Season 1, Episode 69

PRP and Ovarian Rejuvenation for Egg Quality with Dr. Samuel Wood

In this episode of the Conscious Fertility Podcast, Dr. Lorne Brown sat down with fertility specialist Dr. Samuel Wood to explore the revolutionary impact of Platelet-Rich Plasma (PRP) therapy on fertility and how it has evolved from PRP to ovarian rejuvenation. Dr. Wood shares how these therapies offer a beacon of hope for women striving to conceive with their own eggs, challenging the notion that donor eggs are the only solution. Through a detailed analysis, Dr. Wood elucidates the evolution of PRP therapy to ovarian rejuvenation and its effectiveness in addressing age-related infertility, premature ovarian failure and premature ovarian insufficiency.

Dr. Wood also highlights the significance of timing in PRP therapy alongside IVF cycles, offering practical advice for those navigating these treatments. Additionally, he underscores the importance of stress management in optimizing fertility outcomes, recommending meditation and visualization techniques as valuable tools for relaxation and success.

 

Key Takeaways:

  • PRP therapy offers hope for age-related infertility.
  • Generation 2 PRP stimulates egg growth effectively.
  • Consider a four-week gap before IVF alongside PRP.
  • Manage stress with meditation for better outcomes.
  • Stay updated with the latest research for best treatments

Watch the Episode

Read This Episode Transcript

Dr. 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 Lorne 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.

Dr. Lorne Brown:

 

Alright, today on the Conscious Fertility Podcast, I have Dr. Samuel Wood, and we’re going to be talking about ovarian rejuvenation, also known now a lot by PRP. And we’re just going to talk a lot about fertility and that population where they’re often told, Hey, donor eggs are the only option, and those that are wanting to still conceive with their own eggs or do another IVF, is this something that’s possibly available to them? Who are the right candidates? And this is why I’ve invited Dr. Samuel Wood on our podcast. He is a fertility specialist, a medical doctor. He’s an expert in reproductive genetics with over 30 years of clinical experience. Dr. Wood’s background includes a master’s degree in psychology, so I guess that’s your PhD. And I think that’s actually such a good fit, Dr. Wood, that somebody’s working with fertility to have that background. So I’m sure your patients appreciate and benefit from that.

He also has a doctoral degree in biochemistry and molecular biophysics. I don’t even know what that is. And a Master’s of Business Administration. So really well-rounded from the sciences and the business side of it as well. He did a residency in obstetrics and gynecology at the University of North Carolina in Chapel Hill. He’s also completed a fellowship in reproductive endocrinology and infertility at the University of California, San Diego. And Dr. Wood, his board certified in obstetrics and gynecology and reproductive endocrinology and fertility. And his practice is in San Diego, California and it’s called Gen five Fertility. Dr. Wood, welcome to the Conscious Fertility Podcast.

Dr. Samuel Wood:

It’s great to be here, great

Dr. Lorne Brown:

To be here. Now for our listeners, as you know, we often have a lot of talks on consciousness and wakefulness, and then we have some that are very focused on fertility. So for our listeners, this is going to be one of those fertility focused talks. Dr. Wood, one of the reasons I wanted to chat with you is that many of our patients are searching for other ways to support them on their fertility journey. And PP is becoming something of interest, but there doesn’t seem to be enough research or we’re not aware of enough of it. So hence I wanted to talk to you. And then my colleague who practices in San Diego, he’s a Chinese medicine practitioner like myself, and he shared after I asked him about, do you know this Dr. Wood, that he does a lot of integration with you and that you really have that integrative mindset and you’re doing some pretty interesting things in San Diego. And here we are, patients asked me to talk to you. Mark Slar knows you well, and there’s a lot of interest in PRP, so I thought we need to have you on our show.

Dr. Samuel Wood:

Well, as I said, I’m very glad to be here. I think the psychology degree is really critically important. My son has become a physician as well, and he did the same major that I did. He didn’t do a master’s degree, but it really helped him. And also I’ve been interested in meditation and related activities since I was about six years old. That’s when I first started meditating and I meditate every day now, all

Dr. Lorne Brown:

These things. Maybe we’ll talk a bit about consciousness then in our talk as well.

Dr. Samuel Wood:

Yeah, exactly. Well,

Dr. Lorne Brown:

I kind of want to start with what is PRP and ovarian rejuvenation? First of all, just for our audience. Some of them, this is the first time they’re being introduced to it. And as you know, our fertility patients, some of them probably could write a paper on it because they researched it so much. But just to introduce us on why somebody would want to do PRP and kind of what this is about, and then we can talk more about how your clinic is doing it over in San Diego.

Dr. Samuel Wood:

Well, I’m really glad to talk about this because there’s a lot of misinformation out there about it. And unfortunately, some other fertility centers have not really kept up with the research. I think we have 10 or 12 papers just in the last two years, overall maybe 20, 25 papers on the relationship between ovarian rejuvenation, which as we’ll see is not just PRP and infertility. So there are some patients, I’m sure we’ll go into this later where PRP is the way to go, but they’re relatively rare and unfortunately, if you don’t get the right treatment, you’re not really going to see an improvement in your ability to become pregnant. And that’s what it’s all about. So some years ago I was actually thinking about retiring and the reason I was is that almost everybody was getting pregnant except for what we’re going to discuss today. Almost everything is fairly easily overcomeable, but this area is not.

And then one day I was just reading a paper and I got the idea. I said, this is what I should focus on. This is the most difficult thing there is. There is nothing more challenging than trying to help women who are reproductively older ones who are younger that have diminished ovarian reserve for one reason or another. And that’s how I got started in this and it’s worked out very well, but it’s demonstrated to me how challenging it really is and why so few people in the world fertility specialists are interested in this. It’s tough. There’s no doubt about it.

