Lorne Brown

 

By listening to the Conscious Fertility Podcast, you agree to not use this podcast as medical advice to treat any medical condition in either yourself or others. Consult your own physician or healthcare provider for any medical issues that you may be having. This entire disclaimer also applies to any guest or contributors to the podcast. Welcome to Conscious Fertility, the show that listens to all of your fertility questions so that you can move from fear and suffering to peace of mind and joy. My name is Brown. I’m a doctor of traditional Chinese medicine and a clinical hypnotherapist. I’m on a mission to explore all the paths to peak fertility and joyful living. It’s time to learn how to be and receive so that you can create life on purpose. 

 

Welcome back to the Conscious Fertility Podcast. Today we’re with Dr. Paul Magarelli. This is going to be a fun one for us because Paul, you’re going to learn about, he’s a reproductive endocrinologist. I’m going to actually share all his education. It’s crazy what this man has done, but I’ve known him since 2008. We met and we’ll talk about how we met, and he’s really been a, I’ll call it a force in integrative reproductive care. So we’ve become friends over the years, so it is a real pleasure, Paul, to have you on the Conscious Fertility Podcast.

 

Paul Magarelli 

Thank you, Lorne. And I’ve also witnessed your growth, growth as an acupuncturist and as a media specialist and as a Healthy Seminars advocate and about someone who believes education is a foremost in anything that we do. If we educate, we create, and if we create, everything is good. So happy to be here. Exciting. I wish I had more books in my background. You have a lot more books than I do actually. I just have a beautiful cup of coffee which says Healthy Seminars here, as you could speak.

Lorne Brown 

Well, let me tell the audience a little bit about you and the way we do the intro. You’re welcome to jump in. I may ask you questions because you’ve been around for a while in this field of reproductive medicine and you have done a lot. So it’s worthwhile letting people know who you are. And then for those that are tuning in, I always say we sometimes have to really focus on the conscious work and sometimes it’s really focused on the reproductive fertility aspect. This is going to be one of those reproductive fertility aspects. We’re going to talk about integration, things you can do to improve egg quality and affordable IVF. We’re just going to go through all the things that Dr. Magarelli has had his involvement in, but I just kind of want to share first a little bit about his background. He did his PhD and MD, a double degree it sounds like over at the University of Arizona.

His PhD was in nutritional biochemistry and animal physiology, so hence why you’re probably a big fan of nutrition when it comes to health and fertility. He is an MD as we mentioned. Then he did his OB GYN at Duke University, and then he went to become a reproductive endocrinologist  a REI at UCLA in Los Angeles. So you both got the educational side of it, the science side of it, and the clinical side, which is really nice to have when somebody’s seeing patients or doing education. And then I just kind want to share where he is a little unique from being a reproductive endocrinologist. He’s a big focus in integrative care, and that’s because he’s actually a pioneer in that because his research has been instrumental in integrating acupuncture into IVF treatment cycles called the Credenda Magarelli Acupuncture Protocol, CMAP, which he co-developed with acupuncturist Diane Credenda, and it’s now often utilized globally to enhance fertility treatments. And his current academic roles include serving as the chairperson at Yo San University Integrative Reproductive Medicine program. And you’re also an advisor to the ABROM, which is the acupuncture and TCM and Board of Reproductive Medicine.

Paul Magarelli 

That was, I did that on Monday.

Lorne Brown 

That was on Monday and then on Tuesday, and I’ll share that, Paul shared his cup of Healthy Seminars. Those that don’t know, I have my clinic as you know in Vancouver, but I also run an educational company where Paul has taught acupuncturists a lot on reproductive medicine. And he’s also been part of the integrated fertility symposium that I ran until Covid put the brakes on it for a while, still planning to bring that back. And he’s also been keynote speaker as part of that. So you’ve been involved in this for a while, so I kind of want to go way back to around 2008. When we first met, you came to Vancouver to teach, but I kind of want to share. I don’t think everybody knows a story about you and Diane because she came to you wanting to do acupuncture with your patients that are going through IVF cycles.

Paul Magarelli 

When I first opened up my practice in 1999, she came around 2000

Lorne Brown

And you’re like, whoa.

Paul Magarelli 

I said, no, I wasn’t. Whoa. It was like, whoa, hold your horses. No. Well, but no, because first and foremost, I appreciated the fact that we were in a new field and people need to understand really 1984 is where things began to percolate in the field of reproductive medicine. In 1976 is when we invented this concept of a reproductive endocrinologist. So it wasn’t very many years that IVF was available and it was crude. I mean by today’s standards. It was a very blunt instrument, not crude, a blunt instrument for dealing with fertility. And all we wanted to do was basically fertilize an egg. That was pretty much it, and got it into the uterus. And we felt that was a miracle. And as you know, it was a miracle when it first began and it really was oriented towards patients with tubal issues. It just made sense.

We didn’t have any other subtleties. If you can’t get the sperm and egg to talk to each other, you have to make it fertilize outside the body and then put it inside the body as an embryo. So when she approached me, I just started, it was my first private practice and I’d been an academic guy, you know Duke, UCLA, and then my first job was at Michigan State University as a professor. And then I began to gravitate towards private practice. So I had witnessed the, and coming in as a scientist, a science and medicine. I’m a very different approach to things and medicine wants to know a lot about, a little, about a lot. Science wants to know a lot about a little one specific thing. And I was that crazy guy in the middle trying to do both or doing either both great or both poorly. But the point was science was a very big part of who I was and then I became a physician.

So when she came in and stated, and it’s a saying that you see on the internet, acupuncture, it works and it’s like saying air, it breathes. I mean, it is too global for a scientist. I’m parsing it out. And I wanted to understand how there really weren’t many publications on how it was more inferential from centuries of work, not with IVF,  centuries working with sex. That’s all traditional Chinese medicine foundation is working with sex and natural conception. How does it work? Well, it’s not working. We’ll take this serve, take this thing, do this meditation, eat this food, those kinds of things which have validity in every culture, every culture approaches it that way. But once you get to medicine, it kind of has to have a different perspective. My perspective was, and it’s a quote that she and I laugh about. It’s, show me the data. You show me the data, I’ll let you treat my patients. And even today, your patients are vulnerable to everything. It’s even worse because the internet can espouse all kinds of things. So they’re very influenced, people who are desperate. And I said to her, my patients are desperate to get a baby. It’s a new field. We’re very crude. Our pregnancy rates were 15 to 20% worldwide and we were the best in the world at that time.

Lorne Brown 

This was over 20 years ago.

Paul Magarelli

And that was a big deal. Getting us to 15% was a huge deal. And these were the days when we did fresh transfers. Day three, sometimes day two transfers, no such thing as a blastocyst, no such thing as icsi, no such thing as freezing, no such thing as PGTA. So anything that could harm that 15%. And that’s the way I viewed everything, any nuanced thing that came aboard without a lot of data, I couldn’t support until there was data. So that’s how we met. And unbeknownst to me, Diane is very stubborn and a very willful person and a very disciplined athlete and had worked with doctors before she decided to take me up on my offer and she showed me the data. So one paper came out, then our tour and Paula’s paper were interesting, which I reviewed. She said, will you read it?

