this, you know, I always talk to people about that. It doesn't have to be this like, oh my gosh, like this heavy thing. It's like, no, let's work together. I've talked to, you know, women as well. I'm like, it's not just getting healthy for fertility, it's getting healthy to be healthy. It's getting healthy to, you know, let's look at 10, 15, 20 years from now. If you put these things in place - if a male starts working on, you know, quitting smoking, now he's gonna be better off in the future if he works on losing weight, if he look works on, you know, having a healthier diet. So it's not just talking about just this now moment of having kids, it's like, you know, this is an overall moment to, because you know, this sperm health is again just a reflection of overall health. And so I think there's much to be said and focused like I think our society now has to really focus not just on women in fertility, really men in fertility. And I think that is a forgotten voice when you're talking in the fertility field.
Dara: I love that you said that it's not just about fertility health, it's about your overall health. And it's true, we often, you know, wanna be healthy to get pregnant, but what about sustaining pregnancy? What about the health of your offspring? What about creating this healthy environment? Yes. That, you know, you wanna be a reflection of, you know, hopefully you wanna have great habits that you can pass on to your offspring. Yeah. And be active and healthy and have a good quality of life for them. Yes. So it's, I love that continuity of care that you're really emphasizing and the approach that, you know, tackling one thing at a time. Yes. You know, you seem so overwhelming when there's so many different areas that you can make changes on. Yes. But I love that you said, you know, really focusing on small, achievable, sustainable goals and then that's one that you can build upon that it doesn't have to feel like you have to do it all at once. And the idea of it doesn't have to be perfect.
Deb: Exactly. I mean, I'm sure you all, and Rena, I'm sure you've all experienced this, that it can be very overwhelming. And I find, you know, people going on to, you know, Facebook chats and this and coming in with all this information and wanting, doing everything right and, you know, and it seems extremely overwhelming and at the end of the day, they're really stressed about it. So I kind of, throughout the years I've been doing, I've been in the fertility field for so long, my approach is a little bit differently. It changed a bit and it's really a little bit more nourishing to people's souls and being like, okay, what can we change? What would be fun changing? And what can we, and I think when, you know, especially when you sit down and even with men, when you start to sit down and say, oh my gosh, if you quit smoking, do you know in one week what your body will be like two weeks in a month? What your liver function, your lung function, your, you know, increase in blood flow to your brain. Like once they start seeing kind of also the results of that. And also really again, why are you smoking? Okay, let's go back to the stress factor and really letting people in a safe space. 'cause Some people will come, they're like, oh, I didn't eat. That's perfect diet. I'm like, it's okay. Like, let's kind of go over things and okay. So, you know, and first of all, I always say like 80/ 20, nothing has to be perfect, right? But let's go back into, okay, what happened this past week? You know, and they're like, well, work was crazy in this. So it's a lot about structure. You know, I, I talk to people a lot like on a Sunday, like what I do is I get down an Excel spreadsheet and I, I put down everything that I'm gonna cook, and then I kind of grocery shop from there. And then the nights, like tonight I'm working till eight o'clock, so in the morning I usually cook. So it's gonna be healthy, but it's gonna be quick. And so, you know, just kind of helping people with tools as partners, not just the woman, but as partners of also what the male can men can do in terms of getting healthier together. So, and small little things. So if we can just tackle diet and stress that can help with sleep, that can help with alcohol, you're getting more nutrients. And so over time, in three months, we can see a much better sperm analysis in terms of sperm health have gone up because those changes were made, but they were made in a more gentle, doable way instead of someone just saying, you have to do this and it has to be done tomorrow.
Rena: I love that. I think there's a lot of hope in that statement.
Deb: Yes.
Rena: A lot of hope. Well, I know that we're having you on again for part two of this. This was so much information jam packed into this. This was amazing. I can't wait to share this with our listeners. And you're such a wealth of knowledge and we're so grateful that you came on to share this.
Deb: Yeah, I'm really excited. I think part two is gonna be, you know, I wanted to kind of tell the audience a little bit more about, you know, the actual sperm parameters and kind of, you know, understanding that sperm health has gone down throughout the decades and the reasons being for it. And then, you know, I think the second episode, I really wanna go into what these different segments of sleep and diet and stress and all these things that we can really work on to create healthier sperm.
Rena: I love that. Well, I to to have that and share that with our listeners because I feel, yeah. We've left them, we've left them hanging with this, and to know like there's hope, there's, there's action items, there's things you can do. And I think that's an amazing takeaway.
Deb: Yes, absolutely.
Rena: So the way we like to wrap our episodes is with a note of gratitude. So something that you are grateful for.
Deb: Oh, oh. Something that I'm grateful for? Oh, there's so many things I'm grateful for. I would say the thing that I'm most grateful for is being a mom of twins. Even though life is crazy, I'm really grateful for, and I feel this every day for the people that all my patients. I'm so grateful I'm in a field… I, I go home every day. And when I say that it's people getting pregnant, it's people going through the journey of trying to get pregnant. It's working with women that have miscarriages. It's working with people that are having a hard time. So this fertility journey is not just one thing, but I feel so grateful that I picked a field that I also have personal experience and on an emotional level and creating these twins, I feel super grateful for my life and helping others.
Rena: That's beautiful. What about you, Dara?
Dara: When I'm grateful for today at this moment is my morning routines. I'm working, my new goal has been to really try to set my mornings off on the right foot to get me in a great space to work, to be my best self, to be present, to be a good mom, friend, wife. And so I'm really grateful for giving myself some extra time in the morning before all the, the to-dos. To be by myself, to reflect, to talk to God, and to, you know, reflect on a lot of the gratitude that I have for the day before and for the day to come. So
Rena: I love that. Beautiful.
Deb: I do the same thing.
Dara: I love that. And how about you Rena?
Rena: I guess, guess I'll piggyback off that 'cause I have let my morning practice slide and it's been, I've been feeling very stressed and crunched with time. So I was reflecting yesterday and I said, okay, what can I do? And I said, I need to rejoin the 5:00 AM club so I can get up, I can meditate, I can do what I need to do to be centered. So I was very tired when my alarm went off this morning, but I got up, I rejoined the 5:00 AM club and it's feeling good. You to have that space for self is really important.
Dara: I love it. Amazing. Well, we can't wait to have you back on for part two, so everyone stay tuned.
Deb: Well, thank you so much Rena, Dara for having me on. I really appreciate it.
Rena: Thank you Deb.
Dara: Thank you so much for listening today. And always remember: practice gratitude, give a little love to someone else and yourself, and remember you are not alone. Find us on Instagram @fertility_forward and if you're looking for more support, visit us at www.rmany.com and tune in next week for more Fertility Forward.