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Fine Tuning Fertility with Elizabeth Mucci

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Fine Tuning Fertility with Elizabeth Mucci

On a cellular level, what drives infertility? This is what today's guest is an expert at investigating and resolving in her patients.

Elizabeth Mucci is scientist, nutritionist and herbalist with a Masters in Reproductive Medicine. It's her science background in biochemistry and physiology that has afforded her a unique, multi-layered knowledge of the various blocks to reproductive success.

Elizabeth shares with us her clinical pearls of wisdom for approaching male and female fertility, including her approaches to those patients with repeated IVF failures or multiple miscarriages. 

Covered in this episode

[00:46] Introducing Elizabeth Mucci
[01:51] Blending science and naturopathy 
[06:10] Genetics influence fertility
[09:16] How do we determine resilience?
[11:23] Physiology and biochemistry
[25:44] Ruling out underlying infections
[29:38] Are toxins a common issue?
[31:36] Unravelling failed IVF
[33:26] The nitty-gritty of male fertility
[37:04] Getting to the bottom of miscarriage
[41:13] Teratosthesia
[42:34] Complementary medicine and IVF
[45:13] Scope of practice and referring on…

Andrew: This is FX Medicine, I'm Andrew Whitfield-Cook. Joining me in the studio today is Elizabeth Mucci. 

Elizabeth is a mentor, educator, and health care professional with over 17 years experience in integrative hormonal and reproductive medicine. As a scientist, nutritionist, and herbalist, with a Masters in reproductive medicine, Elizabeth is a passionate health advocate, whose principles as a clinician and teacher have enabled her to help thousands of patients start their families both in Australia and overseas, including the U.S., U.K., Canada, China, and Japan. 

Prior to joining Elizabeth's fertility program, most of these patients had been facing particularly challenging fertility issues that have resulted in multiple miscarriages and repeated IVF failures. Elizabeth's great ambition is to provide both her patients and peers with the tools that they need to help more people around the world to build a happy, healthy families they've dreamed of. 

Welcome, Elizabeth, to FX Medicine. How are you? 
Elizabeth: I'm good, thank you. 
Andrew: Elizabeth, I have to ask you first about your education because you started off from a purely science basis and then moved into natural medicine. It's very often the other way around. 
Elizabeth: Exactly. Exactly. 
Andrew: So, tell us what first drew you to doing biochemistry and physiology? 
Elizabeth: I've always had a passion and curiosity in knowing how the body works. And as a younger child, you know, animals, plants, everything. And I think that just as I was going through, I always loved science but as I was going through, I could see the path I wanted to sort of take. It was branching off into human, you know, obviously human science. But then particularly in helping the body be at it's optimum, looking at what that meant, what we could do about it, and yeah, I studied with some amazing professors. I would, you know, ask them lots and lots of questions. And if this was sort of supported or if this was set up, could that then mean that we could achieve this? And often they'd go, "Yes, it could mean that we could achieve that." And that just got me on fire for that…
Andrew: So, the thing that I'm picking up is that you have been eternally curious. So you would have been a painful child? 
Elizabeth: Yeah, lots of questions. 
Andrew: And so, what did your biochemistry education teach you, not just about reproduction but about any disorder that humans encounter? 
Elizabeth: What it showed me was that there were ways to support or, I like to use the term scaffold. Using a scaffold system that will help us support our body biochemistry. And therefore, you know, except maybe lacking particular enzymes or whatever condition that we have. But trying to support that biochemistry and therefore see where that led. And also, what was... I am a ‘kill two bird one stone’ type of person, and the more I can sort of, you know, fix with the one sort of solution, the better. So, I realized that if we kept following back this biochemistry, a lot of them were linking to some major sort of issues, and therefore, in dealing with where the source of the issue was, we were fixing lots of symptoms and things at the same time. That really got me intrigued. 
Andrew: So, with regards to that biochemical scaffolding, you know, and the picture in my brain is the Boehringer biochemistry pathways, you know, I love them. I still have my poster, the two posters, yeah. And I found the book the other day, it was stacked away somewhere, I found it so I'm really pleased. 

But when we're looking at that scaffolding and you see the enzymes, what we don't often hear about or get taught about are the nutritional requirements for those enzymes. Indeed, there are other requirements, there's temperature, there's acid or alcohol. 