I said, of course. I said, show me the data and of course I’m going to do it. And I had lots of questions. Physiology, we didn’t have a cause and either of them, there wasn’t a cause. There was an inference quieting the uterus, the polys protocol, quiet the uterus and you won’t have expulsion of the embryo, which at that time was a big reason why people didn’t get pregnant, we thought. Whereas, oh, they must have spit out the embryo after we put the embryo in. So quiet is a great idea. That’s the bolus. And then Senator Torrance said, well, in order to get things to work, you need blood flow. And that makes sense to me. And we have nothing in western medicine that could preferentially do blood flow to the pelvis. That’s where the action is. That’s where the uterus is. That’s where the ovaries are. So that made sense. So it began to have an inkling that there was some science that might support the use of acupuncture. And that’s kind of how we started.

Lorne Brown 

So the point was you talked about two studies. There was some data then you were willing to have Diana work with your worst case prognosis patients. 

Paul Magarelli 

Very reason that our field is extraordinarily competitive is reproductive IVF, let’s call it IVF. It’s not reproductive medicine, it’s IVF, the field of IVF. And the industry of IVF is extraordinarily competitive because we have to report our clinical results to a public database. And that’s unheard of now because we did that if Dr. A had a higher pregnancy rate than Dr. B, somehow everybody thought Dr. A was better versus Dr. A picked his patients that were more successful versus Dr. B who saw everybody. So I decided after I, it’s been worth a year, year and a half of this back and forth, and I had five patients, I couldn’t get pregnant no matter what I did. And I said, listen, I’ve been speaking with this acupuncturist. She’s passionate about it. We’ve got some papers, can’t tell you whether it’s going to help, but it certainly is.

I can’t find it. And I did. I looked and looked and looked, did acupuncture hurt anything? Anything? I mean, did it hurt hearts? Did it hurt livers? Did it hurt metabolism? I needed to understand if there was a negative side. Our medicine has side effects, goods and bads. I really, there wasn’t anything that stood out to me physiologically. And so I said, here’s five patients, many of which were very much older in their forties. And at that time there was actually an ethical dilemma as to whether we should treat people who are 40 or not very different today. And it was controversial, not ethical, controversial. And so I sent her five, she sent back three of them pregnant, so I didn’t even get to charge them. She sent them back pregnant. I didn’t get fat right naturally through the use of traditional Chinese medicines. And one of them, she got another baby from.

Okay, now I was intrigued. And so I said, listen, if we’re going to do this, and there was some inkling in the industry that this was important or that may be important. And I said, let’s do a study. And the study had to be in a western format, which is very rigorous compared to some of the stuff coming out of China at that time. China, today’s become western in charge of their publications. And we did, and long story short, first we demonstrated that those patients who have a low ovarian reserve or sperm parameters or BLE flow had a 15% improvement in their pregnancy rates and live birth rates. And it was like, well, the pregnancy rates weren’t statistically significant, but the live birth rates were, which of course that’s the holy grail as a baby, not just getting pregnant. And at that time remember up starting at 15%.

So if I could add 15%, that was unheard of in the industry. Every year we had a 1% increase, maybe, sometimes not, and this one activity was going to give me 15%. And so we began to look at that. We began to look at good prognosis patients and began to look at what kinds of patients PCOS, male factor. We began to look at the mechanism by which acupuncture would help. And it turned out it does impact hormonal fluxes during the time in which you want to get pregnant in a positive way historically, which was cooperated by both animal studies and really ancient human studies. And then the industry took off.

Lorne Brown 

And then with your paper that you did, you did a study where you did, you combined the Paula study and we’re talking about a 2002 German publication of acupuncture before and after IVF, of which most clinics don’t do anymore. Those were fresh day three transfers and now they’re frozen day five. Just for people that are listening. I’m not suggesting you run to your acupuncturist and say, you got to do Paulas on me. Most don’t do it that way. And you also combine the standard Victorian where she had the acupuncture blood flow protocol. What were the results that you found that you published with that pregnancy rate, like birth rates, lower miscarriage rates? 

Paul Magarelli 

You kind of said it. In other words, what we found was that more patients were likely to get pregnant. Those patients were absolutely more likely to deliver a live birth. Miscarriage rates declined by 50%, multiples, which was a big deal. Multiple pregnancies, triplets, quadruples, Quintuplets, et cetera, were happening all the time. When I started in this field, I mean twins, triplets, quadruples were the norm.

Lorne Brown 

You were putting in multiple embryos.

Paul Magarelli 

Yes, because at that time our pregnancy rates were so low and with acupuncture it seemed to harmonize things so that we always got one live birth, very rarely or we reduced multiples. I think it was 80% the number of multiple pregnancies, births that we had. 

Lorne Brown

Because you don’t want multiples despite the fact that patients often want multiples. You don’t want multiple. It’s a risk to mother and baby.

Paul Magarelli 

Totally. And the numbers are staggering. Even for twins, 21% chance they’re going to have long-term problems being a twin, mentally, physically, et cetera. It’s cute. Everybody wants ’em. They’re desperate again. But honestly, there’s one uterus for a reason. We don’t have uterine horns like in animals where they have, when a dog can spy pups, it’s because places for each pup, each pup has a place to grow separate from the other pup. It’s not that they’re all growing in the same womb. And so ours is one womb as you know, and that’s why it’s built that way physiologically. So across the board where at the beginning there was one or two clinics in the United States utilizing acupuncture with their patients. By the time of our studies every single year for about five years, we published a portion of the studies. And now every single IVF center in the US and embedding in Canada either recommend acupuncture, offer acupuncture, or don’t resist the use of traditional Chinese medicine. So it is now part of the culture in this part of the world or North America I guess would be the best answer in North America. It’s part of the culture that people utilize both. And from my understanding in China now, there’s a real push also for that combination in IVS centers because I’ve been seeing some publications coming out of that.

Lorne Brown 

Excellent. Now we’re going to fast forward to modern times. We were talking plus 28, ancient, very ancient. I’m going to list a few quotes and see if you remember these quotes. And then we’re going to tie this into a kind of epigenetics. I’d like you to talk about that.

Paul Magarelli 

Absolutely.

Lorne Brown 

So first of all, everybody, Paul and I have had some good times. You remember actually still going back to ancient times for us after that 2008 when we met 2009, we were in Austin, and that was when the ABORM, the acupuncture and TCM Board of Reproductive Medicine started, and you’re an advisor of it, and that was part of your hoping that IVF clinics could find people at least that have taken exam, done extra studying in that area. That was kind of the idea behind it. And I shared this story because maybe I’ll tell the story because we’ve had some good practical jokes on each other. We’ve been in the hot tub with our good friend, the late Ray Rubio, about male factor and those poor firemen hearing us talk about sperm for an hour in a hot tub. What was the hot tub doing to our sperm? Remember? I do. We may go there, everybody if we have time. You want to hear some funny stories. But I do. What I wanted to quote is

Paul Magarelli 

It wasn’t our sperm, it was the physiology of sperm production.

Lorne Brown 

Yes. But because we were in the hot tub, it made us think about it, heat and salt. Right. Well actually I’m going to ask the question we ask. So let’s see your answer for it today is one of the questions we ask and I got to set the setting here. There’s the late Ray Rubio, myself, Spence, and a few other acupuncturists, Dr. Magarelli, and we’re rapidly firing him with questions about reproductive medicine. And there’s three guys on their day off at this hotel and they’re firemen. They’re drinking beer in the hot tub and we’re talking about sperm loudly, and these guys are uncomfortable. Well, we got ’em to leave. That was, they were like, what the hell? But one of the questions we said is so heat can insult sperm, he can affect the motility or count. And the question is, if a guy had a fever or was in the hot tub, does that mean tomorrow his sperm isn’t great or is it in three months, that 72 day spermiogenesis? So for those that are watching, their husband might have had covid, they had a fever or they’re in the hot tub. When would that heat insult impact the sperm or over how long a period? Because men are always making new sperm. So eventually that insult would be gone.

