How to Improve Egg Quality: Fertility, Mitochondria & Biological Age with Aimee Raupp

Aimee Raupp

Not every 35- or 45-year-old is the same biologically or physiologically. So chronology is one part, and that’s the number of years old you are. That’s your birthday that you celebrate every year. But just because you’re 41 or 39 doesn’t mean you are the exact same mitochondrial status or physiological functioning status as every other 39- or 42-year-old out there. And that’s the stuff that is modifiable. And what impacts that is how you live your life. That is your epigenetics. And also, though, I would say other things that impact that are pre-existing conditions. That’s a huge driver of these unexplained infertility cases, which I totally can’t stand that terminology.

Lorne Brown

By listening to the Coherence Code Podcast, you agree to not use this podcast as medical advice to treat any medical condition, either in 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 guests or contributors to the podcast. Welcome to the Coherence Code Podcast, where we explore how the mind and body work together so you can move from stress and inner conflict to clarity, calm, and alignment. My name is Lorne Brown. I’m a doctor of traditional Chinese medicine and a clinical hypnotherapist. And through my work, I’ve seen that healing happens when we remove what gets in the way and allow the body and the nervous system to do what they’re designed to do: to heal. Welcome to the Coherence Code Podcast.

Welcome to the Coherence Code Podcast. Today’s guest is someone I’ve known and respected for many years in the fertility integrative medicine space, Aimee Raupp. Now, Aimee is a fertility expert, licensed acupuncturist, herbalist, and bestselling author, and she’s spent more than 20 years helping women and couples improve fertility, optimize egg quality and navigate conception naturally or through IVF. She is known for her integrative approach, combining traditional Chinese medicine, functional nutrition, and emerging research in metabolism, inflammation, mitochondrial health, and reproductive medicine to help uncover the causes that may be impacting your fertility. Aimee’s also the author of several books, including The Egg Quality Diet, Body Belief, and the newly revised edition of Yes, You Can Get Pregnant: Natural Ways to Improve Your Fertility Now and Into Your 40s. And this is the second edition. Now, today we’re going to go beyond, I believe, generic fertility advice, as my intention is to explore why some people still aren’t getting pregnant despite normal testing, what egg quality really means biologically, why embryos, even euploid embryos, those normal embryos, sometimes fail to implant, how chronic stress and nervous system dysregulation may affect your fertility, and also what may be missing in your fertility workups.

No pressure, Aimee. Welcome to the Coherence Code Podcast.

Aimee Raupp

Thank you for having me, Lorne. I’m honoured to be here. Thank you so much.

Lorne Brown

We’ve had so many good conversations off camera over the years, and it’s really fun to have you here on the podcast. When I talk to my listeners and the people I see in my practice, they’re always asking how they can improve egg quality. And I thought we’d start with: what does egg quality really mean from a biological perspective? Because even in your book, there’s that quote, “Age matters, but biology matters more than most people even realize.”

Aimee Raupp

Yeah. I think if we talk about it from a Western perspective, egg quality, in my brain, is mitochondrial function. The eggs, the ovaries, the tissue in there is one of the most mitochondria-dense tissues in our body, the female body. So as we are aging, mitochondrial function can naturally decline, but there’s so much, and we know this now in the world of regenerative medicine, with lots of money going into the research behind aging and how to reverse or delay or manage it, that is about maintaining mitochondrial function. So to me, when I think about the egg, the quality is about energy. And so then that’s our Chinese medicine side. It’s about the qi, it’s about, I think, the essence. I also think about the outer shell of the egg and its flexibility, if you will. This is how I imagine it in my head: as the egg becomes worse in its quality, it becomes less penetrable by the sperm. The shell gets harder.

And I might even think about that from… No, I might. I do think about that from an energetic perspective as well, in the clinic and with patients. And if that shell is hard, then when the sperm does fertilize it, or if it succeeds, are we maintaining the chromosomal integrity, and is cellular division then happening properly or improperly? And there’s our euploid versus our aneuploid. So I think egg quality comes down to a lot of different factors, and it’s not just about age. Like I said in my own book, it’s about biology. It’s about how you’re aging, and also the environment in which those eggs are developing and growing. We know the process of folliculogenesis is that 90- to 100-day cycle. That cycle within the body is impacted by these external influences: the level of inflammation, the chemicals in the environment, the nutrition, the mindset. All of those things come to impact egg quality.

And so I would see it as the health and the longevity, the capability, the integrity of the egg. That’s how I would define quality.

Lorne Brown

And so when you’re approaching the men and women that you see, first of all, maybe we should unpack a little bit what mitochondria are, because you talked about how important mitochondrial health is. Just share why that’s important when it comes to fertility. What is the function of the mitochondria when it comes to egg and embryo quality and implantation?

Aimee Raupp

It’s basically energy production. That’s how I would say it. It’s the energy for the cells to do their job properly. And so if the energy is low, we are not going to have proper cell division, or even proper implantation or proper fertilization. It’s kind of out of steam. That’s the way I would look at it. And we know conception is a massive miracle, I think one of the biggest miracles of all time, and that miracle requires an amazing amount of energy. And so if mitochondrial function is compromised, then we are looking at compromised egg quality, compromised cellular division, compromised fertilization, compromised implantation. So energy, energy in the force. And I would say, I’ve been thinking about this a lot too, and I’d be curious about your thoughts on this: I really think mitochondria are our essence. It’s our postnatal essence. That’s how I would say it. I mean, I know there’s some prenatal as well, but I think that’s what it is.

It’s this fuel, this foundation that we can improve upon. It’s not just continuously declining, but it’s essence. And of course there’s qi in there, but I just think the foundation of it is the template of how we’re functioning.