Elizabeth: Oh, one hundred percent…

Andrew: So there's all of these other things that we don't know, and we just assumed that they happen because that's life. But those enzymes require that to work. How important are these other things that we don't, we can't give any supplement? We need warmth, we need fluid, you know. 
Elizabeth: Oh, definitely. You want the right condition and therefore, you know, and that really helps in disease states in particular. Because you might think, okay, in this particular diseased state, the body might be sacrificing other sort of, you know, optimal conditions to try and help a particular other area. And in fertility, that's quite important. Especially when you look at, you know, the testes of the male is on the outside of the body to keep it cool. But he might be one of, you know, he might want to keep really fit and decided to do a whole heap of exercise, and heating up the body, and then... 
Andrew: In tight shorts. 
Elizabeth: Yeah, a hundred percent! Or in a, you know, Bikram classes and, you know, all that sort of stuff where you're thinking that, you know, that might be fine into certain conditions or for people. But, you know, it could be really damaging for, you know, fertility sake for instance. 
Andrew: So, with regards to these basic sort of things, you know, temperature and moisture and pH for instance, a common naturopathic concept is the one of alkalinity or acidity. And I've always been rather skeptical of what we're measuring? Where are we measuring it? Because the body has these elegant, you know, amino acid, carboxylic versus bicarbonate, buffer systems. How out of phase can they get and what issues do they present people, let's say with fertility issues? Like how overt are they? 
Elizabeth: So, that's going to be different for different people. So, what you have is some people depending on their genetic makeup will be a lot tougher and resilient in particular situations. And then you've got other people with, you know, a slight temperature, it's just totally wrecked it for them, in that particular month say, for example, or whatever. Or you might have someone that's drinking a lot of alcohol and they're becoming quite acidic, and they could even have inflammation and joint pain, and a whole heap of things happening as a result. But their fertility, when you go and test their sperm analysis it's looking quite fine. And then you'll have somebody else that can't drink at all, and the slightest amount of alcohol that they've had is actually having a massive impact on their fertility. 

So, a lot of it is about looking at what ancestry that person might have. It's one I particularly go for. I always ask where are they from? 
Andrew: As in geographical ancestry. 
Elizabeth: Geographically. 
Andrew: Wow. 
Elizabeth: Yeah. So, geographically, because if you've coming from maybe like quite an ancient background. I mean, that's a survival of the fittest, a lot of them didn't have antibiotics back then so you've got a lot more resilience in some sort of areas than you have in others. 

You've got other people, say for instance, that might be people who have come from desert areas, and they thrive in that. Then you put them into our sort of zones, and then they're putting a load of weight on because they're having what we deem maybe a healthy diet, but for them that's sugar load is way too much, and it's causing a whole heap of inflammation and etc. 
Andrew: So is that something that you lean towards genetic testing or at least the ancestry genetic testing for, or do you just ask them? 
Elizabeth: Yeah, I don't go that far but I just ask them. And often, I just sort of find that actually helps me guide their dietary requirements as well. Because, you know, people from the Mediterranean areas, the Mediterranean diet is better for them. We know that sugar will be much worse for them. They will tend to become a lot more inflamed. And often, a lot of polycystic ovarian syndrome girls come from that area. And so hence, the sugar sort of, you know, sort of situation there. And compared to someone who might come from Asia who can eat rice and things like that. 
Andrew: You know, I've discussed this with a few practitioners with other conditions as well. It keeps on seeping through. What is resilience? How do you define that? 
Elizabeth: I use tools like iridology and things like that in my practice. But it's more about hearing their history. You know, I would run them through a whole bunch of questions about how well they handle… how often they get sick, you know, what's their immune system like? Do they have aches and pains? Do they tend to get joint pain? 
Andrew: Tired all the time? 
Elizabeth: Yeah, yeah. You know, what happens to them if they've done quite a bit of exercise? Or what happens if they’ve been out in the cold and the rain, and things like that? And also their family history, you know, were there autoimmune diseases in the family. You know, what other things were there in their family history, because they're carrying the genetic makeup of their family history. 