Dr. Lorne Brown:

So yeah. Why is it that it doesn’t seem like there’s a lot of centers I’ll actually share in Canada at the time of this recording, PRP in the uterus is something that can be done and is being done, but not into the ovaries. When I talk to some of the local clinics, they just say there’s not a lot of good data to show that it’s working. But I have a feeling you think differently from that and curious if it’s something that’s helping a lot of people. How come other clinics haven’t jumped on it? Because when we started doing genetic screening and it didn’t take very long blasts when something had some data and was working, it seemed like clinics jumped on it pretty quickly. So what’s happening with the PRP?

Dr. Samuel Wood:

I think there’s a general reluctance to do something new. And in fact, it was some years before PGS became popular and even when it became popular, there were many people that were against it and there still are now. I think there’s just a natural reluctance to do new things, but I think you have to keep up if you’re going to take care of certain kinds of patients, let’s say patients with PCLS, polycystic ovary syndrome for example, you have to keep up on the latest information that’s available. We have published and published and published this. There’s actually a lot of good data out there in my opinion. And I think any fertility specialist going to take care of women 39 and over really needs to keep up with it because time is so critical. You don’t do the right thing for a patient, you give it another year, another two years, sometimes their chance of success is gone.

And that’s a really sad thing. Today I saw a patient who waited four years, four years, and they just said, oh, he’s just not trying hard enough. Have a half a glass of wine. These are fertility specialists saying this to women. And unfortunately, a lot of times fertility specialists are saying that to women because they want to get them, believe it or not, they want them to become old enough that they’ll accept egg donation. And they know if they try to do IVF for example with these patients, the chance of success is not high and they don’t want to take that hit on their statistics. So instead they have them do other things and they don’t really give ’em the best treatment. They don’t really keep up.

Dr. Lorne Brown:

So let’s talk about this population’s advanced maternal age or those that have had unsuccessful IVF cycles and been diagnosed either with diminished ovarian reserve or premature ovarian insufficiency or even just it’s an egg quality issue or embryo qualities aren’t looking great. What would be your approach and are you into the, it sounds like you are the integrative model. It doesn’t sound like you’re just doing PRP. So when you’re looking to optimize egg quality or your term ovarian rejuvenation, are you looking at diet? Are you looking at supplements? Are you a fan or the data with acupuncture? And then what are you doing with your PRP? Because when I did my own you start to learn more about it. I was aware of PRP and then I realized you have generations of PRP or levels of different P rrp, so you don’t have a PRP for everyone you have based on what this person is coming in with, you may give them a different style of ovarian rejuvenation. So big question, but I’m kind of wondering, people just come in and do PRP, they can keep smoking, drinking, not taking care of themselves, or is there a nutritional dietary component is acupuncture. I know my practice, we like to use low level laser therapy with acupuncture. And then what is your PRP or what is PRP doing and why have you not retired because you found this other service?

Dr. Samuel Wood:

It’s a complicated question, but here’s the important thing to remember. PRP doesn’t work. It doesn’t work. If you look on our website, you will see a paper that had over 300 women in it, over 300. And for age related infertility, PRP does nothing. And so it bothers me that despite that data and in the absence of any new data, people are offering PRP to women who are reproductively older. We know it doesn’t work. And that’s why we started working on generation two. Generation one is platelet rich plasma, which works wonderfully for athletes that are injured. It works extremely well. It does not work for age related and for, so we call that generation one, generation two is something we call pl, which is enriched platelet factors. What we do there is we don’t activate a platelet and then inject it into the ovaries. That’s basically what PRP is.

And the reason we don’t is that the growth factors that are released from activated platelets, the concentrations are rather low. And I think that’s why it doesn’t work. If however, you take an activated platelet and you put it in an incubator for an hour or two and then you isolate the growth factors that have been released by the platelets, then you’re onto something. We haven’t published this yet, we will soon. But basically for most growth factors, you get a 10 times greater concentration when you put them in an incubator and you let them do their thing, which is to release growth factors. That’s what platelets do in real life and it’s what they do in an incubator. When you inject that, then you can see a profound effect on age-related infertility.

Dr. Lorne Brown:

So I want to just unpack because I know you have four or five styles of ovarian rejuvenation and it’s starting to get a generic term of PRP, but you’re saying that ain’t correct. So the original out of Greece, we heard a lot about it was PRP plasma rich protein where they injected back. You’re saying great for injuries, not so much for advanced control H, you didn’t see it work. Then you’ve done something similar PRP, but you put in the incubator and now you’ve activated the growth factors. So you’re putting back the growth factors versus the PRP part. You’re putting back the growth factors and that you’re seeing clinically an improvement in advanced maternal age or in ovarian quality egg quality.

Dr. Samuel Wood:

Yes. Let me say one of the things first, we do use PRP in one situation, and that’s with premature ovarian failure. So these are women that have high FSHs, low AMHs, and they’re under the age of 40 for them. It does seem to help along with the other treatments that are required to succeed. So it’s not that we never do it, we just don’t do it for age related infertility.

Dr. Lorne Brown:

Just to differentiate, what’s the difference? So you have somebody that you said, what was your term? They had high FSH, low A MH, premature ve and failure I think is what you said.

Dr. Samuel Wood:

What’s fascinating about premature vein failures is everyone calls them menopausal. They go in to see a fertility specialist. They say, listen, it’s sad, but you’re 35 and you’ve already gone through menopause.