Lorne Brown

So we’ll geek out a bit. In Chinese medicine, I look at it just the way you’re describing it. We have what we call prenatal jing essence and postnatal jing essence. So the health of the parents leading up to conception, and then the health of the mother throughout the pregnancy, creates the prenatal jing of the child. So for this woman that’s trying to get pregnant, that’s her prenatal jing. And she doesn’t have a lot of control over that. That’s what she inherited. That’s what we’d call genetics in Western medicine. And then the postnatal jing is what happens after you’re born, so through diet, lifestyle, toxins, environment, immune health, stress, all that. And so I really like the metaphor or analogy you’re using, that mitochondrial health in Chinese medicine, we look at this as both jing and qi, prenatal and postnatal. And what our listeners are interested in is that what their parents did before they conceived them and throughout the pregnancy, that’s done.

Aimee Raupp

We can’t change it.

Lorne Brown

So my understanding, then, is there are things that are modifiable that can support what we call in Chinese medicine postnatal qi.

Aimee Raupp

Or epigenetics.

Lorne Brown

Right? Yeah. Epigenetics is what they call it in the West. So yeah, I would love to hear, and I’m going to tie it in this way because you go into this in your book in quite some detail. I’d love for our listeners to hear that there’s a difference between chronological age and biological age. Not all 35-year-olds, not all 40-year-olds are equal. So can you talk more about the age factor and biological aging, and also the things that are modifiable? Because I think that’s what the listeners are looking for. What can I do to improve egg quality? What can they do to change or improve the terrain, which I think is what you’re suggesting?

Aimee Raupp

Well, I think that’s the biggest pushback we have with the standard model of fertility: okay, it’s just your age, and over the age of 35, things severely diminish, and eventually donor eggs become your only option. They’re basically putting every 44-year-old in the same bucket. We know that very differently as clinicians, and at this point now we’ve been doing this a long time, so we’ve seen a lot of cases. Not every 35- or 45-year-old is the same biologically or physiologically. So chronology is one part, and that’s the number of years old you are. That’s your birthday that you celebrate every year. But just because you’re 41 or 39 doesn’t mean you are the exact same mitochondrial status or physiological functioning status as every other 39- or 42-year-old out there. And that’s the stuff that is modifiable. And what impacts that is how you live your life.

That is your epigenetics. And also, though, I would say other things that impact that are pre-existing conditions. That’s a huge driver of these unexplained infertility cases, and you and I feel the same way: I totally can’t stand that terminology, because it just means we haven’t looked hard enough. There’s always a reason; we can figure this out. So it’s more about how we age, versus “this is it, you fell off this cliff, the eggs went bad.” That’s just not how it works. As we do age, sure, I always say the pipes get more clogged. It’s kind of harder for things to absorb and detox. And I would say, honestly, we have to work a little bit harder. The older we get and the more we want out of our body, the more input it requires from us, and I think more thoughtful, targeted input.

So we’re really understanding our epigenetics and how our body responds to the food, to the diet, to our lifestyle. It’s this tuning in on all those levels. And when we do that, that’s how we can modify how you’re aging and how your cells are doing what they need to do, or not. To me, I kind of throw out the age number. I throw out AMH, I throw out FSH. I don’t really care about the numbers, because they don’t tell me much. In the way we’re trained in Chinese medicine, how you present, how you feel day to day, your skin, your hair, your nails, your bowel movements, your energy, the relationships you keep, how you absorb your world, that all really impacts how we’re aging. And so that’s the stuff we’re going to work on that is modifiable. And then to understand, too, almost the burdens the body is carrying; that ages us more than anything else.

Lorne Brown

Yeah. So you’re talking about chronological versus biological age. And there is a biological reproductive window within chronological age. So when you talked about your pipe example, you’re not saying age does not matter, because we do have wear and tear. Looking at you now, at 95, I don’t care how much you do with diet, you’re not going to look like this. So there is a warranty and expiry date on this physical body. And Chinese medicine says we’re supposed to live to about 12 and reproduce until our late 40s, right? The cycles of seven.

Aimee Raupp

Yeah.

Lorne Brown

So age is an issue, but 43-year-olds and 44-year-olds are still in the reproductive window. But if somebody came to you at 65 saying, “I want to conceive naturally with my own eggs,” you’re not going to say, “I can help make you biologically…”

Aimee Raupp

I’m going to send them to Dr. Murphy and make them do PRP and stem cells and things of that nature. No. Yes. So you’re right. Where I want to push back, though, is this whole idea that yes, we decline with age, our egg reserve declines, our quality declines. There’s influence we have over that. Data also now shows that even women in menopause still have about a thousand eggs left in their ovaries. So we don’t wake up one day and they’re all gone. They go dormant. They become less responsive or non-responsive to hormones. So there is this cycle. There is a reproductive window. I think it’s much bigger, or at least I would say eight to 10 years longer than what the Western medicine model is telling us. I do think now, with modern reproductive techniques, things like PRP, stem cells, I mean, there’s so much going on, even bioidentical HRT, there’s a window that we can probably extend with our patients as well.

The 60s is pushing it. Yeah. So of course there’s a window here, but it’s not 35 and it’s not a cliff. It’s a slope. It’s a decline. I think the largest study of its kind looked at 20,000 eggs, not embryos, and even in women aged 43 and 44 (I think the study ended at age 44), it showed that about 30 to 40% of the eggs were still euploid, with normal chromosomes. So there’s not some cliff that you fall off where all the eggs go bad. And you also can’t think that it’s just about the egg. There are so many other factors that influence fertility outcomes, like the sperm, the environment, the uterus, all these things. But I guess I would say that the mainstream thought process that is put on women is not entirely accurate.

Lorne Brown

Yeah. I like to find that middle ground. In our world, politics are so polarized.

So there’s, as you said, conventionally, based on stats, the 35 cliff and people really focusing on chronological age. And then there are some people who think if you just think happy thoughts, you’ll get pregnant. That’s how polarized it is. I think where you’re coming from, and what I wanted to share with you, is there is a window; there is a reality. If you’re coming at 42, there’s still lots of hope for you. If you’re coming at 35, there’s lots of hope. If you’re coming at 48, it’s still not impossible, but it’s like buying a lotto ticket. For every person that wins, there are millions of people that bought a ticket and didn’t win. There is a reality. Because I think the Guinness record for somebody conceiving with their own eggs is either 53 or 55.

