See the full conversation with Dr. Merhi below!

Aimee Raupp:

All right. I'm live. Hello guys. I am live. Let's let some of you guys come on. Sorry, I'm a few minutes late. I know a lot of you set your timer for today's conversation. I am super psyched. So I am actually here in Dr. Merhi's office. Our plan was to sit next to each other and do this live, but then we realized masks and the whole thing. So we're actually sitting six feet apart. He's on the other side of the room and I'm going to invite him to join live right now. So, let's get this party started. So we're going to be talking about rejuvenating fertility. Well, I hope we don't echo.

Dr. Zaher Merhi:

COVID style.

Aimee Raupp:

COVID style. Perfect. Look at that. Okay. So hi. So nice to-

Dr. Zaher Merhi:

Hi.

Aimee Raupp:

So we've never met physically in person, but super nice to be here. And so today I wanted to talk with everyone about your awesome offerings. And first of all, his center is called Rejuvenating Fertility. So for all of you guys, he's actually got my book on his desk. For all of you guys who have read, Yes, You Can Get Pregnant, you know that I say, you're not broken. Your fertility isn't a switch that's on or off. You just need some fertility rejuvenation. And then now he has a center called Rejuvenating Fertility, which I just think is awesome. And so I was here last week [inaudible 00:02:40]. So I was here last week and I tried ozone for the first time. Super duper cool. So he has a machine here that you guys saw the picture of. So tell us about ozone and why it's good for fertility and what it does.

Dr. Zaher Merhi:

Sure. So let's start with what ozone is. Now, if you look at the oxygen molecule that we breathe, it's made of two molecules of oxygen. Now, ozone has a third one. So that's why it's O3.

Aimee Raupp:

O3. Right.

Dr. Zaher Merhi:

So now the ozone, for those who don't know, there's an ozone layer around the earth that protects the earth from the UV light, from the sun and so many other things. Now, ozone back in World War I, they started to use it as an antiseptic because they needed to sterilize things in surgeries or whatever. So they started to use ozone. And since, with time, it became ozone therapy. So it started to be used for dermatitis, for eczema, for injections in the knees, [inaudible 00:03:54] for ulcerative colitis and Crohn's disease. So many [crosstalk 00:03:59].

Aimee Raupp:

So anything inflammatory.

Dr. Zaher Merhi:

Exactly. Anything inflammatory, and vaginally for HPV and other STDs.

Aimee Raupp:

Wow. Interesting.

Dr. Zaher Merhi:

Absolutely. So if someone cannot take antibiotics and have an infection, you can put the ozone catheter vaginally.

Aimee Raupp:

I put a catheter up my vagina-

Dr. Zaher Merhi:

Yes.

Aimee Raupp:

In this office last week and I'm going to do it again in about a half hour.

Dr. Zaher Merhi:

So, the ozone, we're the first to use it for fertility. I always like to have a story. It's actually one of my patients, three years ago, she's the one who told me about the ozone because she used it for her hair and other stuff. So I did some literature search and found there's a lot of studies on animal models showing that ozone therapy improves ovarian function, get pregnancy improvement in animals and also improves sperm in male animals. And this is when I started and I got the machine, the machine that we have, which we can show later.

Aimee Raupp:

Which is, you don't mind me sharing, it's like a $50,000 unit. It's a legit machine. I think that's important to share so they understand the technology that goes into it.

Dr. Zaher Merhi:

Yeah. So you sit in the machine, you sit naked and then the ozone goes through both the skin, through the skin and also you introduce a catheter vaginally and then the ozone goes through the vaginal wall to the uterus and the ovaries and get absorbed.

Aimee Raupp:

And then for men though, they sit on something right? Under their prostate.

Dr. Zaher Merhi:

Right.

Aimee Raupp:

So they don't have a catheter inserted.

Dr. Zaher Merhi:

No they don't. And so then, you sit half an hour and it's actually very relaxing and you feel warm and you feel sweating. The [inaudible 00:05:46]

Aimee Raupp:

Yeah. I had a little sweat, like as if I have an infrared sauna at home. So kind of similar, not as hot. And then also you get tingly kind of where your hands and feet are touching the metal, I suppose, where the ozone is through. But then that wears off. It was not uncomfortable at all. I thought it was very relaxing. I listened to a meditation.

Dr. Zaher Merhi:

It is relaxing.

Aimee Raupp:

Yeah. It was really relaxing.

Dr. Zaher Merhi:

So, and then you do half an hour session twice a week. Usually patients do it for three weeks or a total of six sessions.

Aimee Raupp:

Oh, okay.

Dr. Zaher Merhi:

And just to let you know that before I started offering it, the money, I did study to show that at least it worked.

Aimee Raupp:

Yes. That's what I want to talk about it.

Dr. Zaher Merhi:

You're right. So it's not fair to charge someone something that doesn't work. So I-

Aimee Raupp:

He charges, though… Can I also share what you charge? Was it 150? So, insurance does not cover this. So it's like an acupuncture session, like 150 a session. Is that right? Or is it more?