Dr. Lorne Brown:

The reason it’s premature is because this is something that happens in your late forties, early fifties. So in your 35, 38, that’s why it’s called premature. So sorry to interrupt. I just wanted to clarify that that’s why we’re calling it premature of ear and failure and often gets the term menopause because they’ve stopped ovulating

Dr. Samuel Wood:

And they have hormone values that are associated with menopause and they have hot flashes, they have many of the symptoms of menopause. But if you were to take their ovaries out and look at ’em under a microscope, you’ll see many, many eggs. They have not lost their eggs. That’s the definition of menopause. It means you have no eggs left, but they have lots of eggs, but it’s really an autoimmune disorder where the immune system attacks the follicles and they’re many antibodies that have been found in the blood related to this. And so it’s something that is potentially reversible. I’ve certainly seen that it’s relatively rare, but what we’ve learned is if you do PRP and you also use hormonal medications, 70% of the time you can actually get eggs out. And because these women are young, a typical age is probably 30 to 35, the egg quality, the genetic quality of the eggs that you get is quite high and they have an excellent chance of success. Among the people we’ve had is a couple who became pregnant within 10 days by doing this treatment, and we discussed that at other places. So yeah, it’s completely different from age related infertility, which is related to a reduction in eggs and a reduction in egg quality. Whereas with puff, you don’t have any reduction in eggs and you don’t have any reduction in egg quality. You simply have a reduction in the ability of the ovaries to release the eggs,

Dr. Lorne Brown:

And that’s where you like to do PRP. You’re much quicker. You said 10 days. I worked with a woman with premature VE failure at age 35. Again, diet supplements, acupuncture, herbs, low level laser, and she had an undetectable A MH elevated, very elevated FSH and progesterone testing, no ovulation. And then over several months of treating her cycle returned and within nine months she conceived and had a little girl, and this was after multiple ovulation drugs, Letrozole and CLO not helping. And we know POF, some of these people just start to cycle on their own, like they go into POF and then a year or two later they come back. And so you’re sharing PRP, that’s a candidate for that group. The majority of the patients I think you’re seeing are the ones that are advanced maternal age or there’s an egg quality issue. And this one is where you’re doing the growth factor. So I’d love you to continue. So those types of women, you’ve been able to help some of those women.

Dr. Samuel Wood:

Alright, just two to make one more point. Nine months is fine. 10 days is extraordinarily short. I only have one person in that range. The longest it’s ever taken for someone who ultimately succeeded is 18 months. So it’s all the things, I feel better.

All the things you did are very reasonable and in the end you succeeded because of what I said, you helped her ovulate. And that’s really all it takes in someone who’s quite young and has good egg qualities as well as all the other factors that are important in infertility. Okay, now back to your last question. Yeah, we did PL and it worked well. There was just one problem with M five, which is it only lasts about three months and because of what we just discussed, whether you’re young or older reproductively, it’s common for it to take more time than that. So then we developed a new technique, we called it ultra and ULTRA involves doing both generation one and two at the same time.

Dr. Lorne Brown:

Now I want to unpack this a bit. These things, so generation one and two, generation one is that PRP then generation one and generation two are growth factors. Okay, so ultra is PRP with growth factors and now sure there’s an extra add-on to that.

Dr. Samuel Wood:

Well actually there is, but that’s generation four. So generation three or ultra is the combination of generations one and two,

Dr. Lorne Brown:

Okay?

Dr. Samuel Wood:

And what it does is it provides a nice bump in fertility for six to seven months instead of three months. Now we’ve looked at this very carefully and there’s not so far a discernable difference in how successful it is whether you do generation two or three. The main difference between the two is how long it lasts and six to seven months, especially if you’re reproductively older, that’s an important length of time because many women who are reproductively older don’t make very many normal eggs, which lead to normal embryos which lead to a baby. So six to seven months is a much more viable length of time in order to succeed. That being said, we’ve had many pregnancies with just generation two. They respond very well and they get pregnant quickly, but most need generation three.

Dr. Lorne Brown:

When you’re doing this, are most of them following into an IVF cycle then after this because of time of essence, and this is how you’re kind of getting your data as well to see how this is working?

Dr. Samuel Wood:

I would say yes, most of them do, but we have a paper coming up, which is eight women who became spontaneously pregnant after doing a band rejuvenation. I’m really happy about that because there are many couples, many women that don’t want to go right into IVF. They want to try themselves first. And it really pleases me that it does work for some couples, some women even spontaneously. And two or three of these women, it’ll be in the paper actually we’re not ovulating before they actually had progressed far enough into the perimenopausal area that they stopped making eggs or releasing eggs

Dr. Lorne Brown:

With the ultra where you’re combining PRP with the growth factor, which gives you what I heard is longer time, it lasts six or seven months. Two part question is what is the mechanism of what this is doing? Why do you think the eggs respond and if it’s six or seven months later because you have the eggs, you’re releasing either in an IVF cycle through retrieval or you’re ovulating, you’re going through a pool of follicles each cycle. So it lasts the six, seven months, is there something happening in the ovary that is helping all the recruitment over these six, seven months which would benefit people if they have to bank embryos or do a series of cycles? It makes me think of just the Chinese proverb: nourish the soil before you plant the seed. And the metaphor here, soil is the cellular environment. So if we have good blood flow, lower oxidative stress and inflammation, healthy mitochondrial function, remove endocrine disruptors, good nutritional profile in that environment, then the follicle which contains the egg will have a chance to reach its peak fertility potential.

And I think if PRP and the growth factors are you’ve added something to the soil that these follicles through their follicular genesis will get bathed in and it sounds like you’re going to have six to seven months to do that, which will be beneficial in trying. So the question was that’s my guess of the mechanism, but what is the mechanism? What do you think about how this is benefiting the egg quality? And did I understand correctly that it’s having an impact on this? All these pools of follicles that are coming through over a seven month period, which gives you a chance to do more than one IVF cycle if you need a bank reel or if a cycle doesn’t work.

Dr. Samuel Wood:

That was very well said. I think that’s one of the important reasons that time is important. But here’s kind of a shocking fact. 80% of the fertility centers in the world have never had a single live birth in any woman over the age of 42. They’re trying, they’re getting eggs, they’re getting embryos, but if they test them they find out that they’re genetically abnormal. So I think that’s probably the primary reason is that everything we do is around keeping a normal egg normal. You cannot make abnormal eggs normal. Not right now. In the future we might be able to go in and take out the odd extra chromosome, but right now we can’t do that. And so instead we want to give normal eggs a chance. And what’s not appreciated is that the protocols that fertility specialists use actually cause eggs to become abnormal and there’s a high rate of transition from normal to abnormal and then you’re sunk if you don’t trigger ovulation on the right day, increased chance of abnormal if your IVF lab does not fertilize the egg in an optimal way, increased risk of abnormal. So it’s very common for me to see patients that have done multiple cycles and when they got their blasis, which is a stage at which embryos and plants were tested, they found out they were all genetically abnormal. So I think that’s what’s really going on here is that sometimes it takes time to get that normal embryo and sometimes three months it’s just not enough. Sometimes it is, sometimes it isn’t. It’s impossible to predict in any given cycle what you’re going to end up with after the genetic analysis.