So, yes, I suppose it's more putting all of that together and listening to things like, you know, I often ask, what are you craving? And just in that sort of, you know, if they go, "Oh, yeah, I just crave sugar." You know, or I'll ask them to rate their energy out of 10. And then I'll break that up, you know, what are they like when they wake up in the morning? What are they like in the afternoon? 
And I'm listening to the waves of sugar going through the day, you know, that sort of thing. And some people just go 10 out of 10 and you can hear that they’re, you know, their diet doesn't tend to match what we would expect that would require for you to have a ten out of ten. So, you know they're a lot tougher. They sort of, you know, they have that atypical personality type of character and you know their grandparents have lived over 100 or they've lived to 95. So, that's what I tend to sort of think, "Okay, these are tougher constitutions." And usually what I find is once I start treating them, they get better very quickly. They respond very fast to the treatment. 
Andrew: I love your line of questioning with regards to how they respond to a stressor. Because I've never heard a practitioner really actively ask that. About how do you respond once you've given a stressor. That's a really good practical point I think. You did the medical or the scientific education first and then opened up to natural therapies. 
Elizabeth: Yep. 
Andrew: Why? 
Elizabeth: When I finished the degree, the double major, what it did was it… because I did physiology which is the function of organs and the structure, and then I did the biochemistry, I could really see how I could support the biochemistry to help the physiology. And so, for me, it was more looking about outside that sort of circle. Okay, now that I've got all these knowledge, how do I help people live their optimum life? 

And so, I was going to go down the road of medicine but I could see the limitations. And so, therefore, I then went and, you know, visited a naturopath and I could see that limitation. And so I could, I was really excited about looking at, if you had this knowledge that I had and I could use all these other tools, and combine them with that knowledge, then where would that… that should theoretically help me, help people live their optimum life. And so as I started going down that path, I could see, "Yeah, I could really, that was sort of ringing true. I could really put the two together." And yeah, it just went on from there. 
Andrew: What interests me, I guess, is where you intervene as a drug or a biochemical sort of entrance or an entrant therapy. Do you say, "Okay, let's..." Why didn't the drug company pick Farnacil rather than HMG-coenzyme A? Was it easier? Like do they cover this in biochemistry? Is it due to perhaps reverse pathways, bi-directional pathways? 
Elizabeth: With me, the feedback systems were really important. That was very, very important because it's, you're looking at... And this is where I think, if you don't know your science really well, you're going to have problems with just following what is given to us as, if there's this problem, this is what we do. Just very similar with the medical industry, it's sort of, you know, when you see this disease, these are the drugs you've got to choose from. Instead of looking at, okay, is it the fact that this is low in the bloodstream or high in the bloodstream? Or is it because the organ is half asleep and actually needs toning, so that it listens better to the hormone that's being pumped out? And in fertility, that's huge. 
So a lot of the time, and this happened along the way and this is what was really interesting. When I first started, they were talking about FSH, the follicle stimulating hormone. And people were coming to me saying, "Oh, apparently I'm menopausing because my follicle stimulating hormone is really high." And to me, that just didn't make sense. It made sense with one part of it, but there was another part to that pathway. So, what I put together was okay, just because your follicle stimulating hormone is high, what does that actually mean? You've got the pituitary pumping out this hormone, that's trying to get the ovary to produce a follicle and grow it. But if that ovary has been bombarded or damaged by maybe IVF drugs, or the pill for 20 or 30 years. If it's been put to sleep for so long, the follicle stimulating hormone would have to rise so high to actually try and get that very lazy ovary... 
Andrew: To wake it up? 
Elizabeth: To wake it up. So is it the fact that she was actually menopaused, or is it the fact that we need to go in and deal with the ovary first. Wake it up, tone it, get it in its best shape, and then watch what happen. So I started doing that. 