But that’s one in several billion. So if you’re coming in your early 40s, the things that you’re going to talk about that are modifiable will probably have more of an impact than for somebody at 49, because there’s just so much we can do with the system. And that’s what I wanted to unpack, chronological and biological age. I wonder if you resonate with this, because we practise similarly, you and I. You’re on the East Coast, in Connecticut, I’m in Vancouver, and people say, “So I understand about biological versus chronological age. I want you to make me biologically younger.” I think people think that our medicine can take someone who is 42 chronologically and behaving biologically like 50, and make them biologically 32. And I always say that we can make you as biologically young as your chronological age.

So as I said, you’re 42 chronologically, but biologically you’re behaving like 50, and we can talk about what that looks like. We can bring you back to a biological 42, and 42-year-old women can get pregnant. If you come in at 50 chronologically, the best I can do biologically is 50, and personally, I don’t think I can help many women like that, if any.

Does that align with your thinking as well?

Aimee Raupp

Yeah, with one caveat, an asterisk at the bottom of the page. If you’re also willing to throw in ovarian PRP or some of these newer stem cell techniques, things of that nature, do IVF, low-stim IVF, collecting eggs one at a time, I think there’s a window of opportunity for some women in their early 50s. I do, only because I see it clinically, not because I’m making it up.

Lorne Brown

Yeah. Remember, biblically, some of them got pregnant in their hundreds.

Aimee Raupp

But again, to your point, I think that’s a really good point. I’d add my two cents, though. I like the lottery ticket analogy. I would also say not everyone’s playing that lottery at that age, so we don’t have full stats. A lot of people aren’t in the lottery at that age.

Lorne Brown

I love that. I love what you just said there. I’ve got to highlight that. Somebody comes to me and on paper it looks impossible. Their REI says, “You’re not getting pregnant. You need donor eggs,” but they’re in their reproductive window. I mean, I have somebody with FSH through the roof who was no longer ovulating, AFC of zero, AMH undetectable, and on ultrasound the ovary looks wrinkled. And we’re going to talk about the mind-body stuff, because I said to her, “You’re going to have to do conscious work if you’re looking for a miracle,” because she said, “I’ve come to you for a miracle.” And I used the lotto analogy with her. I said, “There are people like you that I’ve seen get pregnant. I’ve helped them get pregnant. But for every person like you, I have a huge list of people I could not help. So it’s like playing the lotto; that’s how many won’t win.” But then I said, “If you don’t buy the ticket, you can’t win the lotto.” So that’s what you’re saying.

Aimee Raupp

Yeah, that’s what I’m saying.

Lorne Brown

And we know women who are 42, 43, 44, 45 are still doing this. So let’s talk about them. To me, this is not necessarily for the 60-year-old. That’s technology that’s coming, and I don’t know what’s going to happen, but let’s talk about…

Aimee Raupp

The majority. You were referencing that client. I just had someone, I think she was 54, reach out to me, and I said, “Here’s how I would be willing to work with you,” and I listed out all the things. I said, “But if you’re thinking that Chinese medicine and nutrition and all that is going to put you back to your mid-40s for trying to conceive, I’m not the right person for you.” That’s what I said.

Lorne Brown

You do integrative, so sometimes both. I brought it up because we’re going to talk about the 100 days, and now we’ve got to get into the modifiables. What are you doing, and what’s affecting mitochondrial health and egg quality? But I’ll share this with you. His name is Dr. Philip Romanski. He’s an RMA doctor in, I think, the New York or Connecticut area as well. He did a study because of COVID, when people had to delay IVF, and his research showed that delaying IVF by three months does not negatively impact your outcome, because people were afraid to wait. And he said there are things that are modifiable that can make a difference in those 90 days, like stopping smoking.

Aimee Raupp

He’s got research on that? That’s great.

Lorne Brown

And then he goes on, “But there are certain things, like if you’re morbidly overweight, where three months is not enough, because you’re going to need more time.” So, do you wait a year to do IVF because you’re trying to get healthy? Probably not. Three months? He said the data from his research now shows, whether you’re in your 40s or your late 30s… It was a retrospective study, because everybody had to wait, remember? And they did not see any change in outcome for the people who had to delay their IVF. They weren’t doing all the proactive stuff, but he showed that waiting three months did not negatively impact their success rates. So now let’s talk more about egg quality. I summarized something from your book, so tell me if I’ve got it right, and then I want to unpack this for our audience. If I had to summarize Aimee’s second edition: you want to improve the terrain. In Chinese medicine, we say nourish the soil before you plant the seed. And what I get from your book is that, for the terrain, you want to look at metabolic health, inflammation, hormonal balance, emotions and mitochondrial health. All of that will improve egg quality, which will help improve whether you get pregnant naturally or through IVF. So now you talked about life and living. Is our lifestyle basically an anti-fertility lifestyle? When you think of everything on that list, so much of our living negatively impacts it, but those are lifestyle diseases, which means they’re modifiable.

You can change most of them.

Aimee Raupp

You can change it.

Lorne Brown

So can you talk a little bit more about what is impacting egg quality when you talk about blood sugar, metabolic health and inflammation? Can you talk a little bit more with our audience about how these can negatively impact it, and then what we can do to try to reverse that?

Aimee Raupp

There’s a study I’ve been talking about a lot. Actually, I was with some colleagues we have in common over the weekend, and they were picking on me because I couldn’t stop talking about it. A few research papers have come out recently on insulin resistance in women trying to conceive. Insulin resistance is when our cells have a hard time responding to insulin. Insulin is the hormone that helps move glucose, the energy needed for cellular function, into our cells, and our cells are becoming resistant to it. And I would say previously, even in this GLP-1, Ozempic world, we always thought insulin resistance meant overweight. Now, in the research these IVF clinics did, these were women with normal BMIs. They were not overweight, but they had insulin resistance. And when the insulin resistance was corrected (again, these were women undergoing IVF), pregnancy outcomes improved fourfold.

