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Everything you know about egg quality is a lie {A Fertility Expert’s Experience!}

In this video, Aimee Raupp and Dr. Zaher Merhi talk about epigenetics and the fact that you absolutely CAN improve your eggs.

SEE THE FULL TRANSCRIPT BELOW:

Aimee:

Hi everyone. How are you? Hello, hello. Let’s let some people roll on. I’m going to have a sip of my tea. Okay. Yes. So tonight, well it’s tonight here on the East Coast. I am bringing on Dr. Merhi and we are going to talk all about egg quality, whether or not you can actually improve it and epigenetics. So it’s going to be a great conversation I think, with leading edge reproductive endocrinologist and myself. And for those of you that don’t know, we’ll wait for Merhi to pop on. Dr. Merhi is a reproductive endocrinologist. He has practices in New York city, Long Island and in Westport, Connecticut and I myself am an acupuncturist and herbalist. I’ve been in private practice for 17 years. I also have studied Western medicine, neuroscience, yada, yada. I wrote these books, namely this one. Yes, you Can Get Pregnant.

Aimee:

And Dr. Merhi and I are working together now in his Westport clinic and then soon in his New York city clinic as well that some of my fertility acupuncturists will be seeing clients from his office. So we love working together. I see you’ve joined Dr. Merhi and you have to ask to join, I think. Oh, did you? Let me see. Oh, you already did. Sorry. Sorry. I missed that. Anyway. Here he comes. I’ve seen Dr. Merhi already today. I gave him acupuncture this morning. Hi.

Dr. Merhi:

Hi Aimee I feel great.

Aimee:

How are you? You feel good?

Dr. Merhi:

I feel great.

Aimee:

The acupuncture felt good?

Dr. Merhi:

Thank you for the acupuncture.

Aimee:

Well, thank you. I got some stuff done at his office today and he got some acupuncture from me. So you made it home okay. Right? You were just-

Dr. Merhi:

You bet. I just got home. I’m here just on time.

Aimee:

I feel like I was just there and you were just there. All right. Hi. So I told everybody that we’re going to be talking about egg quality, whether or not we can actually improve it. And how, I guess it’s linked to epigenetics if you will. But we discussed this morning while he was on the acupuncture table what we were going to talk about today. And I think obviously epigenetics and egg quality are closely linked, but let’s hear your take on it or typically like if a woman comes in and says to you, “Can I really improve my egg quality? I’m not making to blastocyst or maybe I’m not getting any PGS normals or having miscarriages and they’re chromosomally abnormal.” What would you tell her?

Dr. Merhi:

The answer is yes. So now with the egg or with anything in the body, there is two things. There is genetics which we all know. It’s like a code you’re born with and that’s it. And there is now something called epigenetics and that’s why I wanted to link both to talk about the egg quality. The epigenetics, epi means above and epigenetics is above genetics. It’s actually what controls the genes inside the DNA. So I can have five fingers. So this is my code. That’s great. I can put a ring, put a ring here, that’s epigenetics. I’m changing. Even though I have the same fingers, I’m changing how they look and-

Aimee:

Changing the expression, right?

Dr. Merhi:

Exactly.

Aimee:

The phenotypic expression is what we say in the scientific world. But to all of you, it’s whether or not that disease is going to manifest or whether or not you’re going to age before your time or maybe even delay the aging process you could say.

Dr. Merhi:

That’s right. So back to the egg quantity, the egg maturation and egg quality, there’s two parts for the egg, there’s the nucleus. Like the egg that we eat, the yolk and the white. There’s two parts of the maturation, the nucleus, which is the yolk and the white. Both of them have to be good in order for the egg to have good quantity. Now, the inside, which is the nucleus, that has the DNA great. But the outside that has mitochondria and other things, believe it or not, when a woman ages or has any problems, medical or whatever, the mitochondria get affected and mitochondria function can affect directly the epigenetics inside the yolks. So this is when things like acupuncture, CoQ10, all that could improve the outside-

Aimee:

The egg whites.