Dr. Zaher Merhi:

I'm not sure.

Aimee Raupp:

I asked last week.

Dr. Zaher Merhi:

Jessica knows.

Aimee Raupp:

Jessica knows. You are like me. I don't know.

Dr. Zaher Merhi:

I'm the worst businessman.

Aimee Raupp:

No. No, you're not. You're just focused on what you're good at. You don't need to be good at the money part. So I think it's 150 a session, which I think is really reasonable, especially if you're saying six sessions, right? So what's that? Three times $600 or something like that. No, sorry, $900. I think not at all a bad investment. So, tell us what you found in the research [inaudible 00:07:11].

Dr. Zaher Merhi:

So what I did is, women with very low ovarian reserve, poor egg quality and we were desperate to help them make embryos and have babies, they did two IVF cycles and between them they did ozone. So they did cycle one, then ozone for six sessions, three weeks, then, another cycle. And we compared cycle two to cycle one. And we found out that patients produced similar number of eggs, but significantly higher embryo rates. So the formation of embryo almost doubled from the ozone.

Aimee Raupp:

Wow.

Dr. Zaher Merhi:

So this tells us that it can improve, to me-

Aimee Raupp:

The quality.

Dr. Zaher Merhi:

The quality. Yeah, exactly. And actually one of the students who now she's in pre-med at Duke University, that was her summer project.

Aimee Raupp:

Wow.

Dr. Zaher Merhi:

And she did a great job and she presented it as well.

Aimee Raupp:

And did you have the husbands or the partners do if they were…

Dr. Zaher Merhi:

No. I do not have studies on men.

Aimee Raupp:

Okay. So you didn't do it. So that was just on the eggs. We didn't do anything on the sperm.

Dr. Zaher Merhi:

This is just on women.

Aimee Raupp:

So that's really impressive.

Dr. Zaher Merhi:

Correct. I'll try to have a study on men once things settle with this, COVID. I'd like to do a similar analysis before, then, ozone sessions, but in men you have to wait three months before you see changes in the sperm.

Aimee Raupp:

Gotcha.

Dr. Zaher Merhi:

So, I have to think about the different protocol. It could be once a week for three months or something like that.

Aimee Raupp:

And what about women? Because isn't it 100 days for follicular genesis? But you're saying the ozone is impacting even the ones that are being recruited right now.

Dr. Zaher Merhi:

Exactly. That is exactly what you said. Look, during the stimulation, these follicles are called the [pantry 00:08:57] follicles. They're going to grow, right? I always say, this is like money that you're going to spend this month. Let's say there is 10 follicles, these follicles they're small. The way you grow them, that's why the medication affects the egg quality and quantity, whatever. So, same thing. If you're exposing them to ozone, which is a very powerful anti-inflammatory and antioxidant agent, they might grow in a healthier way, similar to Omnitrope, the human growth hormone.

Aimee Raupp:

Yes, gotcha.

Dr. Zaher Merhi:

There are people, exactly, take human growth hormone a week or two before the stimulation in order to improve the environment where the follicles are growing inside the ovaries. So that's how basically it works. Now, three mechanisms. I always like to talk about how ozone works. One is a very powerful anti-inflammatory agent. It works beautifully, especially for women who have endometriosis and women who have inflammation. And again, I don't have enough studies to support it, but I've had a few patients who have endometriosis who told me that ozone relieved their pain for-

Aimee Raupp:

So whether or not they're trying to get pregnant, just managing endo symptoms.

Dr. Zaher Merhi:

Exactly. Because endometriosis is basically inflammation.

Aimee Raupp:

Yes, that's all it is.

Dr. Zaher Merhi:

We all have some kind of inflammation. Number one. Number two, it's a very powerful antioxidant, like vitamin E, and D and this is with nutrition. Three, it increases blood flow.

Aimee Raupp:

That's it. Yes.

Dr. Zaher Merhi:

That's why we tend to sweat. Exactly. Now, increasing blood flow to the ovaries when you put especially the vaginal catheter, could improve, more oxygenation, basically. So these are the three mechanisms by which ozone could potentially improve the outcome in patients especially those [crosstalk 00:10:53]

Aimee Raupp:

I have a burning question, though, too. So in that same vein, if AMH is a hormone secreted by the ovaries, would you anticipate AMH levels improving using ozone? Did you see that in any of your studies?

Dr. Zaher Merhi:

That's a great question. I did not honestly measure AMH before and after. It's something to think [crosstalk 00:11:13].

Aimee Raupp:

We could do that on me. Because I actually had mine measured before I started the ozone. So we could actually remeasure it in a couple of weeks.

Dr. Zaher Merhi:

That's perfect. Well, there are things like vitamin D. Your book, vitamin D improves we reproduction. We actually have showed, we took women with PCOS or polycystic ovary syndrome, and they were vitamin D deficient, we [inaudible 00:11:34] them with vitamin D and AMH improved significantly. So, definitely there are things that improve AMH. Whether ozone is one of them-

Aimee Raupp:

We don't know.