Paul Magarelli 

I’ll give you the classic answer and then I’ll give you today’s answer. So it can be historic. And today, historically the answer would be in approximately 70 to 90 days, you’ll begin to see changes in the sperm because the heat is affecting the sperm at the level of bas. The basal cells are what make the sperms, which become sperm. So it’s somehow affecting the machinery of that sperm, whether it’s in quantity or quality or both. It’s affecting it today, I would say that it’s at 70 to 90 days and at the time of the insult, because I think we don’t have very good tools, but we didn’t have good tools back then. We have a fairly good tool today called the DNA fragmentation index. It’s a reasonable tool to look at the impact of the environment on the sperm and the sperm dysfunction. I don’t think this study hasn’t been done as far as I know, but I would bet that if you had a person doing a DNA fragmentation study on the sperm prior to the fever, during the fever, and then a month after the fever, you would see changes during the fever in what’s happening with those sperm.

It makes biological sense to me. But overall, a dramatic effect is going to be seen for prolonged fevers, not just a day in a cold, but prolonged fever is a weak high temperature is 103, 105 Fahrenheit. Then you’ll see that effect with lowered counts, possibly increased azoospermia where you’re seeing changes in the shape and the motility in about the 70 to 90 days. So you’re not doing anything that’s perpetual long-term unless you take hot tubs every single, single day, then you’re going to see a cumulative effect because the sperm just don’t like heat, and that’s why the testicles are outside the body.

Lorne Brown 

So we are going to talk about epigenetics, but I want to talk about the guy a little bit more just because we’re on track with that. I actually listed some course titles that you had proposed for the IFS and some that you’ve done. I was going to throw them at you and say give us a quick summary.

Paul Magarelli 

I have the wrong liquid

Lorne Brown 

Here. Exactly. Copy. I won’t make it too hard. Are you Dr Bag? Don’t worry. But I don’t know if you actually taught this one or it was one of the proposed ones, but the title was is it really unexplained or is it undiagnosed Malefactor sperm’s role in recurrent pregnancy loss and unexplained infertility. So that I think of, can you just continue then since we’re talking about the male, because often in my practice still that I’m in practice over 24 years at this point in time, it’s still majority of the women come even when diagnosed male factors, the guy that’s coming into my practice. And I don’t think the reproductive field, your field has done a very good job at communicating that it takes an egg and a sperm cell to make a healthy baby. But I think it’s because men still think that it doesn’t matter if they just have sperm, it’s going to work and the quality is not an issue. Does sperm impact the unexplained infertility or miscarriage?

Paul Magarelli 

It certainly has a much larger component today because the denominator has gotten smaller. When I was trained it was 15% of infertility was unexplained. I can tell you that today we’re probably at 5% unexplained. And that’s only because we haven’t really looked at the males. We’ve been able to dissect the genetic components of fertility. We’ve been able to dissect the endometrial components of fertility. We’ve been able to dissect the infectious components of infertility. But what you’re getting at is if there’s a male factor it doesn’t, having more intercourse or switching partners is not going to change the outcome significantly enough.

Lorne Brown 

Wait, switching partners would change the outcome significantly because you got new different sperm?

Paul Magarelli

No, changing the female partner, I’m talking from the male’s perspective, is that the male will say, and King George said it, the reason he didn’t get an heir, a male heir, so he killed a whole bunch of his wives was because it was the wive’s fault. Whereas we know now we know that the male is the one who contributes to the sex chromosome depending on an ex carrying male sperm, which would be a female or Y carrying male sperm, which would be a male in the offspring. So the answer to your quick question, and just as a quick answer is two things. One, as we evolve towards the health of the fertile person being significant, which forget to epigenetics as being critical for those circumstances where we can explain their infertility, the unexplained it’s going to be, look at the health. We have to understand male factor infertility is a marker of health. So not only is it worthwhile for the male to manage the male factor infertility for fertility purposes, but it’s going to play a huge role in his long-term health. Everything from testicular cancer to longevity is being marked by a sperm. It’s associated with male factor infertility or just simply abnormal sperm parameters.

Lorne Brown

Canary in the mind they call that when you have male factor infertility, you as a physician out, there’s issues with the sperm. You want a full workup, cardiovascular, oncology, everything because it’s the canary in the mind that maybe something else has

Paul Magarelli 

Happening. So it’s worth it to do it for that reason for the males, although they should do it if they want a happy marriage. But it’s not that you said my field doesn’t focus on it. We have focused on male factor infertility since we were taught infertility, which is 30% or 40%, the male 40%, the female 20%, both of them. So if you look at that, it’s a 50 50 deal. Why is infertility there? The people who get healthcare in North America, I’m going to speak to, are females. Men do not get healthcare. They go when they die, they go when their heart is about to give up. They go when their smoking makes it so they can’t breathe. They go when they can’t walk up a flight of stairs for claudication. Men are programmed in the western society to bear it because their jobs are hard, they’re toxic.

But we’ve always been focused that it’s the male who has to provide the framework for which women can reproduce. And that’s true of the animal kingdom. A lot of animals in the animal kingdom are the male is going to provide the food, he’s going to provide the safety, the perimeters, protection, and we give up on ourselves when we do that. And I don’t think it’s any different in fertility. So when the female says to the husband, you have a sperm issue, okay, what vitamin do I have to take? Now that’s a great thing, but it may be you have to cut back on smoking alcohol tinctures.

Lorne Brown 

Well, let’s let the guys know for, and we know 90% of the people listening, it’s a generalization, but probably are females that are listening to this. So basically if you’re in a relationship with somebody that has sperm, diet’s going to play a role, lifestyle’s going to play a role, are they sleeping? The stress exercise toxins in the environment are really hard on the sperm. Then there are supplements that the sperm can benefit from because of a poor oxidation diet.

Paul Magarelli 

Yeah, and that can protect you in that

Lorne Brown 

Oxidation. So we have to, now there’s some acupuncture studies. We do herbal medicine for it, and there’s even some photobiomodulation, low level laser therapy studies that have come out. So basically sometimes the semen analysis is not going to tell you whether that sperm can give life or not. And so we use,

Paul Magarelli 

It’s not meant to. It is not meant to tell you if it’s going to work or not. It’s only comparing you to a group that has been shown to have fertility. Not every single one, but well have fertility to those that don’t have fertility. And it’s a screening process. It by no stretch of the imagination does it tell you which sperm is going to work or not work. You could have a very little sperm count and make babies every day of the week and it could have a very high sperm count and not make a baby ever because there’s other factors. It is a screen, much like the pap smear screen for cancer of the cervix. It is not a test per can. It’s a screening mechanism that says go to the next step. So maybe that’s the point today. Abnormal semen analysis says go the next step, which is get it evaluated so that you can understand the health and vigor of that sperm. It’s only a warning sign, much like blood, it’s a vital sign.

Lorne Brown 

If their semen analysis is normal and they’re having miscarriages or unexplained infertility and the female checks out, well, do you want the guy to get more involved? And what are the next tests? You mentioned DNA fragmentation.