So I kept saying they were panicking and often I would go, "Look, let's go into the ovary, and let's start to actually work on the reproductive organs, and see what happens." And low and behold, most of the time, the FSH was dropping and they were starting to ovulate. And they were doing really well and then they'd fall pregnant. So, I've had women that have been told they've menopaused, to come back out of that situation and go on to have a child. Just because I've taken the other end of the pathway. 
Andrew: Now, was that your biochemistry physiology training that taught you that? 
Elizabeth: Yes. 
Andrew: Or your natural? 
Elizabeth: No. The biochemistry physiology training taught me about the feedback systems. The naturopathy gave me the tools. And if you really understood it, you knew how to use it. 
Andrew: How do you ratify? How do marry the two when you come from like, quite a hard core scientific background? And you're marrying this, you know, ‘that's a pseudoscience thing’. And yet, that gave you the tools to intervene. 
Elizabeth: A hundred percent. I think it's about being open, so that's where, I mean, you've got to actually be extremely willing to be humble enough to go, "Look, just because I wear this hat, doesn't mean it's the only hat to wear." I often to say to people, "You know, I'll hold up a cup with my patients." And it might have a drawing on one side and me blank on the other. And I'll say to them, "You know, if I asked you to draw this cup, your cup is going to look really different to my cup with those right though.” And for me, it's always been about walking around the cup and getting a full perspective. And that's the way I view all of this. 
Andrew: You came out of doing biochemistry and physiology. You then went on to do, naturopathy. That sort of forgive me, herbal medicine. 
Elizabeth: Yeah, and then nutritional science. 
Andrew: And nutritional science, then you went to practice. 
Elizabeth: Yeah. 
Andrew: So, what happened? Did you just go, "Oh, this is fantastic. I know both sides, I can talk the scientific talk, I understand it, and I have the tools to actively treat people and they're working." Did it immediately fall into place? 
Elizabeth: A lot of it fell into place. I trained with a naturopath for a while who is in fertility. And again, as I was working with them and I sort of thought, "Oh, there's so many more questions you could ask here." This is actually, if you're going down this path, if you ask this, this, and this, it would open your eyes to this whole other biochemical sort of world, and you would know how to fine tune this. So that sort of helped me get the confidence I suppose and know what sort of questions I could fine tune. 

And so, what I often do with patients is I take them through, you know, particular questions that I'll go, "Okay, now that you've said that, let me just take you down this path." And they'll go," Yes, how did you know that? And yes, how do you know that I'm waking up through the night?" Because you would know the biochemistry. And then I would, if I'm going down a path and they're saying, "No, no, that's all fine." Then I'll go, "Okay," and I'll branch off to a different path. Because I'll know, “Okay, so it's not maybe the magnesium sort of pathways, but it might be the sugar pathways. And that might be why you're not sleeping very well." So then I would go, "Okay, now let me ask you these other questions though." 

And so, it's just more, it's just the two marry so beautifully and it was, yes, it's really about fine tuning. I think if I was going to, you know, suggest maybe to a practitioners, you know, what sort of things could help them is just get some really good solid questions that are going to help them know, "Okay, if this person is saying that at that particular time of their cycle, this is what's happening. Then that might mean a whole heap of other stuff." So, people will often say to me very commonly, they will say, "Oh, yeah, I've been suffering, you know, the PMS sort of symptoms but the doctor said that's normal." And often I'll say to them, "Yeah, that might be ‘normal’ or that might be ‘common’, but it doesn't mean that it's healthy. What your body's doing is it's crying out telling us, 'I'm out of balance here so I'm going to give you these symptoms.'" But because this whole heap of people out of balance it's seen as common. Where with me, it's like, you know, I'll ask questions like, "Okay, did you feel tired before you got your period or while you got your period?" Because they are two different things. You know, one will be a sugar issue, one will be an iron deficiency, you know. And so it's really knowing about what happens at different stages, that real fine tuning, and that can only come with education. 
Andrew: Well, I've got to say that education was specifically primed for you to go into a biochemically driven thing for like fertility. You know, what's interesting to me is though, it also depends on the level of education that you're getting. 

For instance, 10, 15 odd years ago, I would commonly hear this term, that progesterone is the, you know, the hormone or pregnenolone, is the precursor to all of the other steroids, sort of, based hormones. And yet I would see in all of my anat and phys texts, whether it be Tortora and Anagnostakos, I think it's Tortora and Berritson or something now. He’s gone through two authors. Whether it be Marieb, whether it be Spence and Mason, it didn't matter. My favorite anat and phys books. And every single one said that the testes secreted testosterone. And there was only one text where I ever saw testes produce pregnenolone, and it quickly changed to testosterone, and that's what secreted. So that really then is dependent on the level of text or the specialty of texts you get. 
Elizabeth: A hundred percent. 
Andrew: We should be really rallying or lobbying our educational institutions to use better texts then. 
Elizabeth: A hundred percent. And that is what I get the most passionate about. It's, you know, often what's happening with patients that I see is that they're coming to me through, you know, lots of years of IVF. They've been down… they've exhausted all these different people and, you know, acupuncturists, naturopaths, IVF specialists, different IVF specialists, they've done a whole heap of things, and they're basically saying, well, they've said, "I've got, hardly any eggs left? And, you know, I've got to use a donor." You know, that's the very typical sort of story. 