Dr. Zaher Merhi:

Remains to be determined. [crosstalk 00:11:47]

Aimee Raupp:

But does it matter so much, right? Because it's more about, we don't really care what your numbers are. You might have different feelings, but I don't necessarily know that we care what the numbers are versus the quality of the follicles that you could maybe… Or the eggs you can retrieve or that can get fertilized naturally.

Dr. Zaher Merhi:

Look, I like AMH a lot, but [inaudible 00:00:12:14].

Aimee Raupp:

Same.

Dr. Zaher Merhi:

A lot of time, we get obsessed with the numbers and then it distract us from the goal, which is a baby. I don't care if your AMH is less than 0.1. If you have a period and you have an egg, that's good. That gives me a baby. That's all I care about. And I always tell patients and I give them the example that, a lot of women who have PCOS, they have high AMH, but a lot of the eggs are not good quality.

Aimee Raupp:

Good quality. Yeah.

Dr. Zaher Merhi:

Well, they get pregnant at the end because they have a lot. But what I'm trying to say is that number does not really… It's important. It's a numbers game, but at the same time, getting obsessed with the AMH and how it goes. And also Aimee, if I take your blood now and send it to two different labs-

Aimee Raupp:

They're going to get different results.

Dr. Zaher Merhi:

You get different results because one will tell you 0.6 or one will tell you 0.9 because [crosstalk 00:13:00].

Aimee Raupp:

And that's significant.

Dr. Zaher Merhi:

That's significant. The [inaudible 00:13:02] variation. The person who is pipetting your blood because they do triplicates, they sometimes-

Aimee Raupp:

Someone just said, “I love this guy.” I love you too, right?

Dr. Zaher Merhi:

I love you too. So, the person who is pipetting or any test, they have coefficient of variation, which is at least 15, sometimes up to 20%.

Aimee Raupp:

Wow.

Dr. Zaher Merhi:

You will get 20% range. And as the number gets smaller, 20% becomes significant.

Aimee Raupp:

Significant. Yes.

Dr. Zaher Merhi:

So that's why I always tell patients, it's great but focus on the egg and the baby, not just on your numbers.

Aimee Raupp:

And the actual follicle count. I think you have to take that into consider, right?

Dr. Zaher Merhi:

I love. That's what I like. Show me the follicle on ultrasound because this is what's going to give me a baby. But show me high AMH but and follicle, what do I care?

Aimee Raupp:

Yeah. It doesn't matter.

Dr. Zaher Merhi:

But look, the ozone, back to the ozone, is really, in certain women you do everything. You become desperate. And I think it's time to move a little bit the field from just drugs and shots and all that. It's important to… We call them adjuvant therapy to IVF. They're very important. Nutrition like you mention in your book.

Aimee Raupp:

Yes, that's it. It's like acupuncture, nutrition, supplements. Yes.

Dr. Zaher Merhi:

Acupuncture, supplements, ozone. If each one improves 5%-

Aimee Raupp:

It's huge. Right. You have 20% all of a sudden.

Dr. Zaher Merhi:

It's huge. That's exactly my point. And I hope it works for everyone. Whether it works or not, hard to tell.

Aimee Raupp:

So tell me too, this study that you did, did you get to live birth with these ozone girls?

Dr. Zaher Merhi:

The answer is yes. A lot of people had. It's a big sample size. I don't remember the percentage, but a lot of the patients with the ozone, afterward had babies. But remember also that they had doubled the number of embryos. So really, it was-

Aimee Raupp:

Significant.

Dr. Zaher Merhi:

Very significant. Not only that. So what I'm doing is now, I have a PhD student, the next step-

Aimee Raupp:

I saw that. Yeah.

Dr. Zaher Merhi:

What we're doing with the ozone, women are doing IVF. We're taking their cells when the egg comes out from the egg retrieval, there is granulosa cells that [crosstalk 00:15:17].

Aimee Raupp:

That's where you're doing with the PGS.

Dr. Zaher Merhi:

We're taking the granulosa cells, splitting them into half, half we're putting in the ozone machine.

Aimee Raupp:

Shut up.

Dr. Zaher Merhi:

And half, on room temperature. And then, we're doing PCR for genes to see if the gene is responsible for estrogen and progesterone production, changes. And we have preliminary data. Very exciting. So we're going to present that very soon.

Aimee Raupp:

Wow. That's amazing. Now someone asked, “Could ozone help with blocked fallopian tubes?” If it's from an inflammatory condition, potentially, yeah.

Dr. Zaher Merhi:

That is a great question. There is a study on cannulation of blocked tube with or without ozone and the ones who did ozone have better success rate. Having said that, it depends on why the fallopian tubes are blocked.

Aimee Raupp:

Yes. That's what I was going to-

Dr. Zaher Merhi:

If it's just a small inflammatory event, yes. But if there is scarring, let's say someone who had bad chlamydia or pelvic inflammatory disease and the tubes is hard. So I'm talking theoretically, I don't want to say that it works until I have seen some studies.