Dr. Merhi:

The egg white.

Aimee:

The mitochondria function.

Dr. Merhi:

Exactly. In order to improve the outcome. Now step back about epigenetics. Things that we have that affect our expression and why you and I are different, a lot of us, even for twins, we can have different things due to the epigenetics.

Aimee:

100%.

Dr. Merhi:

There is internal and external factors for any expression of a gene and the internal we can not change, but the external such as smoking-

Aimee:

Lifestyle, diet.

Dr. Merhi:

Pollutants, the diet, obesity, smoking-

Aimee:

Where you live, the chemicals you’re exposed to at your workplace. So many. The bath and beauty products you use and the toxins you’re exposed to 100%. So it’s like nature versus nurture, really and the nurturing aspect, how you treat your body, how you live your life, determines that epigenetic expression.

Dr. Merhi:

Absolutely. And that’s why if I clone you right now Aimee, I wish I can do that by the way, but if I-

Aimee:

We can clone each other and then we can go to that beach we were talking about this morning.

Dr. Merhi:

If I clone on you and then I put one, let’s say in the United States and one Aimee let’s say in India, eating only Indian food, believe it or not, you both will have different health issues when you guys get older. Maybe the Aimee in America will have maybe more diabetes, hypertension. I’m just giving examples. Maybe the one there would have more cancer because she was supposed to whatever. So what I’m trying to say is that the epigenetic and the environment is very important and hence… And let me tell you why this conversation we started it is, I also get asked a lot women want to use donor egg. Again, I don’t push patients for donor eggs ever because they have the right to use their own eggs, but when they started to, say, “It’s not my-

Aimee:

I love that. Did you guys hear that? Let’s just pause for a second, that’s tweetable. Because you have the right to use your own eggs. Yes.

Dr. Merhi:

Yes.

Aimee:

That’s a tweetable moment. I like that.

Dr. Merhi:

I think so. But when they start to think about donor egg and they get emotional, that’s not my genes and not my DNA. I say, “I respectfully disagree.” And I write on a piece of-

Aimee:

I totally disagree.

Dr. Merhi:

Paper about epigenetics, because if I get egg from Aimee and put it in someone who has medical problems, let’s say I put your egg your healthy, eat diet very well. I put your egg in someone who has let’s say diabetes, hypertension, smoker and all that stuff. That baby that’s coming from that egg, because it’s been exposed to that environment and because of the epigenetics that change the DNA expression, will have different diseases or will be the much worse than, than the same act that grows inside your body. Having said that, the environment inside the uterus does have an important role on the DNA expression. And if you are-

Aimee:

We talked about the child’s palace today guys. I told him about the child’s palace and how it’s like the vessel. You still have to prepare the vessel. Even if you did donor egg, it doesn’t solve all the problems in a sense.

Dr. Merhi:

Right, right. Exactly. So that’s why I think patients again, who are thinking about potentially using donor, they should in my opinion read more about the epigenetic, it’s not just only about the DNA and which egg is coming from. You’re having your partner’s sperms if you have a male partner, you’re carrying the baby for nine months and you really are shaping-

Aimee:

Becomes you. Really becomes you.

Dr. Merhi:

You are shaping that embryo tremendously. So that’s-

Aimee:

Yeah. I always say you’re just borrowing a couple cells. You’re just jump-starting the situation. If that’s an option or if that’s a desire for a woman. But it’s still about, we still have to prepare for that transfer, we still have to prepare that vessel and make sure you’re going to give the nutrition. But I want to talk more about the yolk, if you will, the nucleus of the because that’s the genetic material that’s coming from mom and dad. And this is really even in my brain. So if that’s bad, if that’s chromosomally abnormal, can that be altered by the whites being worked on? Am I making sense? Or is that more like heritable diseases? Like if dad has cerebral palsy or something like that. Is that what it’s more like?

Dr. Merhi:

There is heritable diseases like sickle cell disease and there are Down syndrome which are problems with the egg division now.