And then in the end, what's happening is that people aren't looking at what else is out there. Because these industries, obviously, they have sort of fine tuned their particular things that they're doing. But when I studied the Masters in reproductive medicine, what I was shocked about was the fact that they actually… the medical world knows a whole heap more. But for some reason, it's not being translated to these patients. So it would be in the hands of I suppose the beholder who decides to use or do whatever they're doing. 

But this particular gyno book that I was reading talked about this group of people in the States, there was a study done, I think it was about eight years now, maybe a bit longer, maybe 10 years. Where they looked at all these people in an area of America, and basically, they get married at a very young age and they have babies till they can't have babies anymore. And so, they were looking at, did they reflect the same stats as what we do here? And the stats were totally different. 
Andrew: Oh, really? 
Elizabeth: Really different. So, you sit there and think, "Okay, if the biochemistry is the same, then why is this happening?" And that excited me because it was like, "Okay, so if we reflect what's going on in this area, then maybe we will start to reflect these stats." And so, even though… because what I was finding in my room where they might, you know, the common stats are that, you know, at 40 you've got about 5% chance of falling pregnant. And at 45, it's a 0.5% chance. That wasn't what this group was showing. This group was showing that at 40, only 17% of their couples had lost their fertility. And at 45, only 33% had lost their fertility. So, you're talking about 67% of 45 year old women were having babies. 
Andrew: Are still fine, yeah. 
Elizabeth: And so I was thinking, "Well, hang on. If they're obviously made the same way, what is it about these people that was allowing them to still fall pregnant?" And it's that sort of stuff that I've seen over and over that I think that's giving us a clue. There really, there are pockets here that are giving us a clue of is it that the egg shell is hardening and the sperm can't get in there. Is that really? Because why isn't that happening over here? 

Or is it the fact that they got married as virgins and there was no infections introduced? So, all of a sudden you've got all these infections and they know that. They know that infections are having a major impact. And then it's about how do we test for them, and how do we actually convince a doctor that this particular one, even though it's common, is actually having an impact? You know, and I've had girls come to me going, "Oh..I've got natural killer cells." And to me, that... 
Andrew: Hopefully, you have. 
Elizabeth: And to me, that would go, "Infection, maybe." Where to somebody else, they would go, "Oh, yeah, you're one of those women." So we better use Prednisone, we go into the Clexane, they use all these other things. Instead of thinking, that's bit of a clue, maybe we better look if there's an infection. And a lot of the times they do have an infection. And we've checked, you know, for infections that aren't commonly checked for, so not just aerobic but anaerobic. 

So, I often check for urea plasma and mycoplasma. You'll get a lot of people, particular GPs, if they don't know that what it does, because it is common, they'll refuse to sort of do the check and all the rest. But we'll check for those and I've had girls who have done IVF for six years. We get rid of the infection. I've only just started with them, and they're falling pregnant on the withdrawal method, trying not to fall pregnant after six years of IVF failing, because we've got rid of the infection, you know. 
Andrew: Okay, so the intervention here, how do you get rid of the infection? 
Elizabeth: Well, the thing is... 
Andrew: Traditionally antibiotics. 
Elizabeth: Well, I do, because for me, it's about speed. Getting this sort of happening, and supporting that. 
Andrew: So, doxy? 
Elizabeth: Doxycycline is a typical one. But in that case, sometimes the infections have been there for so long, that 10 days on doxycycline is not doing the trick. So what I tend to do is I use my herbs as well as, you know, support. Yeah, both. 
Andrew: This is where I like the marriage of natural and pharmaceutical medicine, let’s say it. But I do like the way that herbs and natural medicines can A, make pharmaceutical medicines or outcomes more effective. And B, have less side effects or reduce the risk of side effects. Do you find that practically working with fertility couples? 
Elizabeth: Definitely. 
Andrew: Yeah? 
Elizabeth: Yep. And often, even with... Look, some of my patients come to me, they've done, you know, IVF for years, and years, and years. “I have to go back to do IVF”, they've failed over and over. We know they've got to go back. The woman might not have tubes, or the guy has to kinda ejaculate sperm and they have to go into the testes. So, we know they've got to go back. And so, it's more about getting their body’s in optimal situation and then when they're going through the IVF, supporting that so that they get the optimal result. 