So a fourfold increase in outcomes just by correcting the insulin resistance, and we’ll get into what that means. They also saw miscarriage rates cut in half just by correcting the insulin resistance. And I would argue, if we corrected the insulin resistance before they even started IVF, did they even need IVF? Maybe not. Insulin resistance is coming from our modern diet and our modern lifestyle: things like eating on the go, eating rushed, skipping meals, ultra-processed foods. There’s another piece of research I talk about in the book on the incidence of infertility (and I also talk in the book about how I hate that word, but I’ll use it here to prove a point). In the ’80s, one in 12 women were dealing with infertility. Now we’re at one in six, and that’s over about 40 years.

Ultra-processed foods went from 10% of the diet in the ’80s to 57%. The average person’s diet is now 57% ultra-processed foods. And we can now link ultra-processed foods to insulin resistance and to inflammation. I talk about it in the book, and I’ve been writing a lot on Substack lately too, that there’s this triangle: insulin resistance leading to inflammation, leading to immune modulation issues, and they’re all working together. These are, I think, the three pillars of what is driving it.

Lorne Brown

I’m all over that with you. Let’s highlight that again and emphasize it, because there’s a whole vicious cycle. Can you say that again? That’s brilliant.

Aimee Raupp

Insulin resistance. It’s a triangle, and they all point at each other. They could be anywhere in the triangle: insulin resistance to inflammation, to immune modulation, and back again. And at the core of this triangular issue, I would say, is mitochondrial dysfunction. It is premature aging. It’s the cells basically saying, “I don’t have enough. I cannot prioritize this energy demand for making a baby, or even for ovulating and menstruating regularly. I can’t handle it.” And it’s this modern lifestyle that’s driving all three. Then if we look at endocrine-disrupting chemicals, that’s another huge piece. Same thing, I’ll be a nerdy statistician here. Since the ’80s, we’ve introduced over a hundred thousand chemicals into our environment, many of them known to be endocrine-disrupting chemicals.

These endocrine-disrupting chemicals are linked to things like endometriosis and PCOS, or PMOS; we’re shifting the name of that. Endometriosis is linked to insulin resistance. PMOS is linked to insulin resistance. And then we also have this inflammatory cascade, where the inflammation is damaging our mitochondria. It’s aging our eggs faster than it should. And I’ll tie that into Chinese medicine. In Chinese medicine, we say a woman who lives in accordance with the Dao should be able to conceive until the age of 49. Now, what does living in accordance with the Dao mean? I know this is so your jam. She’s living in the nature of her world and of her life. She’s going to bed at normal, regular hours. There’s a consistent routine. She’s maintaining healthy, joyous relationships more often than not. She’s eating with the seasons. She’s taking time to slow down and nourish herself.

There are all these layers of lifestyle that we have, I would say, abandoned in our modern lifestyle, but we can easily get back to them. It was fun doing the revision, because a lot of the Chinese medicine principles we’ve talked about for thousands of years now have research behind them, much of it from the last 10 years, between the first and second editions of Yes, You Can Get Pregnant. Take the research on blue light: there’s a direct correlation between blue light exposure at night and higher FSH. Blue light exposure at night means lower melatonin. Melatonin is the master antioxidant, and the eggs love melatonin as their antioxidant. Our doomscrolling at night? Guess what? It’s driving down melatonin, compromising egg quality, driving up FSH and taking the ovaries offline. Just that. Getting morning sunlight resets the whole system, wearing your blue light blockers, putting the red light filter on your phone.

So we’re looking at the chemicals in our environment, the ultra-processed foods, and I think the amount of stress now on women too, because we all work, we run a household, we’re growing a family; there are these incredible burdens. Another interesting stat: I think the average woman is exposed to about 200 chemicals before she leaves the house in the morning. Men are exposed to about a hundred. So when we layer all that in… I love what you said. I forget how you said it now. A disease of our society? Is that what you said? Lifestyle?

Lorne Brown

Yeah. These are degenerative diseases now. There’s a term they use loosely in the West that I’ve co-opted for fertility. They call it inflammaging.

Aimee Raupp

Yeah, 100%.

Lorne Brown

Inflammaging, right?

Aimee Raupp

That’s this whole triangle: insulin resistance, inflammation, immune. Because that’s the other piece too, and I know we’ll get to it. My husband and I are trying not to use the word “trigger” anymore, because we feel it’s so overused, so “bamboozle” is the word we’re using instead: it bamboozles me. It’s very bamboozling to me when people talk as if it’s all just about the egg. The egg is really important. She has around 600,000 mitochondria, compared to the sperm, which has far fewer. But it’s not just about the egg, everyone. It is about the terrain, it is about the sperm. And then, going to the inflammaging and immune modulation piece, it’s about the environment in which you’re trying to implant that embryo, too. That’s really, really important, and it’s still so overlooked when it comes to fertility.

Lorne Brown

I want to unpack and review some of the things. I made some check marks as you talked. I’m taking notes, everybody. So, your triangle of blood sugar dysregulation, inflammation and immunity, right? You talked about diet. So, for our listeners, diet can impact this triangle. You can actually eat an anti-inflammatory diet. You wrote a book on this. I wrote a book on this. So diet is something that’s modifiable. I’ll check that. You talked about stress. We’re going to go deep into that, hopefully later in our conversation, but with chronic stress, your body doesn’t feel safe. It’s how you internalize it, not the stressor, but your internal perception of it, that can put you into that hypervigilant, sympathetic state, and over time that will lead to inflammation and blood sugar dysregulation. So you talked about that. Movement and exercise: lack of movement, too much movement. You need to move, and that will help with inflammation and blood sugar regulation.

Aimee Raupp

And immune modulation.

Lorne Brown

Yeah, and immune, all of that. The gut microbiome, we didn’t talk about that, but it will impact inflammation and everything else. Then there are the things we can do. We talked about diet, movement and stress reduction. Sleep will affect blood sugar dysregulation. You talked about blue light and sleep, so getting good sleep. And if you can’t sleep, go see your acupuncturist, because they’ll use acupuncture, Chinese herbs and targeted supplements to help you sleep naturally.

Aimee Raupp

Regulate your blood sugar. You can’t sleep because your blood sugar’s dysregulated. That’s why you’re waking up at three o’clock in the morning.