Aimee Raupp:

Seen the patient. Yeah.

Dr. Zaher Merhi:

I'd like to see some evidence before I say something. But these are big question. These are the things that actually-

Aimee Raupp:

We're trying to figure out.

Dr. Zaher Merhi:

Yeah. But also questions from patients gives me ideas for my future research.

Aimee Raupp:

Always. That's what I always say because people are like, “You know so much.” I'm like, “You know where I learn from? You guys.”

Dr. Zaher Merhi:

I get it from my patients. That's actually very true.

Aimee Raupp:

I learn it from you guys.

Dr. Zaher Merhi:

That's very, very true.

Aimee Raupp:

Because I don't think of these things. And I'm like, “Oh, I'd better go research that.” So then, tell me too, so ozone is recommended, though. Say a woman is trying to conceive naturally and maybe has been told her FSH is too high or her AMH is too low. Or, even just to increase her odds, would you say ozone is good for that situation as well?

Dr. Zaher Merhi:

Yeah. I don't want to use the word you recommend because it's a powerful thing. I don't want to recommend ozone, but it's something to consider. If you want to try to get pregnant naturally, you're not ready to have IUIs or IVF. Start with diet and acupuncture, ozone. Try to get things and see. Because you'd be surprised. We have a lot of patients who did IVF, IVF, IVF. Now they stopped and they get pregnant naturally.

Aimee Raupp:

I know.

Dr. Zaher Merhi:

I have a lot of those, actually. It was my first patient in training back in 2003. I can remember [inaudible 00:17:40] here. She literally, and she said to me, “I have no money to…” I was still in training. I said, “Well, let's try intercourse.” And then she got pregnant. So what I'm trying to say is that things with the body that can get better or worse, there's a lot of people, 50% of my patients have been pregnant before, but now they can't get pregnant. So something happened also with time. So what I'm trying to say is that it can get better or worse with time.

Aimee Raupp:

Well, age is an inflammatory process, basically though, too. Right?

Dr. Zaher Merhi:

Aging. Absolutely.

Aimee Raupp:

So it's like we're fighting the, what is it? The ROS the [inaudible 00:18:18] of the species.

Dr. Zaher Merhi:

That's right.

Aimee Raupp:

And then, so tell us about the PRP. Because this I'm interested in too. And I feel like you're… Are you one of the only clinics around in the tri-state area that's doing PRP?

Dr. Zaher Merhi:

Honestly, I'm not sure. Maybe other people are doing it, but I'm not aware. So the PRP or platelet rich plasma-

Aimee Raupp:

Platelet rich plasma.

Dr. Zaher Merhi:

It's your platelets and your plasma that we take from your arm, like a regular blood draw. We extract it in the lab and then we put them in a tube and then we inject them inside the ovaries, or we can infuse them inside your uterus for implantation. Now, I actually, like I said, I keep saying, seven years ago it started in Greece, and I thought they were crazy. I'm like, “What is that? This is BS.”

Aimee Raupp:

This is BS.

Dr. Zaher Merhi:

I'm being honest with you.

Aimee Raupp:

Yeah, I know.

Dr. Zaher Merhi:

I had a patient like, “Dr. Merhi, I want you to [inaudible 00:19:13].” I'm like, “No, I'm not.” They went to Greece. But then obviously a lot of the… Especially at the end of 2018, 2019, then more people started to study it in the lab at the basic science level and they showed improvement. And this was when I started to do it. So I can tell you, it's magic for some patients. And it doesn't work for other patients. Again, like everything, conventional IVF work for some of them and doesn't work for others. So I always tell people, “I don't know if it's going to work for you or not.” Because I get asked, “Do you think PRP is going to work for me?” The answer is, I don't know until you try it. Because it's a experimental thing, anything experiment might or might not work for you. But I can tell you, a good percentage of my patients who have either low number of follicles or poor egg quality, are really doing very, very, very well and are having babies on PRP.

Aimee Raupp:

Wow. Have you seen live birth in your clinic from PRP?

Dr. Zaher Merhi:

Absolutely.

Aimee Raupp:

Absolutely. Okay.

Dr. Zaher Merhi:

I had [crosstalk 00:20:18]

Aimee Raupp:

So I've had a couple of POF girls with high FSH and it lowers their FSH. And I've seen follicular development where they weren't necessarily having it, but I haven't yet seen… And I've only had like I think three clients that I know of that have done the PRP. I haven't yet seen them actually conceive yet or make it to live birth. So I was curious about that.

Dr. Zaher Merhi:

Yeah. Actually a few days ago, on my Instagram, a patient, Susan, made a video about her experience about PRP and how she's pregnant now.

Aimee Raupp:

Amazing.

Dr. Zaher Merhi:

Her AMH is so low, like it's almost undetectable and every IVF clinic on the Long Island-

Aimee Raupp:

Wouldn't take her.

Dr. Zaher Merhi:

Told her, “You'll never get pregnant. You need a donor egg.” And we tried before the PRP, we didn't make good blastocysts. We did PRP, got blastocysts and now she's nine weeks pregnant. She just graduated.