Most of them, it's very rare, that I won't get a positive result out of that. But that's even though they've failed, and that's more of, I suppose the take home message for me is do your research. You know, check what's there. Don't just go, "Okay, I've been told that you failed this, so therefore, it must be that you're really stressed. We'll deal with the stress." Or it might be that, "Oh, we've found there's the thyroid problem, so that's what it is." Usually, I’ve found it's about three or four problems that are having an impact. 

What WHO found was that often even in a sub-clinical, not a sub-clinical sorry, a sub-fertile couple, out of three years, they will tend to get a pregnancy. So, it's sort of like, you know, one might be super fertile, one might not. But out of a three year period, usually you'll get a pregnancy. But what I'm tending to find is that usually there's problems in both. Or it will be that it's not optimal. That's where, you know, commonly I'll have couples come in where the woman might be 10 years older than the male. I know I will get a pregnancy out of those ones. 
Andrew: Oh, okay. 
Elizabeth: It's very rare I don't. Even though that she might be 45, sorry 43 to 45, because the guy is a lot younger, I will tend to find that I will get a pregnancy. And that's what started me thinking, "Hang on, is it the age of the egg or is there an impact here from the guy as well?" 
Andrew: Yes. So, conversely, do you find greater issues when there's an older husband and a younger wife? 
Elizabeth: Not greater but... 
Andrew: Or different issues? 
Elizabeth: Different, different issues. And it will depend on the exact, you know, what we're saying before, the resilience of the person, how well their absorption is. So I'm commonly dealing with gut. Because I need them to break down their proteins properly, to go into the amino acids so that we can build up the DNA of this egg and sperm scenario. 

You know, infertility, the thing is that fertility is not needed for the body to survive. So it's like that canary down the mine shaft. It's the first thing your body is going to give up. You've got this really high nutritious situation here. It goes, “Where can we get our nutrients from because I'm not sleeping really well and I'm sort of, you know, burning the candle at both ends and I'm drinking a bit”, and this body goes here’s a great nutrient source. And so, yeah. 
Andrew: So, talking about toxins and pollutants, and things like that. How much of an issue do you find this in couples in the 21st century? 
Elizabeth: Again, it's going to depend on the person. So, you could have someone that's overweight, who is handling that very well. So I've had girls at 148 kilos fall pregnant. And then you'll have somebody else that might be 80 kilos, that's going...that's not ovulating because that is not great for them to be that weight. 
Andrew: So, is that more along that, your hereditary line... 
Elizabeth: Exactly. 
Andrew: Like the thing that's singing off in my head is the fat, fertile, 30, flatulent, Mediterranean lady who gets gallstones, but they're really fertile. They're overweight but they're really fertile. 
Elizabeth: Exactly. Exactly. 
Andrew: Okay. 
Elizabeth: That's why the more science you know and the more fine tune you can put... You know, you're putting that person in their context. You're putting them in their hereditary context and their lifestyle context. You know, they might be really toxic, you know, I always detox everybody. But, you know, I'll start off with a detox but then I'll be supporting the liver function. Because the liver is one of those things that's going to, you know, that whole P450 enzymes scenario and where it's, you know, you load it up with a whole heap of stuff to do. It's not going to do the stuff that are fine tuning hormones. 

So, it's more, what I often say to people is look wherever you can help your liver not have to do this work. I'm going to encourage the good hormones, but if you keep doing this, it's like we're taking two buckets out and putting two buckets in of water in a sinking ship, you're not getting anywhere. So, yeah. It is really that, you know, that funnel effect. That's what I tend to do. I get as much information as I can from both people, and I keep funneling down and fine tuning. And that's that macro-micro sort of scenario. 
Andrew: Right. And you say that patients often come to you after failing multiple courses of IVF, multiple cycles. Do you find ever that the act of detoxing has a negative effect on them? ie., they start to unload all of these hormones or their liver wakes up. 