Lorne Brown

Those are all things people can do. And then there are supplements: berberine, myo-inositol. There are things we can do to help regulate blood sugar, inflammation and mitochondrial health: CoQ10, PQQ, ALA, there are lots of things, right? Then there are some of the things that you do. Acupuncture has been shown in mice to help with mitochondrial health and regulate inflammation. Blood sugar regulation has been shown in humans; Elisabet Stener-Victorin has done quite a few studies on that. I know you’ve helped consult on photobiomodulation, laser for fertility. That’s been shown to help with blood glucose. Are you using that in your practice now too, some light therapy?

Aimee Raupp

I am. I’m sending them to Murphy for the GigaLaser, but I’m definitely recommending and using red light as well, the NIR, as I always defer to Lorne as my master of all things photobiomodulation. I think all of it is going to help. I think you taught me this too: the laser penetrates much deeper than the LEDs, but they both still have a positive impact on mitochondrial function.

Lorne Brown

Alright, let’s move on. I think we unpacked the triangle information.

Aimee Raupp

I talked about it in the book. Did you see the laser section? I had the whole conversation in there because, and this is a total aside, you were forever saying the Japanese study used a cold laser that penetrates much deeper than near-infrared light or LEDs. And so I went into that a lot in the book, because so many people out there are saying you can just use red light and it’s the same thing as the Japanese study that reversed the severity…

Lorne Brown

I’ll clarify that. Wavelength determines penetration, and we want to get enough photons to that depth of penetration to have a biological impact. Red light, for example, doesn’t penetrate as deeply as near-infrared. So that’s the key. And then it’s just dosage: laser versus LED, and how much time, how much power, the irradiance. So it’s much more complicated. People like the GigaLaser because of Anne Marie Jensen, the good doctor in your area who’s using it, whom I got to meet and talk with, and we have that in Vancouver as well. There are many ways to replicate that, but at the end of the day, it’s: what’s your wavelength, what’s the power, how much time? That will determine whether you get enough energy to the target tissue for the mitochondrial part. Then there’s a whole systemic piece about blood sugar and inflammation. So we still know almost nothing,

but we’re learning. We’re learning. You briefly talked about this: to have a baby, you’ve got to have egg quality. In your book, you go into detail. We just talked about how there are a lot of things you can do to help with egg quality regardless of age, and that there’s a biological window. However, there’s a lot you can do to give yourself a better chance at good egg quality. You also talked about guys. Can you bring that in a bit? For those trying to conceive with somebody who has sperm, because it does take two cells, an egg and a sperm cell, to make a baby. If you’re using donor sperm from an unknown donor, there’s nothing we can talk about here for improving that. But what about those using sperm from somebody they know, whether it’s their partner or a known donor?

How important is the sperm in this equation, if the goal is to take home a healthy baby?

Aimee Raupp

So important. It’s 50% of the equation, five-zero. It’s 50% of the equation. That’s another area where research has exploded in the last decade. I also think we know more now as practitioners: the standard semen analysis reference ranges are based on the lower 5% of fertile men. I would prefer we look at the upper 90%. I’d like you in that percentile. So in the book, I also talk about the WHO semen analysis parameters versus functional health parameters and what we’re aiming for. There’s also clear research showing that the higher the total motile sperm count, the better the pregnancy outcomes. Then there’s DNA fragmentation, which basically reflects the amount of oxidative stress and DNA damage in the sperm. You could have a normal-looking semen analysis but a high oxidative stress load or a high level of DNA damage.

In the research, DNA damage is also linked to implantation failure, miscarriage and poor fertilization, so poor IVF outcomes. So we need to be looking at the sperm, and even more, in my opinion. We should be running labs on all the partners and doing microbiome assessments to understand what else could be going on. I’ll always say that even if the semen analysis looks good, we can always make it better. I also think there’s a great energetic piece there. When a woman is going through this and she’s partnered and using his sperm, it’s nice that you share the load together and you’re both doing the lifestyle and the diet. Energetically, you’re also stating, “We’re in this together, and we can both improve and shift things.” But sperm plays a significant role. We’re even seeing links to developmental issues once the children are here, and a lot of that wasn’t talked about at all.

And again, I think it’s a lifestyle disease as well. We’re seeing the same things, the ultra-processed foods, even low vitamin D, the blue light exposure, the chemicals in the environment, impacting sperm health as well, and it has to be improved.

Lorne Brown

So men need to man up and get involved with diet and lifestyle: alcohol, drugs, smoking, get rid of that, and hot tubbing.

Aimee Raupp

100%. And the insulin resistance piece. We see it so much in our clients when we’re running labs on them and their male partners. I see a strong correlation at this point. Again, this is me speaking clinically. There’s probably research; I haven’t dug into it. But I see insulin resistance linked to poor DNA, higher DNA fragmentation and poorer overall semen parameters.

Lorne Brown

Inflammation, oxidative stress, all those things. Good news for women, though. Great news. If you have one of those guys who isn’t cooperative or supportive, stem cell research now shows they can make sperm cells from women. They can take your skin and turn it into sperm. So soon you won’t even need the guy.

Aimee Raupp

And what happens there genetically? So it’s like…

Lorne Brown

I can only tell you the superficial part that I read, because it’s not at the point of human trials or available to the public. I’m trying to figure out which interview… I think it was Sam Wood’s interview on my podcast where he talks about this.

I don’t know if it was Mary or Sam Wood, but I think it’s Sam Wood. Basically, for same-sex couples: with two women, one gives the egg, and from the female partner they’ll take her cells and make sperm. With two men, one gives the sperm, and from the other they can make an egg. So that’s the future. But anyway, we digress. I was just giving news to the women that eventually, even if your partner’s not cooperative, rather than upgrading to a new partner, since you’re already perfect, you can just make the sperm and egg all from you.

Aimee Raupp

Wow, that’s amazing. I mean, it is. We work a lot with couples, as I’m sure you do too, and I see so many of the men are so willing. I think what happens in the clinics is, “Oh, the semen looks fine. He’s fine. It’s you. It’s all you. It’s all you.” And they’re not running labs on the partners. They’re not looking at thyroid or vitamin D or anything that’s important. They’re also not doing DNA fragmentation testing. So I don’t know what we’re using to make the decision that they’re fine. We need to dig deeper.