Paul Magarelli

DNA fragmentation is probably the best sense to see the functionality. It’s the best functional test. In the past, we actually did hamster ache penetration assays. I had a flashback when Diane, Dr. Cred came to my office. I remember I was building a hamster lab because we had to get hamster eggs and use them as a marker of the ability of the sperm to penetrate the zina of the hamster egg. And that was a model. So there’s a functional model. Nobody does that. Nobody’s going to do that if nobody does that. DNA fragmentation is another model of that. So we don’t have a lot, that’s the point we don’t have other than the semen analysis to explain what’s going on. We have tons of information and research which shows the impact of smoking, alcohol, drugs, and lack of sleep stress. We have tons of lifestyles, which seems like a very low level impact, having a huge impact on sperm.

Sperms are sentinels. The sperm itself. The reason I philosophize that, the reason it takes three months to see the impact of the environment on the sperm is because when the males set out to find a safe place to raise the tribe, they would be ahead of it. It would take two to three months and they would be living there and be exposed to that environment. Now they bring the tribe. If nobody gets pregnant that first month, they know that is a bad environment for us and we have to move on. And they didn’t know it as a science, they just know this has a bad vibe to it. And so it’s a sentinel of the environment. It’s telling you if the environment is safe or not? And if it’s not safe, meaning his habitats, his lifestyle, his whole body is not safe, why would he want to reproduce? Makes no sense.

Lorne Brown 

And there’s things that you can do. So lifestyle is key. And as you mentioned, at a low level as in these are where I share that these small actions lead to huge results. So sleeping diet, not smoking, moderate alcohol, recreational drugs, avoid heat and salt. And then there’s other things you can do to continue to support it. So talk to your health professional about that. I would like to go back to the epigenetic idea, and I want to bring out a quote, and this is where one day I said my, I have this formula. I say, a healthy baby equals a healthy egg plus healthy sperm plus healthy uterine environment. And then you said, why don’t you just call it healthy body equals fertile body, healthy body. Fertile body. Remember that? Yes, I do too. I use

Paul Magarelli 

It.

Lorne Brown 

Yeah.

Paul Magarelli 

A healthy body is a fertile body

Lorne Brown

Yes. So now I want to bring up a quote from the integrated fertility symposium. So I got to set the stage for this. We had a panel, and on the panel we had some naturopathic physicians. We had some doctors of traditional Chinese medicine. We had you Dr. Paul Elli on there. We had a reproductive urologist, Dr. Paul Turk, and I’ve been quoting you, so hopefully this is correct because this is how people make up things in their mind, right memory. But this is what I remember. You said in the group, we were talking about integration and there was debate about referrals and who’s doing what. And you said, listen, what I do, you Paul Magarelli Western Medicine gets patients pregnant faster. And then what you do, what you refer to at the time, complementary alternative medicine, the acupuncture naturopaths, as you pointed to us, you said, what you do gets patients pregnant better and together, you said that’s why you like integration. Let’s help get our patients pregnant better and faster. And that ties into epigenetics. So can you now kind of go into why you teach at Yoong University, a Chinese medicine school, and you become, I think, an advocate for integrative medicine. You’ve coined the term during the integrated fertility symposium multiple times in your talks you would call it one, medicine for increased success and pregnancy outcomes. Can you kind of just share with the audience what this idea is? Epigenetics better, getting pregnant better, and just kind of talk about what you see with integration.

Paul Magarelli 

Good memory, by the way, you weren’t hallucinating. IL is not showing OP or in good shape. From my standpoint, I was evolving my understanding of the role of traditional Chinese medicine as a form of complementary medicine at that time as a teaching point because they had to deal with reproductive endocrinologists, Western medicine doctors who were very pharmaceutical oriented practitioners and the pharmaceutical industry are the ones who had to do randomized controlled trials. The way we think about them today, they don’t apply to every field of medicine. They don’t apply to life. But because our minds are all about randomized controlled trials, blinded to what drugs people are taking, I wanted them to have something in their heads that would make sense in that conversation with a reproductive endocrinologist. And what would make sense is that no matter how well we put the sperm inside the egg with icsi, if you have a poor A or a poor sperm or both, meaning they’re not functioning at peak reproductive capacity, your outcomes are going to be lower regardless of the technology.

Since we Western medicine don’t have the time, patience, ability or structure to deal with the quality of things we tell people, eat a healthy diet, don’t smoke. Well, when I was in medical school, the person who smoked the most was a pulmonologist. The people who dealt with lung cancer all the time, their offices were so smoking when you walked in. So do as I say, not as I do, but with traditional Chinese medicine, in most cases, they kind of talk the talk and walk the walk. And that’s particularly true for Dr. Knda because she’s a competitive triathlete and she’s been in western medicine, eastern medicine. So she lives, she eats, right? Does whatever it takes. And that was the person I was most exposed to in terms of traditional Chinese medicine. That’s the person. So for me, one of the things that was confusing at that time was this thought by acupuncturists: we could fix FSH because NSH is a marker of low ovarian reserve, and if we could fix FSH, it’s just hormone more produced by the brain.

That’s all it is. We are improving their outcomes. And I said, well, give me a mechanism, give me something that would explain that. And they really couldn’t. They would talk about T following the blood, all these things or blockages in the flow of qi stagnation, those kinds of things. I said, but okay, so what’s the mechanism? Those are words, but what’s the mechanism? I’ve come to understand that the mechanism by which they had very small but incremental changes sometimes in FSH as a marker of ovarian reserve was they improved access to where the eggs are. So that would lower the FSH, which means you have more eggs. They would create a media, the body is bathed in blood, of course, and lymph, and that media brings all the nutrients and takes away the toxins, et cetera. Well, if you can improve what’s being flowed around an egg or a sperm cell with let’s use more oxygen, better fuel, less toxins, it is entirely likely that that microenvironment would enhance outcomes.

So that’s a mechanism that our pharmaceuticals can’t do. We just bombard the system with more and more and more of everything hoping something happens, but we don’t change the environment. So yes, we may get more eggs, which statistically will get us more embryos, which statistically will get us more babies faster. It’s not necessarily that we’re going to help that person who has more than enough eggs of a poor quality or that person with really out of sprout of poor quality. We’re not helping them. So this one medicine concept or this combination concept for me is make the microenvironment, and I see it very crudely, make the pool in which the egg is living and the pool in which the sperm is swimming, non-toxic, more oxygenated have more of the nutrients that are necessary for all of the machinery and the egg and the sperm to do their job.

That still makes ultimate sense to me, and that’s what drives me for us to not only work together, but to ask questions and do research together. And that’s what brought me to Yoan is being part of their doctoral program to come up with research ideas, to get them to understand why I want them to understand their medicine in a western light. That’s been the biggest thing for me. And luckily for me, Diane was able to convert a lot of the Chinese concepts into Western medicine, but she did western medicine for 25 years as a radiology technician. So she knew the language. She was able to help me understand your language about systems that are one medicine, one body, one human. We’re all dealing with one human, and we’re just explaining it from different points of view. So that’s kind of where I’m at today.

Lorne Brown 

Perfect. So we’re going to go back to the game because we’re going to continue on this conversation, the game of, I’m going to list the topic and say, tell me what you mean by this or summarize the talk. So I do remember you did this talk, and this is going to tie into what you said, one of your talks at the IFS, the Integrated Fertility Symposium was called Epigenetics and the Mighty Mitochondria Maximizing Egg Quality and the Health Blueprint of Future Generations. So can you enlighten us a bit about the mitochondria and where it comes from? Is it the sperm or the egg mitochondria that we’re interested in when we think of embryos, why the mitochondria is important and how this impacts future generations? Because our goal in Chinese medicine is not just the baby. We want healthy baby healthy parents, right?