For instance, I remember one lady who I did not do a service to. I actually referred her off. Because she had dysmenorrhea and that caused horrible, horrible acne, cystic acne in this lady. She wanted me to keep treating her, I couldn't. I just couldn't do it. I sent her off to somebody who is more specialized than I. And it was because I'd really stirred some stuff up. Do you find that common, like the load on the liver, is that heavy after doing multiple cycles or is it just like, as you say, this resilience? 
Elizabeth: It's the resilience. 
Andrew: Right. 
Elizabeth: So, it depends. So, I'll have someone that's done heaps of IVF. And I'll tell them, "Look, you know, obviously when you're dealing with hormones, the hormones are going into the nucleus of the cell. So, we've got to see that cell die and a new cell regenerate before we're really seeing a much better body." And so, often you're wanting to do a three month thing beforehand, and then you're reading the background. 

So, if that person's got a lot of longevity in the family, they're going to handle a detox so much better than someone that's got quite a sickly background. So, it's taking that into account. And then also, you know, what sort of tools you're using to detox, and what else you're doing at the same time. So I often, as I detox, I'm also dealing with a whole heap of other biochemistry to make sure that they're handling the detox well. 
Andrew: With regards to male versus female preparation for pregnancy, we often concentrate on the female because we see the females more often in practice. But it's then said that it's the males that really need quite a lot of work because there's 120 days for spermatogenesis. How important do you find it and how easy is it to get the male on board? 
Elizabeth: So, very important. The male sperm, 20 sperm can fit across an egg. Which is why the testes is on the outside of the body, okay. So, they get damaged very easily. A sperm analysis really helps us. Because it will tell me what sort of damage is happening. 

So, is it the fact that, you know, he might be making a lot of sperm but all of them are getting destroyed? So, then you would look at, okay, what's denaturing this? Is it the fact that they're heating up? Or is it the fact that he's, you know, he's doing a whole heap of gym work all the time thinking he's keeping really fit? Is it the fact that he sits around a lot and he's just, you know, heating everything up? Or is it the fact that he's drinking or smoking, or whatever? 
And, you know, you're looking at that particular... Is it the normal forms that are being affected? Or is it looking amazing, and actually the DNA of the sperm is affected? So I always ask for DNA fragmentation and I'll do that because that tells us a hidden story. So a lot of people have gone down that IVF road and they've looked at their sperm, and they're going, "There's nothing wrong with me." And then I'll say, "Oh, have you got a DNA fragmentation?" They go, "What's that?" And then we get it and we can see, there it is. It's really badly fragmenting. 
Andrew: And the causes? 
Elizabeth: The causes will be, well, oxidation. It will be, you know, how nutritious he is, how strong his DNA is actually holding together because he's absorbing proteins really well and he's eating enough proteins, and all the rest. Usually, you know, the antioxidants are a big one there. 
Andrew: Do you find that they work? Do you find that antioxidants work? 
Elizabeth: The antioxidants work. So, with all my work, I never just get a result and leave it at that. Yeah, I don't do that at all. For me, I get a result, I will show them the result, I explain it in detail. And I will then get them to get another result two and half months later or three months later and I'll show them how it's changed. 
Andrew: Treatment level, yep. 
Elizabeth: The other thing that's happened is what I found, some of my patients come to me saying, "Look, we've done IVF." And when we did PGD testing, so the genetic testing of the embryos, all of them were bad. And we can't get any embryos that are healthy. And they're saying, "It's because I'm 39, you know." And then I will get the male DNA and you can see it's very poor. Help that, it'll come back excellent and then I know some of the times, they'll have to go back down the IVF road. Some of them actually carry genetic defects and they've got to pick out the embryos that are the healthiest. And they go back and go, "Oh, my god, not only did I get 12 embryos and last time got three. But this time I've got five that were amazing and I've never had any." And that you implant one and off they go and they fall pregnant, and they know it's a really healthy embryo. So, we've seen the changes. 
Andrew: So, just rescuing the male... 
Elizabeth: Has made a massive massive impact. 
Andrew: Has made a massive difference to the survival of the gamete. 
Elizabeth: Yeah, exactly. 
Andrew: Wow. 
Elizabeth: Yeah. 
Andrew: So, with regards to miscarriage, which you spoke about before and infections, which is really really interesting to me. Like a total undiscovered, you know, cause of issue. What do you find are the main issues? Is it, as I said before, are we talking lifestyle issues here? Or are there age disparities? What do you find the main ones are? 
Elizabeth: So, when it comes to miscarriage, you're looking at things like the hormonal balances in the luteal phase, so that's important. You're looking at where they actually ovulated in reference to when that egg was ready. So often what happens is, if the egg was developed say by day 14, but it wasn't kicked out to say, day 18, then that egg's DNA has aged quite a bit. Then you've gone and fertilized it. And then it might last to week six and then you're finding that it's dying off and they check and they go, "Yeah, it had a chromosomal issue." Then I get them more perfect with the way that they're doing that and they go and fall pregnant, and they have a healthy baby. 
So, often I'm working with gynos and obstetricians, and they send me patients, and some IVF specialists, and they're sending me patients saying, "We don't know what to do here, she's miscarrying. And every time she miscarries there's a Downs or a Turner syndrome, or is there anything you can do?" And then that patient, we do a three month thing. Make sure that everything is great with her. She's filled with all the nutrients she's needing to help egg quality. Work with him, make sure that his lifestyle and her lifestyle are where it needs to be. And then they go on to have really healthy, maybe not even one but two or even three babies afterwards, not miscarrying. 