Aimee:

Got you.

Dr. Merhi:

I want to explain this. And this is very important for whoever is watching. Your eggs right now. Even if you’re 60 years old, they have normal yolk. It’s 46 chromosomes. Now, as the eggs-

Aimee:

This is brilliant.

Dr. Merhi:

You have 46 chromosomes, your husband has 46 chromosomes. We need an embryo that has 46 chromosomes. Now the ovaries and testicles are unique organ. And that’s why they’re called reproductive system because they split the DNA into two 23 chromosome. Then 23 plus 23, they meet to make a 46 chromosome. Now, your eggs even if you’re 60 years old have 46 chromosomes when the follicle is small.

Aimee:

Got you. Okay.

Dr. Merhi:

When the follicle starts to mature, when it reaches around 12 millimeters, this is when the DNA, the white, remember the white and the york.

Aimee:

Plays the role.

Dr. Merhi:

White is actually what’s responsible into splitting the DNA equally. Now if a woman gets older-

Aimee:

So it’s like, when people say all my eggs are bad. It’s like, no, that’s actually not possible. Their eggs are not bad.

Dr. Merhi:

They are all actually good right now.

Aimee:

Good. All your eggs are good.

Dr. Merhi:

But as they mature… Correct. The DNA one.

Aimee:

All your eggs are good. I love that.

Dr. Merhi:

As they mature, the whites-

Aimee:

That’s when they get impacted.

Dr. Merhi:

If it’s are not good, it doesn’t split. And now if it’s splitting the DNA unequally, like cutting an apple, a piece that’s bigger than the other. Now you have 24 and 22 instead of 23, 23. 24 plus 23 sperm they make it to become 47, which is down syndrome. And that’s the problem with aging. Now, improving the white or changing the white. Think about it this way. The future will be any women-

Aimee:

It’s changing the white.

Dr. Merhi:

Exactly. Changing the white, even at a 60 year old can have a baby with her own egg because get the white from someone much younger, 20 years old. You’re 60 years old. Take your yolk with the white-

Aimee:

What is it called? It’s implantation. What is it called?

Dr. Merhi:

It’s called Mitochondria Replacement therapy.

Aimee:

Mitochondria Replacement. Right, right, right. Yeah.

Dr. Merhi:

Or nuclear transfer. So we take your yolk-

Aimee:

Nuclear. Yeah. Okay. I heard about it yesterday.

Dr. Merhi:

And put it in a white of someone younger if you’re 60 years old and the white that was coming from 20 year old, fuse them, then mature it in vitro maturation. Now the white is young, it’s most likely is going to split it equally into two 23 chromosomes. So that’s what the future is going to be. That’s why-

Aimee:

So what about ozone or PRP?

Dr. Merhi:

That’s exactly what-

Aimee:

Does that have an impact on the white? Do you think?

Dr. Merhi:

Absolutely. Why do we give a Human Growth Hormone? We give a Human Growth Hormone. There are a lot of people that use HGH. Human Growth Hormone affect the white. It turns into IGF-1 that’s important for the white. It makes us some because we have less growth hormone as we get older. Remember, we don’t want growth hormone because I don’t want to grow anymore. As it goes down, I’m replacing it so now the eggs are happier. The white is happy and this is how the PRP works. By the way we had the second per patient today.

Aimee:

I know. Jessica told me. So go ahead, share the story. It’s so good. So good.

Dr. Merhi:

Did that PRP last month just by sex alone. I swear to God, I can’t even tell you but anyway-

Aimee:

And how old? 42 never been pregnant, right?

Dr. Merhi:

42 years and eight months. Never been pregnant her whole life. So-

Aimee:

So almost 43, 42 and eight months. Okay.

Dr. Merhi:

She came for us to do serial ultrasound and office hysteroscopy, but we’re doing urine pregnancy test before the procedure. Thank God we did it. And like, oh my God, it’s positive. We did the PRP in March 17th. She was like, “No, no. You’re joking.” She’s like, “That’s not mine.” I’m like, “It’s yours.” So we took blood, we ran it. It was 529 her ACG.