Paul Magarelli 

Generationally.

Lorne Brown 

Generationally. And you did a talk because you did a kind of deep dive to understand what impact integration could be having. So again, the topic was called epigenetics and the mighty mitochondria maximizing egg quality and the health blueprint of future generations. So I think this continues on what you started, but can you elaborate a bit about the summary of that talk?

Paul Magarelli 

Well, I’ll tell you what, I’m still waiting for my Nobel Prize for that paper. That was probably one of the best deep dives I’ve ever done. I don’t know, my mitochondria we’re all firing at the same time, so everything was working. The mitochondria is the battery of the cell. You don’t have a good battery, your lights are dim, you don’t have a good battery. Your computer may not work at its efficiencies and it’s not slowing down. If you don’t have a good battery, your flashlight is not going to work very well in the dark. So for the human cell, the mitochondria is what takes the outside stuff, carbohydrates, proteins, fats, and it converts it into a form that can be transported inside the mitochondria, which can provide the A TP, which is the energy currency of the cell to allow function. And what is the function?

Well translating into chromosomes, into proteins and enzymes that allow your metabolism to work. What is the function? Translating it into energy. So you could think, walk, see, talk, those kinds of things. And in reproduction, the energy, especially from a sperm standpoint is going to be: can I swim to my target and beat all the other millions of buddies so that I could be the sperm that gets there to fertilize the egg? The egg itself is asking itself a question. I’ve been asleep and it has been for decades because you lay down all of the eggs when you’re a fetus and you never make more eggs. And those eggs are quiescent, quiet like a bear hibernating, they’re hibernating in a very low metabolic state. Well then any other biologic process is going to age and wear and tear. Do I have what it takes to get to be energized to the next phase, which is sensitivity to the hormones?

And then the next phase, which is being available to the sperm and the next phase is to engulf the sperm and allow it to cause that smy to happen. And in the next phase, the vision of that massive cytoplasmic ball that this microscopic seed of a sperm has come in and started changing the process. And can I do that evenly and consistently in a way that keeps the chromosome separated? Because we start from when we divide our cells, we want to divide equally, but there’s reduction division and there’s simply mitosis, which is actual division where one cell becomes two and you want to make sure the chromosomes split appropriately. So there’s all of these processes and if you go back to concentrating on what would I want to look at to define this problem? Well, I want to look at the efficiency of the battery in that cell, and then I would look at all the components that are part of that.

Well, it turns out a lot of the things that we look at from an epigenetic, by the way, epigenetic means that it’s not chromosomal. It’s the stuff that allows the chromosomes to express themselves. It turns on and off the genes within the chromosomes and it’s super sensitive to the environment. So you could think of them as doors that allow that gene to work and or overwork or under work. And there are genes that will stop and start the process. And there are outside things outside of the genome epigene on top of the genes that will control whether or not this gets turned on or not. And so by changing the lifestyle in the environment, what you’re doing is you’re changing the on and off switches. And of course you want to gear them towards health and wellness, right? Toxins will turn them off maybe in a wrong way or super activate them. A lot of cancers now are considered problems from the outside, turning on excessive activity of the gene. So I can’t control it. Their whole body has a controlled way to look like Laura, look like Paul. And even if we get a cut, still look like alarms, look like Paul repair and restore and get back to function.

And this is what blew me away was when I did this deep dive, I started looking at the Chinese herbs and the classification of the Chinese herbs, the general chairman,

Lorne Brown 

They have which one is the king of the formula, which one’s an envoy directing other herbs to the area which one’s assisting. So it helps do a better job.

Paul Magarelli 

And so now I could, because they have methodologies to look on and off of the genes when exposed to these Chinese herbs, and it really, it’s supported that this was a general, this was an envoy. And that’s what was fascinating to me. Now I have a model, the epigenetic model, which we use in western medicine. And I have this pile of plants and herbs and other things that will from a Chinese medicine, explains something. Both of them are treating the same thing. You can now get even more integration, more bridging of understanding, and then you get the best of the TCM world and the best of the western medicine world and you get a synergy one plus one equals three. And to this day, I would love to revisit that whole topic because that’s probably a decade ago. I don’t know what year that was. But the Chinese in particular, researchers are hugely asking the question: how the hell does TCM work in a western understanding of genetics, epigenetics and processes turning on and off genes? I can’t imagine today there’s even another order of magnitude more information, which would help. I think your traditional Chinese medicine doctors approach your patients better about creating formulas for today’s patients, not for 2000 years ago patients.

Lorne Brown 

And I remember, I think you shared many papers on the herbal, but just because we’re talking the mitochondria, there was a paper that Jane Littleton introduced me to. So this was like 2009 ish back then where in mice they showed the herbs that are considered Y tonics actually improved a TP production in the mice and other categories. We have chie tonics or blood did not, or not as well. So tying this all in, just a side question is back in the day in the early two thousands when I was practicing, the clinics would say No herbs, no Chinese herbs. Funny enough, I remember once they took our patient off of coq 10 and the patient said, the IVF doc said you can’t take any herbs. And I’m like, this is not an herb. But anyways, now they sell it, things have changed.

Paul Magarelli 

Let’s not bench our colleagues.

Lorne Brown 

So things have changed either my pees, now we do herbs with patients, but we don’t usually do it on their first cycle or they don’t start anything new like three days before transfer or they’re halfway through their stems. But if they have challenging cases, they are open to their herbal medicine. And I’m curious to you, are you comfortable with patients taking herbal medicine or not? I think obviously, let’s just put the assumption by a qualified trained Chinese herbalist. But where are you at then since your deep dive with the Chinese herbal medicine with IVF?

Paul Magarelli 

Do you know Brian? I think he taught at Yoan because he does menopause and so Oh,

Lorne Brown 

Brian Grosso

Paul Magarelli 

Grosso.

Lorne Brown 

Thank you. Yeah, he’s on the Healthy Seminars. Actually, the part two question will be uni receptivity that you were on,

Paul Magarelli 

Okay, yes, we were at dinner drinking way too expensive wine accidentally. We weren’t planning to spend that much money on eating big steaks. Of course, I’m a carnivore in that sense. And he goes, Paul, you know what herbs are? They’re concentrated foods. They’re concentrated foods, they’re things you consume. They’re concentrated foods. So if we could switch this from an herb, which we equate to medicine to a,

Lorne Brown

You equate it to like a prescription

Paul Magarelli 

Drug to a drug and get to, oh, these are just concentrated foods, then there would be no objection because in western medicine we don’t have an idea about the impact of foods. So if we just say these are concentrated foods, I’m giving them a group of concentrated foods that are found to be nutritious. What is nutritious? It gives energy to the cells, it gives required products to the cells. They could be essential nutrients. They could be just protective nutrients. So I like the idea, and he and I are going to do this, by the way, we’re going to do a talk on that and I’m going to develop a statement for A SRM, which I already actually started it about. Herbs are concentrated nutrients. Let’s move on this bologna about worrying about the herb. Doing some medical malfeasance to the stimulation protocol is like worrying about an ant interfering with the sledgehammer.