Dr. Lorne Brown:

So I’d love you to clarify a bit because I’m thinking of the probability here. It says sometimes it takes a while to get normal, so does the intervention, is the intervention really doing anything? There’s a normal egg in there and you’re just doing multiple IVFs and eventually get that normal egg, then you’ll have success. So how is this intervention making it any different? Because that normal egg is normal, you’re not changing the abnormal ones. So why even do anything? Why do the extra intervention if we’re just waiting on the odds of getting a that normal egg that’s somewhere in there

Dr. Samuel Wood:

That makes a lot of sense except that there have been thousands and thousands and thousands of cases done at these 80% of the fertility specialists. They’ve never gotten a normal embryo, never gotten one even though many normal eggs were made, many normal eggs started, but what they did was negative. When you use a typical dose for a woman who’s 39 or over and you say to her, listen, you’ve got resistant ovaries. If we don’t, you don’t teach you hard, you are not going to be able to make enough eggs to succeed. And they tell ’em, women, only a certain percentage of each woman’s eggs are normal, so we need to get a lot of eggs, a lot of eggs, and then we’re going to find a normal egg to make a normal embryo and then you’re going to get pregnant. But what they’re not telling ’em is when you use high doses of medication, you’re actually poisoning those eggs. You’re reducing the chance that they’ll end up with a genetically normal embryo. So there’s no doubt that what we do helps, no doubt at all because these women last year, someone failed 18 times before getting pregnant, another case another 18 times pregnant, that one ended up in the newspaper here. So we’re increasing the chance that an egg will stay normal, we believe, and we have good evidence that virtually all women occasionally make a normal egg even if they’re considerably older than 43. When they do, we want to keep it normal.

Dr. Lorne Brown:

I have a theory and it’s a theory, so you’re the expert. I got to ask because why I think what you’re doing may be helping and why people like that you work with like Mark Slar in San Diego and what we do at Accu Balance of Vancouver, my understanding is the mitochondria of the egg, it takes energy when there’s that fertilization and the chromosome split apart. It takes energy and there can be a lot of errors if the egg is older or not healthy. A lot of oxidative stress and I think acupuncture, diet supplements, lifestyle growth factors, it gives the age some rejuvenation protection. So it can withstand some of the manipulation that happens in an IVF lab. It can withstand some of those drugs that would make them abnormal. And so that’s where I think it may be helping because when they separate and then the sperm and the chromosomes come together, again, there’s a lot of energy but a lot of opportunity for errors. And if the egg is healthier, it is more resilient, then it can handle the stress of those drugs or the manipulation that happens in an IBF center. That’s my theory.

Dr. Samuel Wood:

It’s beautiful.

Dr. Lorne Brown:

I don’t know if that’s what’s happening.

Dr. Samuel Wood:

No, I think you’re absolutely right. We don’t really understand what these various treatments do, but I like them and I actively encourage my patients to see Dr. Slar and to follow that regimen. I used to have my own regimen, but basically now I love his regimen and that’s what he does. We do have supplements that we recommend. We put all patients with advanced maternal age on supplements and I think the supplements are very valuable. Most of the data on the supplements so far is based on mice, but we’ve gathered some data too on humans and we are seeing a benefit there. I’m a huge believer in acupuncture. I would say probably 70% or more of our patients do acupuncture, interested in light therapy, interested in just about everything you mentioned. And so he and I have actually discussed doing some studies looking at these various treatments because right now it’s just not certain what effect they have and there are ways of doing excellent research and being able to publish this research so the patients know whether or not there’s data to support it. If they want to do it anyway, it’s absolutely fine because one bit of data doesn’t mean that much, but if you can get data that shows that this or that treatment can potentially be effective, I think that would be wonderful.

Dr. Lorne Brown:

Thank you. And I agree I would like to see more research on this. And you mentioned the mice. Yes, if only our patients were mice, it would be so much easier. Right. So going back to the overview of rejuvenation, it sounded like you had another after the combining PRP and growth factor, it sounded like you do. Oh no, I know the question I want to ask because I want to talk about your other levels, but I think you hinted about the high doses of hormone treatment. So if somebody already has elevated FSH, it sounds like you don’t go with a high in Chinese medicine and homeopathy less is more. Are you saying then you don’t pound the ovaries with high doses of medications then if they’re already with high FSH?

Dr. Samuel Wood:

Oh no, absolutely not. Well, what’s interesting is if someone has high FSH, you give them nothing, no stimulation whatsoever. It won’t work. The most medication that any ovary wants would be an FSH level of let’s say 20 to 25. That’s it. And that’s why we see so many patients that not only didn’t succeed at another center, they never even got to retrieval because they went in and they had a 25 or 30 FSH and they said, as I said earlier, we’re going to get tough with you. We’re going to teach your ovaries a lesson, they’re going to make some eggs. And so they gave them more FSH and they sent them far beyond what an ovary wants. And when you do that, you actually see growth stop even using low doses. We see that. We see that the FSH has gone too high and we compare the size of the follicles on a Wednesday with a Monday and there’s no growth.