Lorne Brown

Yeah. And we’re going to go into testing. I think it’s the culture of conventional medicine currently, which is different from Chinese medicine and functional medicine: if you’re in the range, then you’re okay. But we’re not about surviving, we’re about thriving. And fertility sometimes requires levels to be in the optimal range, so rather than at the low end of normal, you’re at the high end of normal. And there goes the semen analysis. You’re within the range of most men, but most men today are nothing like they were 50 years ago. So we keep lowering the standard to say you’re like everybody else. Great. That would be like saying if your BMI is high, you’re normal, because most people have a high BMI. That doesn’t mean it’s optimal. Let’s talk about workups. From your book, I know you don’t like the term “unexplained infertility.”

So can you tell me more about that? And what do you think is missing from fertility workups, things you’re doing in your practice that often aren’t done in the conventional workup?

Aimee Raupp

As Dr. Murphy said to me over the weekend, I’m obsessed with insulin resistance, and I am. I shouldn’t say always, but lately, having really dug into the research, I’m always looking at it. On a standard workup, you’ll normally see an A1C and a fasting glucose. That gives us some information about insulin resistance or blood sugar regulation in the body, but we should also be looking at fasting insulin. I like to see fasting leptin as well. I also like to see a timeline, because you’ll notice that over the last few years, her fasting glucose used to be 85 and now it’s 92, and her A1C was 5.1 and now it’s 5.4. She’s still within the normal range, but she’s clearly becoming more and more insulin resistant.

Lorne Brown

Can I add to that? From what we talked about earlier, that’s biological aging. Chronologically, you’re a year older, but biologically there’s inflammaging, or accelerated biological aging. And that’s why you like to see a series of these, because we can see if someone is aging at an accelerated rate. Sorry for interrupting.

Aimee Raupp

And we can bring that back down, which I think is awesome. We can bring it back down to what it was. I’ll say that: we can bring it back into the functional range. Then we’re looking at inflammation markers. I like to look at homocysteine. I like to look at high-sensitivity CRP. Of course, a complete thyroid panel, including thyroid antibodies, and vitamin D, which is also not often checked, and that kind of blows my mind. It’s checked more and more, but not often. Iron and ferritin are also markers that give us some information about energy status in the body, or inflammation. The higher the iron, the more I’m concerned about inflammation. The lower the iron and ferritin, the more blood deficient they are from a Chinese medicine perspective, and they’re just not functioning at full capacity.

Yeah, then I’ll look at hormone levels too. But beyond AMH and FSH, I’m looking at testosterone and DHEA, and of course prolactin, estrogen and progesterone, and where they should be on day three versus in the luteal phase, which gives us a complete picture. Then we’ll probably do some microbiome testing as well, the uterine microbiome and gut microbiome. That’s more of the functional medicine stuff. But on a standard workup, I wrote something recently where I said that with a $20 add-on test, fasting insulin, we’d be picking up insulin resistance in a lot of these people. And then, based on that study, if we corrected the insulin resistance before they started IVF, what would happen with their pregnancy outcomes? I don’t want to sound overconfident, but I think I could guarantee you that pregnancy outcomes would increase majorly in these women if we just corrected the insulin resistance before they even started IVF.

Lorne Brown

And that’s tied into inflammation, I believe, because most of the data I keep reviewing connects systemic inflammation, so inflammaging, to fertility decline, unexplained infertility and miscarriage. So again, there’s your triangle.

Aimee Raupp

There’s your triangle. Then I would go into the coexisting conditions. In unexplained infertility, a large portion of the cases, and this is actually in the data as well, 50%, five-zero percent, of unexplained infertility is actually undiagnosed endometriosis, which is a systemic inflammatory condition that also impacts blood sugar regulation. There’s tons of data showing it impacts IVF outcomes, fertilization rate and implantation rate. So I’m not saying everybody should run off and get endo surgery, but knowing whether we have it or not is important for understanding your IVF protocols, your transfer protocols, your stim protocols, and for a functional assessment. Can the egg and sperm even meet? Are the tubes open or not? We’ll get the patency of the tubes from the HSG. Collecting that information, you see a lot of Hashimoto’s and celiac disease when we dig deeper and diagnose those, and sometimes even rheumatoid arthritis, Crohn’s or colitis. These undiagnosed autoimmune conditions, or diagnosed ones where no one is looking at the picture together and asking, “I wonder how the inflammation from the autoimmune condition is impacting her overall fertility outcome?”

You see that a lot with POI cases, premature ovarian insufficiency. Most of these women have celiac disease and Hashimoto’s when you dig deeper. A lot have endometriosis. Then we look at chronic endometritis; that’s another one. That’s the uterine lining infection. Adenomyosis is another one too, and I have a lot of Chinese medicine for those as well, if you want to go into it. Chronic endometritis, not to be confused with endometriosis, is a low-grade infection in the uterine lining. It’s basically a bacterial infection, and a course of antibiotics often treats it. To test for chronic endometritis, you need an endometrial biopsy. You don’t necessarily always need a hysteroscopy, but you need the endometrial biopsy to identify the endometritis, or a test that collects menstrual blood. Of women who are tested, 50% are found to have it.

Five-zero. You’re not implanting, you’re not getting pregnant with that. Why are we not testing women for that before we move to IVF? Why are we not looking at the uterus? This is a simple test, a simple test. A course of antibiotics. We can use Chinese herbs. For me, a lot of endometritis is about poor blood flow to the uterus. The tissue’s not healing. It’s like a non-healing wound. We talk about that with astragalus, and I think about that a lot. Adenomyosis, same thing. It’s creating an environment that doesn’t get healthy blood flow, so the microbiome is more likely to be off and these infections are more likely to arise. It’s not a hospitable environment. So, looking at the uterus. There have been a few cases where I’m having a hard time finding the… what’s that called? The red flag, if you will, the missing piece.