Lorne Brown 

You take the acupuncturist, I’ll do the western side bump switch. I’m going to challenge you on this, I would think then from a western medicine perspective, these are things they’ve said. One is, well, they’re estrogenic, so it’ll mess up with our cycle. They’ll say that, which I don’t

Paul Magarelli 

Agree that. Okay, stop. I’m going to go through each one of them. You wouldn’t give it. So in other words, I wouldn’t give, I know the menstrual cycle, I’m board certified. ABORM certified, I  studied traditional Chinese medicine and work with it. I’m not going to give anything that makes counterintuitive sense. That’s why you must see someone who’s licensed as a herbalist because they have to know whether it’s estrogenic, progestogen, androgenic. There are times when estrogen is fantastic. You may want to do that for a patient who you can’t get the lining to grow with your chemicals, but I could get the lining to grow with the herbs. Yes, you wouldn’t give chemotherapy if you had a cold. You wouldn’t give that drug to a person just complaining of a cough. So why would I expect an herbalist to give chemotherapy for a cough? You’ll give cough syrup. So my answer to that is you have to trust my education as much as I trust your

Lorne Brown 

Education, you acupunctures talk too much. Alright, let me go onto my next question that I agree with. Well, you said they’re concentrated foods, but our drugs are basically isolated from food as well as herbs and supple. That’s where our drugs come from.

Paul Magarelli 

Fantastic.

Lorne Brown

They’re like drugs.

Paul Magarelli 

So then we both agree you have some drugs that I have no access to. I have some herbs that you wouldn’t for the life of you understand or even understand the mechanism because that’s not your training. So you use your tools, I’ll use my tools for the health of this one patient.

Lorne Brown 

All right? I’m going to have to tell my associates at the clinic not to work with you anymore. That was our herbal question. Shout out to Brian Grosso. Let’s finish off a little bit on the mitochondria and then we’ll jump to you for receptivity. So the mitochondria, I remember you’re talking about, it was like a foreign DNA and the thing, the virus in Chinese medicine, one of the acupuncture points called z gong is known as baby palace. And that’s the point just kind of located above the ovaries. And the big part of what we think we’re doing is we’re supporting that environment. In this case we’re supporting follicular health. So can you then continue on this idea of epigenetics and hopefully optimizing that egg quality through how we’re supporting the follicle. Then blood flow. Is this why we care if we can bring more blood flow to the follicle? Are we affecting the mitochondria of the egg or are we affecting the mitochondria of the follicle, which is then going to charge the egg?

Paul Magarelli 

Okay, the answer is always yes to that question. In other words, there’s no delineation. This is, and again, I’m going to wax philosophical for a second when I’m dealing with insulin resistance, right? We’re talking about fluid that comes from the outside and goes to the inside, right? That’s what we use. That term goes in the stomach and then it goes out. It gets absorbed. What’s outside? What’s inside? Well inside is every single cell in the body, every single cell. You may have a headache and I take some aspirin, my toe is going to get better. I have a little bit of arthritis in my toe. That medicine is going to be distributed to every single cell and every single cell knows its location and function relative to every single cell in the body. So if you have a here, which you guys talk about a lot, and you put, I have a toe provenance, I put needles in my thumb, my toe feels better.

And I started laughing because it makes no sense, but it makes absolute sense. If you think of the inside of your body as a unified hole or a soup, it has a lot of ingredients, but it’s still in the same broth. And that broth will leave this, and it doesn’t differentiate except for the scrotum and the brain where it has the blood-brain barrier where it’s segregates and maybe the placenta, which is two organisms, but pretty much we don’t have parts of our body that segregate components of the blood serum, lymphatics, et cetera. So when you say, does it help the follicle? Of course, because if I energize the follicle for it to produce, that’s by the way where your estrogen, testosterone progestins at all come from. That’s a good thing for pregnancy and for outcomes. Now, we say this, when the foibles sleep, it’s in almost a zero metabolic state.

It’s sorting what it’s dormant, right? But that’s too powerful a statement because we really can’t separate out that cell. If that were true, we could take that cell and put it on the table and it would do just fine in 40 years. But there’s got to be some, and again, I’m hypothesizing and I’m sure it’s written, I just haven’t looked at it. There has to be some talking to the body about that particular cell. What the hell is it doing there? Is it a parasite? Is it a bacteria? Why is it just sitting there? Or, whoa, this is a really important cell. Let’s make sure that it’s warm and cozy and it has just enough nutrients and it has a little bit of metabolism. Let’s get rid of the waste. So in my mind, one body, one medicine, traditional Chinese medicine, thinks in this way that it’s a whole, and we deal with the whole person, not only the person, but the person’s environment.

Not only the person’s environment, the society in which they live, not the society and the world they live in when not only the world, but with the universe. They live that kind of hierarchical look at their medicine, translating that to western medicine, it would be simply that every cell has a function. Those functions are integrated into a hole, and they each in that hole are impacted by the other disharmonies or diseases or malfunctions or poor blood flow or toxins. And that everything we do to enhance that one hole, we would be able to see improvements in outcomes. Now, here’s a big point before we end, and this is a big point. What western medicine does, it gets from zero to 60, right? We don’t get to a hundred. We never get to a hundred in our pregnancy rates. We haven’t. What I see in traditional Chinese medicine is getting us in that person who goes from zero to 60 to 70, not from zero to 70.

And that’s a point of contention. And it’s because we’re hammer, we’re big, we were massively pushing the system, which may or may not be helping our society, but we get to the result the patient wants. What happens sometimes is there’s this impression that without acupuncture you’re not going to get pregnant. And I want to change that. We talked about a healthy body, fertile body. We’re now talking about every cell. Once a cell is part of every cell working together, we’ll get to the outcome better, faster, quicker, with a healthier outcome, but don’t expect it to go. And I see this with patients who get really mad. I did what you said. I did acupuncture. It didn’t work. You said That’s not the mechanism. If I add acupuncture to this protocol, I’m hoping for 2, 3, 5, 8% improvement in the population. But for you, it’s still a yes, no question. You are or are not pregnant. That’s it. Zero or a hundred.

Lorne Brown 

So I mean, when you’ve used human growth hormone in your, I mean, everything you’re doing is to help optimize to give them a better chance. But like you said, on an individual basis, it’s either going to work or not. There is no statistic for you. It works or not, but going into it, these are things that we can do that has shown in a general population to support. And now you make the decision whether it’s worth the time and money investment.

Paul Magarelli 

But if you look at a longer view, that group, not you, that group that did the acupuncture, that group were 15% more likely to get pregnant and have a baby versus those that did not do it. You may be the lucky one. It works straight. You may be the unlucky one. It’s not impacting your needs. We don’t know what your need is.

Lorne Brown

Here’s just because I want to support the field of Chinese medicine because it deserves it. In my humble opinion, when you go through an IVF and it doesn’t work, you don’t say that it was worth the money. I feel great. When you go through the acupuncture three or four months and you don’t have headaches anymore, your bowels aren’t constipated or diarrhea, you don’t have the rash or you don’t have terrible menstrual pain and you don’t get pregnant, you’re disappointed and get pregnant. But most people are appreciative that they can now sleep and they have better health.