But then when you reduce the FSH levels, then you have a chance to succeed. So we’ve helped women up to a 57 FSH. These are not off patients that can have it 120, 130, but these are women in their forties up to FSH of 57, and we’ve helped them become pregnant. The way you do it is by reducing the FSH. That’s how you’re stimulating them. It’s too high. But once you drop the FSH, then the ovaries are able to respond. We use a variety of different measures to get the FSH down. We even have several patients who have gotten pregnant using birth control pills. That’s all they took, birth control pills. Now people think that’s impossible, but it’s not. When you take a birth control pill, what happens? Your FSH level goes down, and if you give them the right dose, we use an eight to quarter a half, all kinds of different dosages. When you give them the right dosage of birth control pills, the FSH gets down so the ovaries can respond and they become pregnant on pills. It’s really quite amazing.

Dr. Lorne Brown:

Now I have more questions on this and everybody, I can think of my patients saying I want more on the PRP, we’re going to get back to the PRPI promise. So here’s what I’ve heard for my 20 plus years in practice, the FSH is elevated because the ovaries or the follicles aren’t responding. So a de facto a quality issue, and anybody can lower FSH by giving the estrogen that inverse relationship. So estrogen will cause the FSH to go down, but that doesn’t mean the egg quality is better. But I’m hearing that you are lowering FSH. You didn’t say how, but I’m assuming, well you said birth control pills, so there’s some estrogen there. I’m even thinking of the priming that people do sometimes 30 days before then would help these kinds of women because estrogen, right? So what’s the mechanism there? If you’re, what is actually, I’ll understand the mechanism this way, what is happening if you give them a high dose of FSH, you use the metaphor like they’re running away, whatever, but what is happening then to change the quality?

Or is there something happening to the FSH receptors? What is happening when we give a high dose of FSH? And then you take that away. Maybe that’s the reverse. You took it away, the high FSH. So is there something that, because I only understood it as it’s a quality issue, you’re not going to change it from a Western medical perspective like you’re as good as you get Chinese medicine. We still think we can nourish the soil and create the environment to improve. It sounds like you’re doing something to the environment. So I’m curious to hear what you’re doing to help that environment.

Dr. Samuel Wood:

Yeah, the problem is downregulation, when you have high levels of FSH, the receptors for FSH, they go back into the cells. They’re downregulated and they can’t respond to FSH. And so you have to get the FSH level, right? It’s not the case that anyone, maybe somebody in their fifties, mid late fifties has no eggs that are normal. They do. It’s just a lower percentage as they age. And so by reducing the FSH level, you give the follicles a chance to respond. They have eggs, and when you give them a chance to respond, the eggs can grow. Then you got lucky. You have to get lucky that they will make a normal egg. So the women that have succeeded with the birth control pill, for example, are in their forties. They’re not in their fifties. You need to end up with the normal egg.

Dr. Lorne Brown:

And so again, we have all the eggs we were born with, that’s females. And so you’re saying when you say release a normal egg, so we have to recruit a normal egg and it has to mature to be released. That’s the lucky part.

Dr. Samuel Wood:

That’s exactly right. But it won’t happen unless the FSH level is low enough. So occasionally in a menopausal woman, you’ll see a cyst. Now cysts are usually dysfunctional follicles. And in many cases, just because the FSH was so high, the follicle couldn’t develop as it should. And as a result did not ever receive the so-called LH surge, which would’ve caused an egg to be released from that follicle soon to be cyst. And when you see these women, they’ll have very large cyst, but most of those started as follicles. And so it’s a matter of restoring the body to where it used to be when it used to be able to respond. One of the things we have to learn is what level is right for that woman. And when you don’t know that sometimes you’re a little low, sometimes you’re a little high, but you tweak it. We do a lot of tweaking. We want the follicles to be able to grow.

Dr. Lorne Brown:

And then not only are you using certain interventions to lower the FSH, but part of that is your ovarian rejuvenation. And so you mentioned you had the growth factor with PRP, I think you call it the ultra, and then you have another ovarian. I think there’s somewhere you’re using NAD. And are you doing, what’s the iv? Because we use nutritional IVs in our practice with glutathione, but I don’t know, maybe your IV is a different iv. Can you tell me, is that a different ovarian rejuvenation generation?

Dr. Samuel Wood:

Well, yeah, we call that generation four or ultimate. Okay, now of course, of course it’s not old. At least I hope not. Life would be boring if you were already doing the ultimate. So yeah, they do IBS of NAD and glutathione. I’m a huge glutathione fan. And then we take a bit of the NAD and we inject it directly into the ovary. Now, ultimate has had different meanings over time. We’ve tried various things. Injecting growth hormone, injecting FSH, injecting small amounts of HCG, you name it, we’ve tried it

Dr. Lorne Brown:

Into the IV bag or into the ovary,

Dr. Samuel Wood:

Into the ovaries. And the one that works the best so far is NAD. It is proven to be amazing. Now, it doesn’t work for all women, but for some women you do the NA divs and in some cases inject into the ov and you see multiple follicles beginning to grow.

Dr. Lorne Brown:

Curious about the NA divs just because it’s something we’ve considered a lot and our naturopathic doctors, we haven’t gone there yet, just the data, but more importantly, the safety. And it seems like it’s several hours to do a proper NAD drip and it can be quite uncomfortable for patients. We haven’t done it yet, but I’m wondering what’s been your experience? Is it several hours the way you guys are doing it, and can it be uncomfortable for the patients?

Dr. Samuel Wood:

There are a few patients like that, but it’s because of one of its side effects, which is nausea. So some women have a lot of nausea associated with that. And it can take, let’s say, four or five hours for a liter bag. But for most women, it’s two hours, three hours. They tolerate it well. They have a little bit of nausea, but the moment it’s pulled out, they feel great. And in the US a lot of people use NAD for not only anti-aging without regard to infertility, but in order to perform better. So someone has a large seminar they’re going to give, they’re going to be, who knows, 20,000 people there, or they’re going to give a concert and they do an NAD infusion. And when they take it out, they feel great. They feel like they can jump over the building. Of course they can’t really, but they feel like they can and they feel like it helps them perform. So we don’t totally understand everything NAD can do. We’ve had no complications, no significant side effects, nothing at all. And it’s one of the most popular infusions in the us. It’s done at virtually every IV infusion center. So

Dr. Lorne Brown:

NAD IV that you do, plus you do an NAD injection. And we’re fans of glutathione, the mother antioxidant as well. And we include that in our IVs. When people have an IV at our clinic, we will most often recommend it and use that. And I like receiving it as well. And so is that for a certain population or is that just something that has evolved from the one that you had from the This is the ultimate, the ultra, is this what just evolved and is it kind of replaced the one before that generation three?