But most of the time, you discover it’s endometriosis, some sort of blood sugar issue, endometritis, or some sort of autoimmune condition. And then we still have work to do. We still have to go and address it, but at least now we have a root cause, and I think that helps healing and understanding this whole process for people.

Lorne Brown

And that root cause is important, and it goes into this whole system. So what I’m hearing from our conversation is that the conventional tests look at FSH, estradiol and LH, very fertility focused, and TSH, part of the thyroid, the tip of the iceberg. But what you’re suggesting, again, is that we talk about the terrain, or in Chinese medicine, nourishing the soil. This egg quality issue is coming from a variety of systems in the body, and that biology is going to impact egg quality directly or indirectly. So, if I can unpack this a bit, you’re testing for metabolic issues, you’re testing inflammatory markers, you’re testing for hormonal issues, you’re testing for things that can impact mitochondrial health. You’re looking at a thyroid panel, vitamin D, the gut microbiome. You’re doing testing that may not be a direct test on the ovary, but if that system’s out, it’s going to impact the ovary.

So it’s a much deeper, more comprehensive dive, looking for root causes that could be impacting egg quality, which then allows you to make those modifiable changes. Can we shift to what I think is… you used the words “missing piece.” I think this is the missing piece in reproductive medicine: your beliefs, and stress in the nervous system and in the body. You’ve written a book just on belief, and you talk about this in your new book. I’m 26 years into practice at the time of recording, and I think we’ve gotten much better at the physical side: diet, supplements, herbs, acupuncture, laser, IVF. Where I think it’s starting to happen more, though we’re nowhere near there yet, is our thoughts and our feelings, psychoneuroimmunology, the science of that. Can you tell me your take on beliefs and emotions? Because this could be woo-woo for some people.

However, I did use the term PNI, psychoneuroimmunology. There’s science around this.

We haven’t had a chance to talk about this, so I want to hear your thoughts and how you address this in the clinic.

Aimee Raupp

I mean, first I like to quote Abraham-Hicks: “A belief is just a thought you keep thinking.” You basically think it into your truth. And then you also seek that truth out in your world. “See, I told you, women who are 35, all their eggs are bad. See, see?” You look for the validation in the outside world. But we know beliefs are dictating the neurochemistry and neuroendocrinology in the brain. It’s almost like a self-fulfilling prophecy. It shifts the neurochemistry into a pattern that fits that belief. You see it a lot when you look at placebo and nocebo research, and I talk about that a good amount in Body Belief. I definitely bring it up in the revised edition of Yes, You Can Get Pregnant too. And you probably say the same thing: what you believe dictates your behaviour, and your behaviour dictates your health.

So that’s all tied together there. But this belief is also going to go into your brain and impact your neurochemistry. I like to call it emotional inflammation. Are you thinking your way into this inflammatory fight-or-flight state, believing so hard that…? And I’m always so careful with this, because I’m never saying this is your fault. But I am saying I want you to check it. I want you to really tune in. And as you said, let’s get really conscious here. What are you saying to your body on a regular basis? Are you saying all your eggs are bad? Are you saying all hope is lost? And that’s a lot of the reason why I put out all the information I share everywhere on social media, and the stories of hope and all that.

It’s actually not me trying to push my ideas down your throat. It’s me saying, look, here’s another one. Here’s another woman who was told all of her eggs were bad and all hope was lost, and she did these things and turned it around. Just to give you that glimmer; you need the glimmer of hope. And I think a lot of the research shows, too, that it’s not about, as you said earlier, sunshine and roses, everything will be fine and I’ll just wake up pregnant tomorrow. It’s not about that, but it is about consciousness. What am I saying to myself on a daily basis? What belief patterns am I stuck in? I think they say we have about 50,000 thoughts a day, and 90% of them are the same. I always mix that up, but I think that’s what it is.

What am I saying on repeat to myself? Am I convincing my body of this? And then my actions support my beliefs. So if I don’t believe there’s anything I can do to improve my fertility, I’m not really going to pursue all these modifiable factors we’ve talked about. And then my health probably won’t improve, and we keep ourselves in this cycle. We know a lot about the impacts of stress. We also now know that the more stress resilient women are (though how exactly we measure that still evades me a little), the better their IVF outcomes or fertility outcomes. So the bounce-back ability is really important too. And where does that come from? Honestly, it might come from the environment we surround ourselves with, the impressions we had growing and evolving as humans, and maybe even how we were raised. But we’re seeing these correlations.

We also know that UCSF did the first imaging of ovarian tissue showing it’s completely wired to the nervous system, which, of course, I think in Chinese medicine we always knew. We always talked about the Bao Mai and the connection between the Heart and the Bao, the child’s palace, the reproductive organs. But now we’re really understanding this nervous system piece and our nervous system status. I always see it as: is it driving the ovaries to want to take part and be a part of this system? Or are they secretly going offline because they’re feeling, I suppose, under attack, undernourished and not getting the support they need from the nervous system?

Lorne Brown

Yeah. So I’ll summarize what I’m hearing you say. First of all, your behaviours become congruent with your thoughts and your programs. A lot of this stuff is unconscious, so there’s no blame here. There’s no room for blame or shame, but it’s the blame and shame that cause the internal milieu to change. Meaning, if you have this constant, incessant negative talk, it’s going to release more stress hormones, and that’s going to lead to inflammation and blood sugar dysregulation, which we talked about. If you have hope, compassion and acceptance for yourself, your nervous system is going to feel safe, and it’s going to shift from sympathetic to parasympathetic, the rest-and-digest, breed-and-feed nervous system, and that frees up resources for healing and conception. And you’ll release those hormones: serotonin, dopamine, oxytocin. The science is showing how our thoughts and feelings impact all the systems in our body: immune, hormonal and nervous.

And again, this is not about blame. Most of this stuff is unconscious. You didn’t choose any of it. You came into the world with intergenerational patterns, and your gender, society, economics, your teachers, your parents, all of that got imprinted. Again, no room for blame. And now that’s how your nervous system perceives reality. So in your work, you’re working on beliefs and on stress, because that’s become the biggest part of my practice. I do all the other stuff, but in my practice, with multiple associates, we’re doing all the acupuncture and laser. People who see me are doing the acupuncture, laser, supplements and herbs, but they’re also doing conscious work with me, because that’s my favourite part now.