Aimee:

Such a could.

Dr. Merhi:

She’s still in shock. So two in two days. It’s crazy.

Aimee:

PRP, and these are both women that had been trying to conceive without success for years, right?

Dr. Merhi:

And they didn’t do IVF. Try just had sex at home.

Aimee:

They didn’t do IVF.

Dr. Merhi:

So really I’m very happy for both of them really. But back to the-

Aimee:

So you think the PRP it’s amazing. The PRP that impacts the whites if you will, does it… The PRP is really impacting the ovaries to recruit more follicles or does it also-

Dr. Merhi:

There are mechanisms and it’s published. There is a lot of articles on it both and basic science lab, animal studies and human studies.

Aimee:

Someone just asked, so mitochondrial replacement therapy, ozone and PRP, it’s called platelet-rich plasma. You can check out the information on Dr. Merhi’s site, which is Rejuvenating Fertility Center or just follow him and then he’ll talk about it.

Dr. Merhi:

So I always tell my patient, if you go to PubMed, P-U-B-M-E-D which is all the medical journals in the world are published there. There’s a search place and you put PRP and ovaries, you’ll see all the recent documents-

Aimee:

So much information.

Dr. Merhi:

And PRP on there, you’ll see. Now the PRP does, it has a lot of growth factors. So it works through three mechanisms. Imagine first before we start, imagine your ovary is a lake and the eggs are the fish. As women get older, as these fish are getting older, the fish are throwing poop and whatever in the water, it’s getting dirty, toxins, whatever wastes. You know what I mean.

Aimee:

Yeah. Uh-huh (affirmative). So .

Dr. Merhi:

So you are at your break. Thank you. Now the fish are living in a water that becomes dirty and muddy and they’re not happy. So the eggs are not happy. And imagine this lake has caviar. What’d you call the egg fish at the bottom. Now, we put PRP in this lake, it does three things. One, it stimulates the fish mechanically just to move. Two, it precipitates some of this dirty stuff in the water to make-

Aimee:

The debris to go.

Dr. Merhi:

To make the water cleaner if you want. And three, it turns the fish eggs into newer fish because ovaries have stem cells and when you inject it, it turns stem cells see into new ones.

Aimee:

And that is like a whole other topic for another time. But you do not run out of eggs. Ovaries have stem cells and there’s research to support this. So this whole notion of your eggs are all gone or they go away is not true. And there’s data to support this. So it’s about activating them and I think-

Dr. Merhi:

But this is how the hair loss work thing, there are stem cells here you inject it, the stem cells turn into hair follicles. And that’s how-

Aimee:

So it’s the same thing.

Dr. Merhi:

Correct.

Aimee:

We’re going to try to wrap up in the next couple of minutes. But so things we can do now without mitochondrial replacement, if you will to improve the white, improve that outer area of the egg is obviously like diet, lifestyle, the antioxidant supplements-

Dr. Merhi:

Absolutely.

Aimee:

Things like PRP, ozone, right.

Dr. Merhi:

Absolutely. That all can definitely… Look, if each one of them adds one to 2% to the quality and improve it-

Aimee:

Yeah. It’s up.

Dr. Merhi:

I will take it. I will take.

Aimee:

Yeah. 100%.

Dr. Merhi:

And having said that, I have patients who smoked all their life and now they want to stop smoking for a few months before they start. And I say, “Your eggs have already been exposed all your life of smoking.”

Aimee:

They’ve been damaged.

Dr. Merhi:

So What I’m trying to say is, the eggs have been there since you were born, everything you’ve done and with all the bad-

Aimee:

It impacts it.

Dr. Merhi:

With all the bad things.

Aimee:

Not me. Not me.

Dr. Merhi:

The good girl. Please. So everything we’ve done throughout our life does affect the eggs because they’ve been there. So now stopping all of a sudden is not going to reverse it immediately. That’s what I saw. So that’s what I always say.