Aimee Raupp:

That's amazing.

Dr. Zaher Merhi:

I know. Susan, she's so funny. When she got pregnant [inaudible 00:21:13].

Aimee Raupp:

That's amazing.

Dr. Zaher Merhi:

And many others. I don't want to mention names because they don't want me to mention names. But the answer is, the mechanisms… Again, I always go back to the mechanism because as a scientist… So the PRP or platelet rich plasma has a lot of growth factors. I don't know if you're aware, but some IVF centers, they give human growth hormone.

Aimee Raupp:

Growth… Yeah.

Dr. Zaher Merhi:

Exactly. Omnitrope, they give them.

Aimee Raupp:

Yeah. There's a handful. It's more and more popular. Do you use it here?

Dr. Zaher Merhi:

I do use it sometimes, but think about it like this, if you're taking a human growth hormone, let's say 10 units in your belly every… The 10 units, not all of it will get absorbed [inaudible 00:21:58]. Let's say nine units get absorbed and out of the nine, maybe eight will make it to the ovaries. Out of the eight units, maybe five will make it to the egg.

Aimee Raupp:

Gotcha.

Dr. Zaher Merhi:

So what I'm trying to tell you is, and because of the metabolism, you're not getting a lot of effect and that's why it might or might not work for some patients with the human growth hormone. Now, with a PRP, imagine I'm taking your own growth hormone and [crosstalk 00:22:18].

Aimee Raupp:

It just soaks it right up.

Dr. Zaher Merhi:

Concentrated into [inaudible 00:22:20] and putting them directly inject that. It can't get better than this. So I saw a patient asked me, “Oh, do you think Omnitrope better than PRP?” Again, I don't have studies to compare both, but to me, mechanistically speaking, PRP makes more sense that it's more powerful than the human growth hormone.

Aimee Raupp:

Yeah. PRP is a little more expensive, though. Right? Because obviously it's kind of invasive.

Dr. Zaher Merhi:

Honestly, Omnitrope is expensive, if you think about it.

Aimee Raupp:

Is it the same as PRP or we don't know the pricing?

Dr. Zaher Merhi:

Yeah. I've heard things, I've heard some Omnitrope is every ampule $1000 for 10 days.

Aimee Raupp:

Wow.

Dr. Zaher Merhi:

You need to take it for many, many weeks. It's like, you can do two PRPs in that treatment.

Aimee Raupp:

Wow.

Dr. Zaher Merhi:

I'm not saying you should not do this. And I don't want to sway people.

Aimee Raupp:

Yeah. It's also, what's available to you too.

Dr. Zaher Merhi:

Exactly.

Aimee Raupp:

It's also what's available. And I also think too, I'm sure you agree, there's a lot of art and not just science to reproductive medicine. And so whatever your doctor feels good about is a really important to go with as well. Right?

Dr. Zaher Merhi:

Absolutely. And I always start with my patients, “I want to listen to your story first.” Because everybody is different. Even if they're twin sisters, everybody's body is different. The history is different. Did they get pregnant or not, miscarriages or not, had a baby before or not. So many things. And that's why it's very important to individualize every treatment based on the patient's history, body and blood results.

Aimee Raupp:

Yes, I agree. And then, you'll do low stim, even natural IVF here.

Dr. Zaher Merhi:

I do everything. I do natural. I do IVF without needles and I do gentle IVF and I do conventional. I do all of them. Now, the conventional IVF, like I said many times before, it works for 75% percent of patients, but 25% of patient, it doesn't work for them. Especially in women with low ovarian reserve, you're going to have to be very gentle on their eggs.

Aimee Raupp:

Yeah. And then practicing here in Westport and then also in New York City. Right? Those are your two offices.

Dr. Zaher Merhi:

Yes.

Aimee Raupp:

Okay.

Dr. Zaher Merhi:

We are based in the city. And here in Westport. I love Westport. It's so nice. I've got to move here.

Aimee Raupp:

I know. You should. We live here. We love it.

Dr. Zaher Merhi:

I live in New Rochelle so I'm halfway between Westport and Manhattan. I'm like, “North or south?” So yes, I do have on 57th Street in Manhattan and here in Westport. Also, I wanted to, Aimee, before I forget, talk about PRP and implantation.

Aimee Raupp:

Oh, yeah. Because someone just said, “I just had PRP on the 10th and I transfer on the 11th.” So yeah. Talk about that.

Dr. Zaher Merhi:

So I have to tell you the data and I'm writing a review article on PRP now, it's very compelling that PRP what it does to the lining of the uterus.

Aimee Raupp:

Wow.

Dr. Zaher Merhi:

One to three days before you have your transfer, if you have failed implantation before-

Aimee Raupp:

Oh, what about a chemical with an IVF? [inaudible 00:25:19].

Dr. Zaher Merhi:

Or chemical [inaudible 00:25:19] or miscarriages or thin lining, all those things, I can tell you and that I can say with confidence, like. “Do it.”