Dr. Samuel Wood:

Yeah, with Ultra it works well, but I realized it’s not the whole story. There are too many other things that could be done. And I wanted to look at whether adding one of these other elements would be helpful. I get most of my ideas about this sort of thing on Sunday night, one Sunday night, I said, we got to try some other things. Nothing else really has worked as well. And so we’re big fans of it. We continue to look for other substances that we’d want to infuse. But for now, that’s what we do. And as I said, we always add the glutathione at the end because I agree with you in my mind that that’s the antioxidant right there. If you’re going to be serious about it, you include some glutathione iv.

Dr. Lorne Brown:

And it seems we’re just not convinced how good the orals are absorbed yet. It seems that it’s pretty hard to get it orally. There’s some out there with the liposomal how they put ’em together. Maybe they’re claiming it’s oral, but I think if you can tolerate IVs, that’s the way to do it. And even we found even intramuscular, the glutathione not as well received or beneficial than if you do it in the IV through the IV into

Dr. Samuel Wood:

The bladder. I totally agree with you.

Dr. Lorne Brown:

So questions around the PRP, I’ve heard mixed suggestions. Some say soon as you do the PRP, you need to go into an IVF right away because of its lifespan. And I understand we’re no longer talking PRP, now you’re talking about ovarian rejuvenation because you’re doing growth factors and other things. And then I’ve heard others say that you want to wait three months to give it a chance and then go into an IVF cycle. You’re sharing that you very rarely do G-S-P-R-P, if I recall. This is only for those that are in their thirties with POF premature variant failure, but the rest of the majority of the patients that have had egg quality issues, unsuccessful IVF that are advanced maternal age, these are the ones. If somebody’s going to go in and have the growth factor with the PRP or add NAD to it, is the benefit pretty quick and it would be a good idea to go into an IVF quickly or should they wait and allow the recruitment over a hundred days. So when you do an IVF, those follicles that they’re going to retrieve have had three months to be in this beautiful soil, this environment.

Dr. Samuel Wood:

Great question. We’re actually doing a study on that. We’re comparing three different lengths of delays, four days, four weeks, eight weeks. Now. I think it’s pretty clear that four weeks is the best time. However, we’ve had some patients that really did not respond until eight weeks. So where do we get the four days? Well, we take care of a lot of patients from China and they come to San Diego and they say, listen, I got to be back in 18 days. And so I decided to try for four days. And what’s interesting is it actually has worked for a substantial number of patients. So we have an ongoing study where we’re comparing those four times, but for a typical domestic patient, I would recommend four weeks. They do pre-treatment during those four weeks, and then they’re ready to start stimulation at the end of the four weeks.

You always check first. You see what evidence there is that they’ve responded. If it doesn’t look like they’ve responded, in some cases we’ll have them wait another four weeks. So the people that have waited three months, we have some patients like that. They’re ones that prefer to get pregnant naturally if they possibly can, but the vast majority of our patients have done multiple IVF cycles. The average is around 5.3 failed IVF cycles before they see us. And so they don’t want to wait. They want to do it as quickly as they can. And as I said, for domestic patients, we recommend that they wait four weeks, but we don’t do anything during those four weeks. We prepare them to start right at four weeks by doing pre-treatment of one sort or another. When

Dr. Lorne Brown:

You say pre-treatment, is this where you talked about the integration, acupuncture, herb supplements, or is this your priming, you’re doing priming or is both?

Dr. Samuel Wood:

It includes everything. There’s a lot of action in those four weeks, getting them ready, I believe, as I said in all those things. And some patients do everything, some do some fraction of those things, but we recommend them to everybody to prepare them to have the best possible chance in four weeks.

Dr. Lorne Brown:

And then I’m going to ask that question again about the timing. I’m going to change it. So take time and money out of it, take where they live out of it. Ideally, if somebody’s trying to increase, somebody wants to increase their chance of a live birth, do you recommend that they do an IVF immediately or wait three months based on your clinical experience, based on your data, take away all the inconveniences because they’re coming in from another country. Just ideally, what’s the best recommendation? I understand you will make changes based on the patient’s needs, financially, location, time, et cetera. I want to remove that and just go based on what you see clinically and any of your research. If you could say this is going to give you your best chance, what would you be recommending in general? For timing,

Dr. Samuel Wood:

I would recommend four weeks. Okay.

Dr. Lorne Brown:

And

Dr. Samuel Wood:

Then the problem at three months is you’re well into the process and you don’t know how long it’s going to work for you. So I would definitely not recommend three months. I think that’s an error. That’s a mistake.

Dr. Lorne Brown:

So four weeks. And then a related question is, is it a one and done thing? You do PRP and you’re done, or is it something you can do regularly with the benefit and reducing risk? Obviously, and I want to add to this question. Again, I’m thinking from how I practice what I see, we use low level laser therapy, we use acupuncture, and we don’t do one acupuncture and you’re done. We don’t say take coq 10 once and you’re done. We don’t say one injection of glutathione. We usually work with them for over a hundred days. So we’re constantly wanting to regulate the hormonal profile, so regulating blood sugar, regulating inflammation, reducing those stress homes, continually increasing blood flow because one acupuncture treatment will increase blood flow, but it won’t last. But we know there’s one study twice a week over four weeks, and then four weeks later after the last treatment, the blood flow had continued right in the, so when we do our laser treatments, we like to do it over three cycles, ideally, because then we’re hitting the a hundred days of that recruitment where there’s massive growth.