Aimee:

I say frequency and consistency. So even if you do the best, you can do like 70%, but then over time, the cumulative impact is major. And I also think too and you could correct me if I’m wrong or reword me, but I do think you could go from 38 to 43 and actually at 43, make better quality eggs, because you’ve overturned all the cells in your body and reduced inflammation and improve a lot of function.

Dr. Merhi:

Absolutely. Well, there are studies on same twins. And when they studied those twins and they put them in different places, they found that the genetics 20 to 30% only affected their [crosstalk 00:18:07].

Aimee:

Yeah. Their life. And the rest was all on epigenetics. I talk about that-

Dr. Merhi:

All that’s environmental.

Aimee:

In my first book and my second book. I find it fascinating. And I was telling you this morning, that’s what Chinese medicine has been talking about for thousands of years, we call it postnatal essence. And it’s like, you’re born was what you’re born with but what you take in from the world, like your food and your thoughts and your lifestyle and the toxins you’re exposed to and your stress levels and your sleep and that impacts how you age. So you can amplify that or you can degrade it. And so-

Dr. Merhi:

Absolutely.

Aimee:

It’s a fine tuned machine. But this whole general statement that once you’re 35, you fall off the fertile cliff and all your eggs are bad is bullshit.

Dr. Merhi:

No, actually all your eggs are good but when they mature and we want to work on the maturation-

Aimee:

So folliculogenesis. So even those 100 days of folliculogenesis impact that white. That mitochondria function.

Dr. Merhi:

Right. But that’s why different protocols, Aimee yields different outcome. That’s why we try different things. Why? Because the way you’re maturing these follicles, especially the transition, when they reach 12 millimeter, that phase is extremely important. And that’s why people say, “Oh, I did Lupron scan, or this or Clomifene.” That effect the white thus affects the division and too much shots too, much medication have been shown-

Aimee:

I agree. Totally affects quality.

Dr. Merhi:

To harm the white and more likely the DNA will split unequally. That’s why people ask me, “How can the stimulation effect the genetics?” Well, it does. Because you are harming the white thus divides abnormally, thus you’re more likely to get genetically abnormal embryos. So-

Aimee:

Eating versus slow cooking.

Dr. Merhi:

I like that.

Aimee:

Microwaving foods versus slow cooking. It’s like you take your time. You’re really like, “Oh-

Dr. Merhi:

There you go.

Aimee:

“It’s such a great stock.” You cook it down versus zapping it in the microwave.

Dr. Merhi:

That’s right.

Aimee:

It’s two different outcomes.

Dr. Merhi:

That’s right.

Aimee:

Okay. So I have something to get you. And he’s had a long day. So there’s people asking, would you recommend PRP somewhere in Southern California? So there is the place in San Diego that’s doing PRP but we have girls that travel from California to get PRP with Dr. Merhi because his pricing is much better. I’ll just say that. I have girls all over the world all over. I have a girl flying in from Paris to do PRP with him. I’ve had someone come in from Texas. I have someone coming from Oregon, California. But you can find it in your area. I would just recommend shop around, look at his site toO even do a consult with him. We have Gen 5. That’s the place in Soquel. Thank you Deanna. And then let’s see, will conventional clinics start using PRP or is it still on trial? It’s not on trial but-

Dr. Merhi:

It’s not on trial. It’s like everything else. Look, egg freezing was experimental. Egg freezing has not become hard in that text.

Aimee:

That’s such a good. Such a good point. Yes.

Dr. Merhi:

It was experimental until 2012. And this is one day SRM said, “Well, now it’s not experimental.” But people were freezing eggs 15 years before it became official by the SRM. But this is how things start.

Aimee:

Yeah, exactly. You just need to build the data and the support for it. So this is what happens when you go into perimenopause. I think that’s when they go dormant. Like you were saying, there’s fish at the bottom of the sea, basically at the bottom of the lake, they just get dormant. They actually don’t disappear. And that’s something you taught me. You don’t run on it. So they just go dormant.