Aimee Raupp:

Wow.

Dr. Zaher Merhi:

I would tell you to do it because to put an embryo and waste the embryo or it doesn't stick just because… Give it a shot. Seriously. It really works very, very, very well. And the way PRP works for the lining, it changes a lot of the genes in the lining that, what do you call it? The embryo glue, the natural glue

Aimee Raupp:

Yeah, the glue. Baby glue, I call it.

Dr. Zaher Merhi:

It increases significantly when you inject, when you infuse PRP and acts very, very fast. A day to two, before the embryo transfer, PRP works like magic.

Aimee Raupp:

What about, like this might be totally out of the wheelhouse, but you know how we were talking about Dr. Braverman and Dr. [Vidali 00:26:21] before we went live and Dr. Thornton, you know how they are testing for-

Dr. Zaher Merhi:

I love all of them, by the way.

Aimee Raupp:

Yeah. They're all amazing. They were testing for things like the TNF alpha and the recruitment of some of these inflammatory cells in the uterus when someone say is pregnant and they're monitoring her from an autoimmune perspective. Do you think something like this would help that, so that the body doesn't start attacking the embryo?

Dr. Zaher Merhi:

The answer os, yes. And actually PRP in a lot of studies show that it's anti-inflammatory agent.

Aimee Raupp:

Yeah. So It's like doing an intralipid or an IVIG in a sense. Right? But right in the spot.

Dr. Zaher Merhi:

Absolutely. It lowers interleukins and TNF alpha.

Aimee Raupp:

Right. Because it's a IL-6.

Dr. Zaher Merhi:

Look at you.

Aimee Raupp:

I tell you. Seventeen years, I've been doing this. I know about things.

Dr. Zaher Merhi:

Well, it's impressive. Actually, just to let you know, there are now patients who have a lot of scarring in the uterus, like had DNCs that the lining scratched or the lining is not good, or called Asherman's syndrome. Just a recent study, I was reading about it yesterday. They actually not just infused the PRP, but they went with the hysteroscopy and injected with a needle at the area where the scars are.

Aimee Raupp:

No. At the area of the Asherman's.

Dr. Zaher Merhi:

And they had successful pregnancy. So, it's huge because a lot of patients don't want to have a surrogate or [crosstalk 00:27:49].

Aimee Raupp:

Or, I have one girl that she, so she had Asherman's, they had to do surgery. It was from miscarriage and DNC. So they did a surgery. Her uterus literally closed itself shut when it was healing. So then they redid the surgery with the balloon. She went on to get pregnant naturally. Has that baby. They've been trying again for six months. She went back in because she wasn't getting pregnant. Asherman's is back. She has an area in her uterus where it's back.

Dr. Zaher Merhi:

It's horrible.

Aimee Raupp:

And she's devastated because she needs the surgery again. But she's now scared because what if I get pregnant and the uterus can't handle it, or when she did carry a pregnancy to term, she actually was pregnant with twins. And she lost one at 20 weeks, which was devastating. And we are wondering if the Asherman's played a role. She actually saw Braverman when that happened. One of the reasons I fell in love with him so quickly, I messaged him. He texted me on a Saturday and said, “Here's my cell. Have her call me.” He got her into the office on a Monday. Because he knew. He was 20 weeks pregnant. She just lost one of them. She doesn't want to lose the second. She already had two losses. But so I'm just thinking about this case in particular, because she's worried about another surgery on her uterus. And so, in this situation, you think the PRP would be a thing to try first, maybe?

Dr. Zaher Merhi:

Look, the answer is why not?

Aimee Raupp:

Why not?

Dr. Zaher Merhi:

If you don't want to have the surgery because the more surgeries you do on the lining-

Aimee Raupp:

I know. Compromises.

Dr. Zaher Merhi:

The worse sometimes it gets.

Aimee Raupp:

Yeah. That's exactly what she's afraid of.

Dr. Zaher Merhi:

So, you want to be as gentle as possible on the lining. So why not? Actually, also the ozone, back to the ozone, when you infuse ozone vaginally, it increased blood flow to the uterus and improves the lining. We've published a paper on thin endometrial lining. Women who are told, “You'll never get pregnant. You need a surrogate.” And two-third got pregnant.

Aimee Raupp:

Wow. That's significant.

Dr. Zaher Merhi:

Yes. We've published that. You can go online and can find the paper.

Aimee Raupp:

That's amazing. Okay. This is so good.

Dr. Zaher Merhi:

We like to try new things, Aimee.

Aimee Raupp:

Yeah. I love it. Well, no, it's about time-

Dr. Zaher Merhi:

We want to think outside the box. Look, Aimee-

Aimee Raupp:

Because some of the people in your profession are archaic and they only want to do things the way they want to do things. And they're not up on the research. I've heard one doctor, he's been around a long time. I'll say that. A New York City doctor. He once said to a patient of mine, “Diet has nothing to do with this. Supplements have nothing to do with this.” And I was like, “I think he should leave. He should be done. Or he should read some of the research.” And so to find people like you, it's very refreshing.