The downloads of the FSH receptors have happened, the follicles are receiving blood flow. So that soil right, that’s using herbs and supplements and acupuncture meditation with PRP. In my mind, I would think that there’d be benefits to having a series of PRP over three months, but I don’t know about PRP. I’m talking to you. So it’s a different intervention. Can you tell me if it’s a one and done or somebody would benefit, take time, money and travel out of it as well? What do you think the benefit is? Or do we know what the benefit is?

Dr. Samuel Wood:

I would say the vast majority of our patients only have it once. There are some centers where they recommend that they have it every two weeks, every month, something like that. I don’t really see the need for that. Also, it’s a huge hassle for patients. I think you have to show some benefit in order to recommend that. Now, we do have patients that say after two months they make a normal embryo, but they know that they’re reproductively older and they may want to have more than one child, so they want to do it again. But by then, let’s say they were MLA for generation two, the benefits are gone. So they’ll do it again. And you see this when three months have passed, someone does the second cycle, they just don’t do as well. So there are indications to do more than one, but in general, they’re related to the length of efficacy of the various treatments.

But one patient I just saw again recently, she started with undetectable A MH levels. I think she was 44 years old, and hadn’t had periods. We did it the first cycle. She started having periods, she made an egg, she made a normal embryo, and now she has a baby from that one. Then she did it again. She did ultra, she did it again, and she was able to have a second baby or let’s say in a pregnancy at around 30 weeks. And then she wanted to have a third baby. And so yeah, in that kind of case, of course you’re going to do more than one because the time of efficacy is gone. But in general, no, in general, by the end of one attempt, whether it’s, yeah, usually if it’s six months, you know, you know what your situation is and then you’re able to make a decision without doing it again. And so most only need to do it one time unless they want multiple children.

Dr. Lorne Brown:

And then I’m thinking of my patients that I see in the British Columbia area. So we have some that will go and do PRP elsewhere because they have to, because we’re not doing it in Canada at the time of this recording in the ovaries. And then they’ll come back and do an IVF here. Will you send your patient kind of your IVF ID if it’s not feasible for them to stay in San Diego and do an IVF? So when they can come back to Canada, I know the clinics here, they’re on the fence with PRP, they’re just waiting for more data. First of all, I think their hands are tied. I don’t think they can do it yet. I’m not a hundred percent sure, but they’re not doing it and they’re waiting for that data. So they’re not like gung-ho telling patients if we think it’s a great idea, they’re open to it, they’re curious to see how things change. And I just know with the patients the stress in this, there’s the investment to come to a clinic like yours and have PRP done, then they want to do IVF. They do want to, you may have a different way of doing IVF. From what you’ve seen with this population, do you send them with protocols so the doctor can consider following somebody else’s protocols?

Dr. Samuel Wood:

Yeah, I do. It’s incredibly frustrating. They just won’t follow the protocol as many times as it has worked. They want to do what they want to do. And so we’ve actually had a few patients, this is just between you and I and the audience who took the protocol, and that’s what they gave themselves. They ignored what the doctor said to do. They did it themselves and they succeeded. And I remember in one case, the doctor said, see, I told you, I told you my protocol was the best protocol. I told you you didn’t need to do any silly low dose protocol and see I was right. And the patient never told them. They actually followed a protocol that they got from us. I think if you’re not an expert in something, why are you just coming up with your own protocol? It makes no sense to me. If there were some medical problem that was being treated at the same time as an IVF, as doing an IVF cycle, and some doctor says, look, I’ve done a bunch of these and here’s what you got to do. I’d be happy to follow it. It’s not a, you’re better than I am or I’m not as good as you. It’s not like that. I think everyone should do whatever the evidence points to give the patient a real chance.

Dr. Lorne Brown:

And has there been a study done because one of the clinics believe or thought there’s some data on this where they’re not sure if it’s the PRP doing anything or more of the needle into the ovary that’s stimulating that healing response that’s causing the improvement. And their thinking would be, you just need to keep doing IVF because the egg retrieval is doing that. But clinically, you’re doing IVS with PRP ovarian rejuvenation. I’m going to stop calling it just PRP because that’s not what you’re doing. So you’re ovarian rejuvenated, and you have patients obviously that don’t do that. In those demographics, do you have clinical data to show that you’re seeing a difference when you’re comparing demographics doing the ovarian rejuvenation?

Dr. Samuel Wood:

Well, there’s an enormous amount of data. What they’re saying makes no sense. These are women that have done IVF after IVF, after IVF. They’ve had their ovaries stuck several times and they continue to fail. How could it possibly be simply putting a needle in an ovary? The couple I mentioned 18 times, someone stuck a needle in there, they never got anything out of it. We know that after 1, 2, 3 cycles, this is the most you can find any evidence to support that pregnancy rates fall when you do IVF, they do not go up because they’ve been stuck again. So their skeptics, unfortunately, don’t realize study is done. It’s done every day in every IVF center. Someone gets stuck many times and the pregnancy rate does not increase. I don’t believe that for a moment. And there’s zero evidence to support that.

Dr. Lorne Brown:

Okay, thank you for that. As we wrap up then, the mind body part, your meditative practice. So just curious about your practice, how has that influenced how you’re practicing since stress is such a part of this journey? I guess I should ask, do you think stress can impact your health and your fertility should be the first question, and then I’m assuming that’s where working with the acupuncture Mark Sclera helps out. But are there other things that you recommend with your patients since you’re a meditator yourself?