Paul Magarelli 

Yeah, you have a much

Lorne Brown

Easier job than I do. Absolutely. Because trying to overtake the body, you got too, and on a serious note with respect, as you know, I’m a fan of integration, so I never complain about the other medicine or try and beat it down without Western medicine. We’re all dying at 40 years old. Right? Right. Great. From a couple hundred years ago. So I like it for that reason. So the integration is powerful and your medicine’s difficult because you’re trying to mimic the body, which is a crazy system. My medicine is, I’m trying to support it and I always use that to nourish the soil ideas. I don’t tell the plant how to grow. I got to pull out a weed, I add a little fertilizer, I add water, and then I say, go, but you’re trying to

Paul Magarelli 

Hybridize. Hybridize the grass. I’ve got make a resistant to pesticides, convert

Lorne Brown 

The sun to photos like you’re trying to be. God. It’s pretty difficult. So no, thank you for doing what you do. We’re getting close to wrapping up. So I have a few things I wanted to check on. One is we did a talk, and I don’t know where we did this talk, but we did a talk together. Thank you for carrying the load because you did most of it. As usual,

Paul Magarelli 

You got to tell me what talk this is.

Lorne Brown 

We talked about conditions, Western medicine needs CAM help, what conditions Western medicine needs Chinese herbal medicine, and back then, this again is easily 2014 around there. And back then you thought PCOS male factor endometriosis are things that you really like to see help that you think it’s a good integration. I’m just curious, now we’re in modern times. What do you think about that integration when it comes to PCOS, male factor endometriosis and if you have a response to that, kind of what’s your thinking and why?

Paul Magarelli 

Sure. Using the word syndrome anytime there’s a syndrome, ovarian hyperstimulation syndrome, ECOS syndrome, chronic pain syndrome, endometriosis, it’s a disease, but honestly we’re still questioning its origin and how it spreads, et cetera. All of those remain conundrums for western medicine. So we patch them, we put band-aids on them, we curette them or we cut them and then we sew them. So yes, I continue to absolutely believe that the TCM profession in a western market should concentrate on these huge ailments. I’m not going to make a political statement here, but infertility is like 0.0, 0, 0, 0, 0 0. One of the medical problems in any society, it only is important to the individual. It’s not important to society at all. It’s just infertility isn’t, that’s not an issue. It’s the person, the individual, the family, the clan, but to a population, those people you put on an iceberg and you float ’em out, they’re not reproducing.

And that’s how society evolved. If people were infertile as a major part of the society, there is no society. So we attacked that, the traditional Chinese medicine because it was there and for many of them it became a very lucrative business model to be a part of their medicine. The part that’s really needed is the patients with PCOS. About 50% of our patients, patients with endometriosis, about 15% of our patients, patients with fibroid, patients with chronic pain associated with the endometriosis male factor. But again, male factor, I would put that aside. Male health, I might say a little bit more, but let’s put the male factor fertility aside, but endometriosis, PCOS, recurrent pregnancy loss, that’s a complete unknown. We still have debates on what that’s all about. And anything that’s like that, that’s obvious and measurable in a population of farmers where TCM evolved, that’s something you can help western medicine deal with. And so I would emphasize that that’s areas where this integration and collegiality and in my role at Yoan, and by the way, I may have a new role as clinical dean there. We’re working on that process right now to lead the research, lead the integration, lead the education, lead this in this pathway of evolving a much broader role in women’s health. And again, this is not men’s health, women’s health where traditional Chinese medicine, lifestyle management, functional medicine can begin to attack these issues that have really not changed for decades or maybe half centuries,

Lorne Brown 

Not so much rapid fire. But I have my last few questions talking points for you. Thanks again for spending this time with

Paul Magarelli 

Oh yeah, it’s fine.

Lorne Brown 

We did a talk with Brian Grossman and Julie McCormick and you were at the end, we’re discussing some of the stuff around uterine receptivity. Just curious if you have anything you want to share with our listeners again about integration and uterine receptivity, if you can remember what you were kind of sharing and you had to cut it short because a call came on, which you prepared for me that you may have to. But can you touch on uterine receptivity using what you can remember from that talk and what made you excited?

Paul Magarelli 

The fundamental thing about uterine receptivity, we are dissecting in terms of uterine receptivity. The factors responsible for the opening and closed door policy that the uterus has for implantation. It has an open door and a closed door date relative usually to the inclusion of projections in the body from a corpus lutetium and the natural cycle and from gesteron around when we give you exogenously and we have began to dissect the on and off of the genes as being associated with the modifications you might have for individuals to enhance their fertility because for whatever reason, their genes open the doors a little later or a little earlier. And what I was suggesting to Brian, and I don’t know the answer to this, in your herbal formularies, in your acupuncture protocols, if you could put on the hat of this idea of turning on off genes, which again, we talked about the epigenetics and turn out or think about time.

What in traditional Chinese medicine is time dependent care? And if you can figure out a time dependent illness or disharmony, maybe it’s psoriasis, maybe it’s seasonal allergies, whatever the hell it is, and look at your medicine as working in a time dependent fashion, then I think you could begin to ask the question, what’s going on in the uterus and improve uterine receptivity or ask the question, what is it about the timing that we can influence? And if you can, that may be augmentative or synergistic with what I’m doing about my uterus receptivity in a very crude way. That’s was the aha moment for him and for me about our, and again, another way of bridging the integration and it takes work on your part and maybe there are experts who can answer this quickly, what traditional Chinese medicine is time dependent for its functionality and what in traditional Chinese medicine can influence the timing of a disharmony for a physiologic process.

Lorne Brown 

Right. So you have a question which makes us think, but not an answer. I was looking for an answer, Paul. I do know there’s that, I think it was a tens or electrical acupuncture study where they did see haw eight 10 shifting, which is a handshake between embryo and the uterus. And then I think it was in one of your talks where you brought up the herbal paper about the herbal formula in a stimulated cycle where they showed an increase in pregnancy outcomes when they were doing fresh transfers.

So back in the day when, well full circle here, when Dr. Diane Credenda came to you, you said, whoa, no, there’s no data, no evidence. And people in your field said, look, show us the evidence, show us the data. And then over the last 20 some odd years, there’s been data, then a lot of people in your field said, well, we don’t like the data. When it showed it was positive, they loved it. When it showed it was negative, mind you, then the study was good, but if the study was positive, it wasn’t a good study. My question is how do you respond now when in 2024, when we’re recording this late 2024, if somebody says there’s no evidence that Chinese medicine or acupuncture can support reproductive health?

Paul Magarelli

Well, the answer is there is evidence whether you like it or not, there are papers published using randomized controlled trials, which I don’t think blinded trials, which I don’t think are a good model for acupuncture for that modality of medicine. There are excellent meta-analyses that have looked at this from every which way to heaven. And then I just ask them or a comment that, do you know that we have been studying Clomid for more than 60 years, more than 5,000 papers, and there’s still controversy. So if you want uncontroversial or non-controversial data, then we’ll never have a conversation because I can’t find that in Western medicine. 50% of most publications now, when we look retrospectively, the data were fraudulent or they were not accurate. They’re interpretations of 50% of the medical literature. And Western medical literature is now suspect based on a variety of new ways of measuring accuracy.

So we are doing the best in fits and spurts, and we’re doing the best in groups, and we’re doing it best in populations to understand what could help some, not all, yes or no. So I’m never going to say it is proof. It’s a scientific method. And science by definition means it changes over time. Science does not mean it’s irrefutable. It just means we looked at it, we studied it using the models we had and the mechanisms for accuracy and removing bias at that time. And 10 years later, it could be the exact opposite. So we’re in a process. Is it harmful? It was my first question. It’s still my first question. I can’t find it harming.