Aimee Raupp:

That's how it always was with my relationship with Dr. Braverman and Dr. Vidali. It's refreshing because I see it. I see it clinically all the time. I see FSH improve, AMH improve. I see that the numbers don't quite matter and it's really about quality. I see all of those things, improving uterine blood flow with acupuncture or castor oil packs or Maya abdominal massage. Now we have another one, ozone. I did a talk a few weeks ago with the cold laser therapy, which I was telling you about too. And it's similar to the ozone.

Dr. Zaher Merhi:

I knew of it and I read about it.

Aimee Raupp:

Yeah. Dr. Magarelli talks about it.

Dr. Zaher Merhi:

I'm very interested.

Aimee Raupp:

I know. You should get one.

Dr. Zaher Merhi:

Low level laser and I'm reading about it now.

Aimee Raupp:

Another $50,000.

Dr. Zaher Merhi:

Ugh.

Aimee Raupp:

You buy it and I'll refer.

Dr. Zaher Merhi:

It's a pandemic, Aimee.

Aimee Raupp:

[inaudible 00:30:53].

Dr. Zaher Merhi:

I'm kidding.

Aimee Raupp:

Girls, when we were doing the laser talk, because he was up in Canada, girls were just messaging constantly of like, “Where can I get the laser in the US?” And I was like, “There are smaller units. You can buy the $4,000 units. They're smaller.” You just have to… It's more time with the patient. You have to stay there and move it around. But anyway, they saw with that, which I think similar with the ozone that women in menopause, periods started to come back when they were using it for pain. So for different reasons, they were using this technique and then things hormonally shifted. And so that's where it led to the fertility research. So it's pretty interesting.

Dr. Zaher Merhi:

Look, at the end, Aimee, you were talking about diet. Everything is related to reproduction, right?

Aimee Raupp:

Exactly

Dr. Zaher Merhi:

Everything in your body.

Aimee Raupp:

Everything is related to reproduction.

Dr. Zaher Merhi:

Reproduction reflects the body health, reflect your immune system. Everything is affected in the reproductive system. That's why when someone is sick, they don't get pregnant because the body is not healthy.

Aimee Raupp:

It's fight or flight. Right? It's survival mode. We say in Chinese medicine too. It's like, when you have an abundance of chi and blood and essence, that's when the body's like, “I got enough to make a human.” Making a human is a big fucking deal. Right?

Dr. Zaher Merhi:

Right. It is. Yes.

Aimee Raupp:

So I agree. We always say that in our world, fertility is an extension of health, which you say as well. And I love that. And to think about that. Unfortunately, the message has been, it's whatever is below the belly button and whatever your numbers are and that determines your fertility. Do you know what I mean? And throw in your age too. And so a lot of women are so scarred by that message and to inspire hope and then that there's these other modalities. And I think-

Dr. Zaher Merhi:

Absolutely.

Aimee Raupp:

I think in years down the road, we're going to see even more methods, what we can do to improve egg quality and get to a blastocyst that we can transfer or get pregnant with naturally.

Aimee Raupp:

I'm just looking at questions.

Dr. Zaher Merhi:

Sure.

Aimee Raupp:

“Do you know if I can use FSA for the ozone?” Maybe. I'll ask Jessica. I can comment back to you, Got Bugs. Melissa: “Well, we love you.” She booked a consult with you when she's back in town. She's one of my clients. I'm excited for that. So you're already on board with him. “How long has ozone been out for?”

Dr. Zaher Merhi:

It's been out for a long, long time, over a decade. It started with dermatology. Dermatologists use it a lot for eczema and for psoriasis. Remember, a lot of people can't take medication like prednisone or anti-inflammatory agent and stuff like that. You'll be surprised when you read about ozone. Over a decade.

Aimee Raupp:

Wow, that's amazing.

Dr. Zaher Merhi:

It was used for studies on HIV, actually treating HIV with that. Joint inflammation.

Aimee Raupp:

So it's like cellular rejuvenation, basically. An immune tonic, anti-inflammatory, so it should work for anything.

Dr. Zaher Merhi:

Everything is inflammation.

Aimee Raupp:

That's it.

Dr. Zaher Merhi:

Everything is inflammation. And ozone is a very powerful anti-inflammatory agent. So it helps with those situations.

Aimee Raupp:

I love it. “Would you recommend PRP before an FET?” I would think the answer is yes for that.

Dr. Zaher Merhi:

I would.

Aimee Raupp:

Yeah. “Does it help for diffuse adenomyosis?” I would think the answer-

Dr. Zaher Merhi:

Ooh, that's a great question. See, something to think about. I don't know the answer, but we will definitely look at it with patients with adenomyosis. That's a great question.

Aimee Raupp:

And then someone asked, “Does it help with egg quality.” Yes, absolutely. “Is it available in the UK?” I don't know of that answer. “Flew out of the state for it. Not sure I can do it again since transfer is on Monday.”