Dr. Samuel Wood:

I recommend meditation to them because meditation is kind of a vague term, and so it’s not easy for them to know how to translate that into their own practice. So one of the things I’m doing is putting together a program to teach people how to meditate in fertility practice. Because if you think about it, lots of different things happen during a typical IVF cycle. And so what we’re working on is different meditations for different things. I’m a big believer in visualization along with meditation. And so you could see how you could easily set up a program where they say, okay, I’m doing this now. And they can punch that area and they can use that as a guide for their meditation because meditation is very frustrating for many people. They don’t see anything happen immediately. In fact, they’re thinking about other things. Their meditation practice isn’t what they want it to be, and they’re not seeing benefits. So I know Dr. Slar also recommends that. And so he’s helped several of our patients as well. But I’m looking forward to releasing a program that will let people do it, I think in the most effective way, which is to include visualization. Yeah,

Dr. Lorne Brown:

The visualization can be quite powerful. It’s part of the language to that subconscious. And it’s a nice way using guided meditation and visualization to elicit the relaxation response, which helps engage that parasympathetic just because so many of these listeners are going to see this title about PRP and ovarian rejuvenation. I do want to share with you, just to follow up on what Dr. Wood had mentioned, that there’s over at the time of this release, I don’t know, high sixties, early 70 podcast episodes. We have many conscious teachers that we have on the show where they talk about meditative practice or consciousness and they have tools and stuff they share. So I do encourage you to go back to start at episode one and just hear what, and we usually bring on experts. So people have published research, published books, PhDs. So we really brought people that can bring credibility to this conscious work.

And then obviously I like to share meditation with my patients, and I have a free one on my website as well to help elicit the relaxation response. And you guys, my patients at least know that a big passion is the conscious work that I do with fertility in our practice. So I subscribe to the idea that, to me, that was one of the missing links. We were working so much Dr. Wood on the physical part of the body, and I thought if we could engage the mind, because if you’re constantly stressed and thinking and worrying, so you keep releasing those stress hormones, but if you can turn that down, tone that down and start releasing more dopamine, serotonin, oxytocin, then the blood sugar changes, then the hormone balance changes, your microbiome changes. There’s so much we’re so worried about, we feed ourselves, but if we change what we feed our minds, I think you can see a profound effect.

And that woman I shared with you that had their premature variant failure, I think the main component of her treatment, we did herbs and ACU and laser. We did do that with her low level laser therapy, but she did the conscious work and got to release so much old trauma. And I think that’s what freed up so much in her body. And then her cycles came back as well. Right. So multidisciplinary, it’s beautiful. So it’s nice. And Mark did share that you’re a big fan of integration and your background in psychology. Not surprised that you’d be putting together a program like this. So we look forward to seeing that. I think I heard you talk about it, but many of the women, I have seen many, I’ve only seen a handful that have done the PRP so far, but a few of them have been very interested in watching their A MH go up. Even when we do a low level laser therapy where we’ve seen the A MH go up, they get very excited about it. I think of a MH as a quantity indicator, not necessarily a quality, although they can walk together. Is that important to you to see a shift in AM H when you’re doing PRP? Are you measuring that and looking at it closely? Is that an important indicator that you are a shift?

Dr. Samuel Wood:

I think it is evidence of a shift, but as you pointed out, A MH is primarily about egg number. It’s not about egg quality. And you may have seen that study, published in the Journal of American Medical Association that showed no relationship at all between MH levels and fertility. And I have seen that many patients with one follicle, one follicle, when you do everything right, all the things that you’ve mentioned and you get a normal egg out of that follicle, they’re going to get pregnant at an extremely high rate. So yes, of course, we look at a MH and we’ve seen many patients have pretty remarkable rises in a MH, but in my mind it’s really not about that. In the end, having more eggs that are not genetically normal really doesn’t help you. And so yeah, it is one of our variables that we look at to see what the response is. FSH is much more important to me than that, but in the end, it’s all about what do you get when you do an egg retrieval? If a couple has chosen IDF, do you get normal eggs? Do you get normal embryos? That’s what it’s all about in the end. And so that’s our primary end value that matters to us.

Dr. Lorne Brown:

And how do we find you then? And if patients want to consult with you, what is the route that they need to take to find you on what’s your website and is there a process that needs to happen in order to get a consultation with you?

Dr. Samuel Wood:

It’s Gen five, the number five, fertility.com. I think the best thing is the phone number, but there are lots of other things on the website that you can do, so hopefully it’s straightforward to get to me. But on the website you’ll see all those things. I have many videos and things like that on YouTube. We do a lot of Instagram work and we try to keep everybody up to date on what we’re doing on the latest thing. We do publish a good deal when we publish, we put the papers on the website so they’re available to you. I am a huge believer that patients need to understand everything that’s being done. There should be no secrets. And so we’re very, very open, very honest about what we do and what we think the results will be. We follow up carefully and patients know exactly where they are in terms of the rejuvenation process, whether or not we’re seeing evidence that’s actually happening. Nothing makes me happier, nothing than to see one of these women who have been told, you have no chance, none. We will not even see you unless you agree to use an egg donor. To see them get pregnant is one of them, it’s a staggeringly positive thing to experience, and I want every woman to have their fullest chance of success going forward.

Dr. Lorne Brown:

Thank you very much, Dr. Wood, for this insightful conversation. I look forward to having you back again, as I’m sure there’s going to be follow-up questions I’m going to receive that I’m going to want to talk to you about. So thank you once again.

Dr. Samuel Wood:

It was outstanding to be with you. Good luck to everyone.

Speaker:

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

Dr. 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.

 

Dr. Samuel Wood

Dr. Samuel Wood

Dr. Samuel Wood, M.D., Ph.D., MA, MBA, HCLD/CC (ABB), FACOG, is a fertility specialist and expert in reproductive genetics with over 30 years of clinical experience. Serving as the Director of Fertility Services in San Diego, CA. Dr. Wood’s academic background includes a master’s degree in psychology, a doctoral degree in biochemistry and molecular biophysics, and a Master of Business Administrator (MBA). After a residency in obstetrics and gynecology at the University of North Carolina in Chapel Hill, North Carolina, Dr. Wood completed a fellowship in reproductive endocrinology and infertility at the University of California, San Diego. Dr. Wood is board-certified in obstetrics and gynecology and reproductive endocrinology, and infertility.

 

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