Lorne Brown 

And the evidence, as you say, there is evidence and nothing is even western medicine, there’s very little of solid black and white irrefutable evidence.

Paul Magarelli 

And it changes. Yeah, it

Lorne Brown 

Changes

Paul Magarelli 

Evolve.

Lorne Brown 

And then in your practice, you had your practice in Colorado, then you were nationally working with clinics. Did you still up until do the transfer day acupuncture, was that still something going on in the IVF centers that you’re

Paul Magarelli 

Yep, yep. They still are. They still are. I don’t know of people who are not doing that, not doing, some of you seem to know that, but I don’t know that the people that I interface with still do that who are on the board and who created the board. But if you talk to them, they would much like to have more and you have to have the right practices. So in the practices that I have, we told them a minimum of nine treatments, not

Lorne Brown 

Just two. Oh yeah, let’s talk about dosage because we are onsite in Vancouver and we have people that do before and after, and we’re always encouraging getting a series of treatments before. But your data and the data you looked at, there is a dosaging that you saw results.

Paul Magarelli 

Totally, yeah. It’s like physical therapy. You can’t go once it teaches you something. Acupuncture teaches your body to be well or how to be well, or it encourages it to be well, the multiple interfaces with the acupuncturist teaches you how to change your lifestyle because acupuncture is not just a needle, it’s a system of medicine. That’s why I don’t like the titles of my papers, or how to use the word acupuncture. It should be acupuncture protocol. That was a better use of the word concept. So we found that we got our best from a statistical test to get 50% of the people who were going to get pregnant. Pregnant, they needed a minimum of nine treatments, which included, which was the cred, maga, really acupuncture protocol, which was derived from the PS and the center Victorian. So we took that, modified it, and then we moved with it. So yes, it’s even like people who would do sports. You can’t win a race just running once. You have to win a marathon running once. And if you’re dealing with the physiology change, which is a healthy bite, we’re not dealing with a fertile body, we’re dealing with a healthy body, all of those interactions need to be coordinated, and it takes time and focus and pursuit. And so I always recommend that there’s a broader look at the role of a healthy body as enhancing your fertility and being a healthy body takes persistence and perseverance.

Lorne Brown 

And we did a chart review where we did on site the acupuncture, laser acupuncture, and it trended. It was two years of frozen transfers of genetically screened embryos. So we knew less chance was the embryo issue, and the people that had the accu laser acupuncture on site had a higher pregnancy rate, lower miscarriage trait, and then they, again, it was just a chart review, so we didn’t put them into groups or categories or diagnosis. Then we looked at the patients we knew, because we don’t know if they were seeing other acupuncturists, but the patients we saw, if they did a series of treatments, at least seven treatments, then it was even a higher pregnancy lower risk care rate. They did a series of treatments leading up to that transfer. Dr. Mag, I always thought of you as an educator, like you really explain, educate and education can be really empowering. You’ve taught Healthy Seminars, you are involved at Yoan. And the other thing as a teacher is you’ve always been an advocate for affordable IVF. What’s up with you now? What’s happening? I think you talked about this technical conceptions company and what are you doing for the field of reproductive medicine? What’s your role now? Not what are you doing? What have you done for me lately? Idea, but what are you up to?

Paul Magarelli 

It’s an evolution. I have been in academic practice. I’ve been in multiple REI practices where it was a group of us. I was in private practice for decades. Then I was in international practice working with the Chinese and my practice in Colorado. Then I was a national practice working with a private company. As of now, I’m in a national venture capital company, and as of October 7th, I’m changing that trajectory and pulling back and I want to be more agnostic, more available to all of the industry rather than a specific employer. So I’m going to utilize my company called Technical Conceptions, and I’ll get the website up soon. Its goal is to train and educate gynecologists, advanced practice providers, executives who work in the field of fertility, and that’s part A of technical conceptions. Part B of technical conceptions is to be an accessible per diem doctor so that people who need to go on vacations, I’ve got medical licenses in about 20 states, I could support them.

The big arm of what I’m going to be doing is creating a reproductive endocrinology and a fertility consortium where I’m going to be supporting educational projects in multiple, competing on a gross level companies, but not locally. So they’re not competitors in the local market. They just happen to be in the same field to allow them to have a cost effective way to train new staff. And then as I mentioned during this talk, right now Yo San and I are working on me becoming the clinical dean at Yo San University because Yo San University is now in an enviable position of being really the leader in the world of integrative reproductive medicine. There’s no other places that offer the degrees and the education, et cetera, that Yo San University. So to all my ABORM members get your DAOM, in other words, go back to learn. It’s always learning.

But we’re going to be continuing and enhancing, and in this is going to be a first, we’re going to build the first reproductive integrative medicine clinic within Yo San, and I will be seeing patients with the faculty and the students at Yoan to coach them around how to best be a patient and how to get the most out of their care. That’s kind of a thing we’re working on right now. So I’m very excited. Everything’s going to start January 1st because after October, Diane and I are going to take some time in New Zealand with the kids and family and recharge. So I’m going to be doing a lot more seminars. So we’ll talk more about it. I’ll have the time for that. I have to update a lot of the seminars that you’ve had. I mean, they go back almost 15 years,

Lorne Brown 

Some of

Paul Magarelli

Them. Yeah, they’re good. They’re solid. But I want to make it contemporary and effective. We are going to be doing symposia. We do one every year at Yoan, which you’ve been at and certainly talked at, and we appreciate that. So it’s really an opportunity for me to take education to another level to finally help. And by the way, my reasoning for training gynecologists and apps in my field is to make access to care affordable. So it keeps coming back to how do we make it affordable and honestly, getting more people able to do it and more practices able to provide it will enhance access, which tends to reduce the cost.

Lorne Brown 

Excellent. I love it. I just enjoy following you and seeing what you’re doing. As you said, evolution, and it kind of mixes your two passions. One is you love to educate. We see this in your educational background. You did the PhD side of it, and then you went and became a physician and an REI and Affordable Care, and now you’re going to find another way to make things affordable. So thank you for

Paul Magarelli 

And Integrated medicine.

Lorne Brown 

Integrated medicine. And so we thank Diane Credenda for coming into your practice and said, I agree, I can help your patients.

Paul Magarelli 

And she ended up doing that. Exactly.

Lorne Brown 

She ended up doing it. So thank you very much, Dr. Mag. I really enjoyed our conversation. Lorne. It’s always my pleasure. It’s my

Paul Magarelli 

Pleasure.

Speaker

If you’re looking for support to grow your family contact AcuBalance Wellness Center at A-C-U Balance, they help you reach your peak fertility potential through their integrative approach using low level laser therapy, fertility, acupuncture, and naturopathic medicine. Download the Acubalance Fertility Diet and Dr. Brown’s video for mastering manifestation and clearing subconscious blocks. Go to ac balance.ca. That’s a-c-u balance.ca.

Lorne Brown

Thank you so much for tuning into another episode of Conscious Fertility, the show that helps you receive life on purpose. Please take a moment to subscribe to the show and join the community of women and men on their path to peak fertility and choosing to live consciously on purpose. I would love to continue this conversation with you, so please direct message me on Instagram at Lorne Brown official. That’s Instagram, Lorne Brown official, or you can visit my websites, Lornebrown.com and Acubalance.ca. Until the next episode, stay curious and for a few moments, bring your awareness to your heart center and breathe.