Dr. Merhi:

No you don’t. Now once the ovaries-

Aimee:

And then the PRP.

Dr. Merhi:

The ovaries wants to hold on to some of the eggs. That’s why women who are post-menopausal still have eggs because once they reach around 1,000 the ovary doesn’t want to give you any more to ovulate. They hold on to them. And this is the billion dollar question as to why they hold on to these last 1,000 eggs.

Aimee:

Yes. That’s so interesting.

Dr. Merhi:

And that is why researchers are going crazy. It’s like, if we can have those eggs get activated, we can’t just only delay menopause, we can also help people get pregnant. And trust me, the NIH have a lot of grants about menopause because when women stop ovulating and those eggs start to grow, less estrogen, there is more heart disease and dementia or both and all that.

Aimee:

Well, that’s it. I almost think the PRP is beneficial regardless if you’re trying to get pregnant. It’s like it’s delaying ovarian aging in a sense. So I think it’s keeping things and the hormones more balanced and active.

Dr. Merhi:

So we do have a paper just got accepted in PRP and endometrial receptivity. It was accepted in a journal called Reproductive Sciences last week. We can share it. We also submitted another paper on PRP and hot flashes. It’s under review. Once I hear from the journal, I’ll keep you posted. But it’s very interesting because some people don’t want to take hormone replacement therapy because they can’t-

Aimee:

And this is a good option.

Dr. Merhi:

They have breast cancer or lupus or kidney problem, or they don’t want to take hormones. And with CRP believe it or not once you inject it, it activates not just the follicles, but also they produce more testosterone, the HGH, all that stuff around the ovary that can help these symptoms, improve sex drive and a lot of other things. But I’ll share the paper with you hopefully I get it.

Aimee:

I love it. Well last question. Would you do PRP to get more eggs before egg freezing?

Dr. Merhi:

The answer is yes. A lot of people do that. There is multiple studies. If you go to PubMed and look at them, that PRP double or triple the number of eggs and that’s why some people say… Again, I don’t tell people have to do it, but when they ask me, I’m like, “You actually might be saving money.” If I’m doing egg retrieval and you’re getting four eggs instead of two or 10 instead of five, because you did the PRP in the beginning, you’re doubling the number of eggs instead of having two cycles, you did one cycle and now you’re done.

Dr. Merhi:

There’s a presentation in Yale and the SRM meeting in October, 2019. It was in Philadelphia. They actually showed that PRP tripled the number of eggs, retrieved in women with very low ovarian reserve. So if you keep tripling it, you’re basically saving instead of three cycles, you’re doing one cycle. So the answer is yes, a lot of people do it before. And I have patients who do IVF in other clinics. They come to me just to do PRP before their IVF cycle somewhere else. Now it doesn’t work for everybody. I want to be straight forward.

Aimee:

There’s no guarantee. It’s just like IVF doesn’t work for everybody.

Dr. Merhi:

It might or might not work for you. I don’t Know. Until you try it. I don’t know.

Aimee:

Yeah. Okay. All right. I’m going to let you go because you had a long day and I-

Dr. Merhi:

Because Kobi is starting to get jealous. Kobi’s like, “Argh.” My dog.

Aimee:

Your dog’s getting jealous. You go. I’ll see you next week.

Dr. Merhi:

Bye Aimee. Nice talking to you.

Aimee:

We’re doing this once a month guys. So just keep joining in follow both of us on Instagram. And if you have specific questions about this live, you can DM me or DM Dr. Merhi and we will get back to you guys. And he’s also doing consults. And like I said, my team is doing acupuncture in his Westport clinic and we’ll start in the 57th street clinic to at some point. So-

Dr. Merhi:

Very soon.

Aimee:

Okay. I’ll see you. Bye.

Dr. Merhi:

Bye. Take care. Bye-bye. Bye

END TRANSCRIPT.

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