Aimee Raupp:

“What was the laser procedure you recommend?” Oh, it's called a cold laser therapy. “It's taken me three to four years of infertility to finally find things like PRP. I'm so glad in the future this will be more available.” Oh, that's nice.

Aimee Raupp:

All right guys. So we're going to wrap up, but before we went live too, just so you know, we were discussing the idea of maybe a book together, something like that. So you'll hear more.

Dr. Zaher Merhi:

I'd love that.

Aimee Raupp:

Yeah. You'll hear more from us for certain. But this was so great…”What are your thoughts on IVM?” What's that?

Dr. Zaher Merhi:

IVM is in vitro maturation. Meaning what we do is, you take the eggs when the eggs a little immature and then culture them in the lab. Now, it's tricky, because the egg has three phases. Very immature, just to make it simpler, a little immature and mature. If it's very immature and you take it too early, it's so hard to make a baby with those eggs. If it's in the middle, then yes. Some studies look at, or some experts say, maybe if you grow or mature the egg in the dish, it might do better than inside your body. This remains to be determined, but we do do IVM and we've been successful with that. I do it for some patients who, when you take the eggs immature, they don't make fertilize or poor egg quality or stuff like that. I like to try to do different things. So, yeah, it's something to think about if the immature eggs are not making it.

Aimee Raupp:

Right. Or if nothing is making it to blastocysts.

Dr. Zaher Merhi:

Right.

Aimee Raupp:

Yeah. Okay. And then, “If PRP doesn't work the first time, will doing it again be beneficial?”

Dr. Zaher Merhi:

That's a great question. In one study, they published in May of this year, they did PRP three times once a month for three months compared to nothing. And this found significant improvement. So whether there is cumulative effect or not, there could be. I have some patients who do it once a month, every month. I have patients who they do it before… They don't do IVF with me. They do IVF somewhere else, but they come to me before every IVF cycle because they need blastocysts for that.

Dr. Zaher Merhi:

At the end of the day, it might work for you if the first time it didn't work. I always, I'm cautious with money. What if it doesn't work the second time or the third time? You [inaudible 00:36:53]. You know what I mean? So it's very hard for me to recommend something. I have to look more about-

Aimee Raupp:

What's going on.

Dr. Zaher Merhi:

The patient. What's going. Review the data that I have.

Aimee Raupp:

And then, “Is ozone okay for a 42-year-old who has third stage endo?” I'm going to say yes.

Dr. Zaher Merhi:

I would say yes too. Now, before you sit on the ozone, there's a quick questionnaire just to make sure that you're safe-

Aimee Raupp:

A good candidate.

Dr. Zaher Merhi:

You're a good candidate. Right.

Aimee Raupp:

So they'll be safe. Okay, all right guys. I think that's all of it. So, you'll hear from us again soon. But follow him on Instagram. What is it?

Dr. Zaher Merhi:

It's zahermerhi7.

Aimee Raupp:

Zahermerhi7 and then also his clinic, Rejuvenating Fertility is also on Instagram too. So you can follow through there as well.

Dr. Zaher Merhi:

And I'm happy to answer any questions they have, even if they don't want to… If they're in the UK or whatever.

Aimee Raupp:

Oh, wait, one more question. “Is ozone recommended before egg stims or before transfer for IVF?” I would think both.

Dr. Zaher Merhi:

If you're looking at egg quality, you definitely need to do it before the egg retrieval.

Aimee Raupp:

Before stims. Yeah.

Dr. Zaher Merhi:

If you're making embryos but it's failing or not sticking or you have thin lining, then do it before the embryo transfer.

Aimee Raupp:

Gotcha. Okay. All right guys.

Dr. Zaher Merhi:

Great.

Aimee Raupp:

Have a great day.

Dr. Zaher Merhi:

Happy holidays, everybody.

Aimee Raupp:

Happy holidays.

Dr. Zaher Merhi:

Bye-bye.

Aimee Raupp is a licensed herbalist, natural fertility expert and acupuncturist in NYC, offering natural fertility treatment, care & coaching solutions to women who want to get pregnant! Get pregnant fast with natural fertility care, Aimee’s online fertility shop & coaching solutions. Aimee Raupp has helped hundreds of women to get pregnant naturally! Aimee and her team are experts in Chinese Medicine, Massage & Eastern Nutrition! Get pregnant naturally, achieve optimal health & vitality, take control of your health! Aimee is excited to work with you at one of the Aimee Raupp Wellness Centers NYC. Aimee's Fertility Coaching Program is a personal guidance along your fertility journey. If you are trying to get pregnant naturally, this program is for you! Aimee Raupp offers holistic, wellness and natural fertility books. Learn how to enhance your fertility and get pregnant naturally with Aimee’s cookbooks and diet guides! Shop Aimee Raupp's natural fertility shop with online workshops, videos, consultation and coaching on fertility, meditation and healthy nutrition! Shop Aimee Raupp Beauty – Natural Hormone Balancing Skincare. Achieve natural hormone balancing with the Aimee Raupp Beauty Line of organic, gluten-free, dairy-free & cruelty-free skincare products!

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