Aimee Raupp

Same. I love it. And something you were saying before, too: it’s not our fault. We came in with generational trauma and belief systems imprinted upon us, and this is how we’re currently wired. But the work is acknowledging that wiring and saying, “Oh my gosh, I do. At the end of the day, I ultimately think this isn’t going to work, or I can’t change this.” And then it’s getting into the questioning behind that and saying, “Okay, is there room to budge that belief?” I always think of Joe Dispenza, where he says it’s right before you have the belief: “Okay, I can go down the regular rabbit hole. This is what I normally do. This is my normal path.” But I can stop for a second and ask myself, “Is there another path?” That’s all you actually have to do.

You don’t even have to form the new belief. You just have to question the one you have and correct the story. Yeah. Yeah. Fascinating.

Lorne Brown

I apologize, because I totally interrupted that thought. If you want to continue, go for it, but I have a comment on that.

Aimee Raupp

Yeah, I want it.

Lorne Brown

You have the belief, and Joe Dispenza, I love his work. I’ve been to three of his retreats as of now. I love a quote that goes something like, “In every situation, you can either unconsciously, habitually react,” which is what you just mentioned, “or you can choose to consciously respond.” React versus respond. However, this is an ingrained program, so you are triggered. It’s happening without your choice. I have a whole process that I call Notice, Accept, Choose Again: NAC. Not the NAC supplement, but the NAC conscious process

Aimee Raupp

 I have one. It’s called ART: acknowledge, reform, transform. Isn’t that funny? 

Lorne Brown

Same idea. There you go, right? Because it’s all about interrupting the story, and if you do it often enough, daily, often, eventually you won’t even get triggered, or what you call bamboozled. You don’t like the word “triggered,” but you won’t get bamboozled. But in the beginning… and the reason I interrupted you, and again, my apologies for that, was the term I wanted: making the unconscious conscious. That’s what we’re doing. When you notice it… what did you call it? What’s your A?

Aimee Raupp

Acknowledge.

Lorne Brown

You acknowledge it. When you acknowledge it, that’s making the unconscious conscious. That doesn’t mean it goes away, but it’s the first step, because if you can’t acknowledge it or notice it, it’s running in the background. So now you’re acknowledging it. It’s still uncomfortable; the program’s still running. And then there are tools to interrupt, transform and metabolize it. I use hypnosis in my practice as part of that. So there are ways to undo that programming and wire in new programming. And as you said earlier, your behaviours are going to be congruent with your programs. If you’re looking for a new reality, your destiny, your reality comes from your repetitive actions and behaviours, which come from your programs. So rather than trying to work on the behaviours, you’ve got to work on the programs. Is that kind of what you’re sharing? Yeah, I like that.

Aimee Raupp

So: acknowledge. Acknowledge the belief. And then reform, which, as I always say, comes from Abraham. Abraham is probably my biggest teacher, and Joe as well. I love Joe, but…

Abraham-Hicks, I was just with them recently. Reform. They always say, “How can I say that better?” That’s the reform: “How can I say that better with the knowledge I have?” Or even ask, “Do I know that to be the absolute truth?” Maybe the belief is that women at 42 have all bad eggs. Is that an absolute truth? No, because I know so-and-so, and so-and-so, and so-and-so; they all did it. “Okay, so how can I say that better? Right now I’m not seeing that as my truth, but there are others out there who have improved their egg quality, even at 42.” So it’s basically teaching you to, like you said, acknowledge, notice and question. Am I living my life based on this? My belief has become my absolute truth, and now I have to start to question those beliefs.

And then the transformation lies in basically what you said: that repetitive motion, the repetitive daily questioning of these things. And then all of a sudden, we start to notice, “Oh, that thought came up and I didn’t even have a battle on the inside. I just worked right through it, and all of a sudden I was on the other side.” That’s the transformation. But it’s not even daily work; it’s minute-to-minute work, I think.

Lorne Brown

It’s a meditation. You don’t meditate; you’re in meditation, whenever you’re noticing. And it’s bottom-up versus top-down, so you really can’t think your way through this. You’re going to feel your way through this, and there’s no room for spiritual bypass, because it won’t work. So we’re not saying think positive thoughts. We should have a part two to talk more about this. We’ll go more into this. So, chronological age matters. However, biological age really matters too. And for those people in their 30s and 40s trying to conceive, there are modifiable things you can do. You talked about the things you like to test, because they tell you what’s going on with the biological aging process. There are so many modifiable things that are in people’s control: diet, lifestyle, movement, taking targeted supplements, choosing when you sleep, all talked about in your book.

Then there are interventions like acupuncture, low-level laser therapy, and mind-body tools as well. I think we covered a lot today, but there’s so much more. You offer courses for the public, you’ve written books, you have coaching programs. Where do people find you? Where can people buy the second edition of Yes, You Can Get Pregnant?

Aimee Raupp

Everything’s on my website, AimeeRaupp.com. I think that’s the easiest place to go. I’m also really active these days on Instagram, YouTube and Substack. I started a new Substack where I’m writing on a regular basis, which has been very fun, and I’ve started a podcast on there as well. My first episode is launching very soon, actually.

Lorne Brown

Excellent. Yeah. That’s awesome. All right, so go to Aimee Raupp’s website. We’ll put it in the show notes as well, so you can get more details there, and pick up a copy of the second edition of Yes, You Can Get Pregnant. Aimee, thanks so much for spending time with me today. I really appreciate it.

Aimee Raupp

Thank you so much. I appreciate it. This was a great conversation.

Lorne Brown

Thank you for spending this time with us on the Coherence Code Podcast. I’m Dr. Lorne Brown, and I will see you next week for another conversation on coherence and healing. If this conversation resonated with you, please like, subscribe or follow the show, and share it with someone who might benefit from it as well. Remember to take a moment to breathe, reflect and stay connected. Welcome to the Coherence Code Podcast.