So, there's the egg quality, the embryo quality. There's the luteal phase that can all of a sudden just, you know, let the lining thin down and you've just let go of pregnancy. Then there's the stress levels as well, so that can have an impact. Because if you're in a really stressful environment and you're particularly sensitive to that. Your body as an animal would say, "Drop this load. You are not healthy enough to have something that's quite parasitic, sucking the life out of you right now when I'm struggling to just keep you alive myself." 
Andrew: So, is that called teratosthesia? Is that where they, because you're improving nutrition and you have a defective blastocyst, that it recognizes it as defective and then says you're out? 
Elizabeth: So that's a defective one, right? I'm talking about getting rid of a really healthy pregnancy. 
Andrew: Right, sorry. Gotcha. 
So, in this case, it's sort of, you know, you've stressed the body out. You've told your body “I can't support a pregnancy.” 
Andrew: I just can't support it, right. 
Elizabeth: So, there's that. Infections are a big one. So, where this particular infections come into knowledge, or say where they alert maybe a doctor, is when you… this is commonly, I'm not talking about all doctors of course. Is where you would miscarry, your waters will break at 17 weeks. And the doctor's gone, "What the hell? Like this was a healthy embryo, what happened here?" So, often, and they’ll know, they'll go in and try and put a stitch in. They'll try and sort of… but it's rejecting that because usually there's an infection. They will think down the road often of, "Okay, is this urea plasma or mycoplasma?" Because they're known in that area have had a history of doing that. Or you might go into premature labor, you still might have the baby but you've gone into labor at 27 weeks, you know. 
In my practice in 18 years, I have had three premies. I should have had 15% of my babies should have been premature. And that.. a lot of it, and even in those cases, one had an appendicitis and had sort of... the other one the doctor sort of went, "Look, your other two babies were premie and I'm going on holiday. So, I'd rather do this now." And then the last one, she had lost two babies earlier and so she was lucky to sort of have this baby and had a really healthy baby. So, there's a lot you can do to actually stop this from happening. 
Andrew: Just coming back to that concept, that teratosthesia. I remember reading it years ago and it was regarding folic acid. Improving the health of the female so that it would reject a malformation, rather than carrying the malformation. How important is this issue of terastosthesia? Or do you find that it's really the incorrect expulsion of a healthy embryo that's happening now? 
Elizabeth: No, no, no, no. It's more, I suppose, for me, it's like often people are coming to me with a long history of miscarriages. And then as a result, we're looking at all the different things that could cause that. 

Now, that could be cardiolipin levels, it could be thyroid issues that haven't been picked up. It could be, yeah, infections. It could be an egg that's aging because that mother has been unhealthy, and needs to do some heavy work, it could be that. You know, if the father, there's an impact there. The hormonal impact. It’s just, it's so many issues. Another one is you didn't even form an embryo properly in the first place, meaning, or an egg. So you're expelling an egg that's not ready to be expelled, so now it's an immature egg. You've fertilised an immature egg, you go to about five weeks pregnant and then it's over. 
Andrew: That's it. 
Elizabeth: Yeah. 
Andrew: I remember reading this paper or a story I should say, and it was saying, complimentary therapies inhibit IVF. How real an issue is this? How bad can natural therapies be with regards to their effect on IVF cycles? 
Elizabeth: That's a good question. In my experience, it's enhanced everybody's IVF. That's by far. And, you know, I just had this happen now. One of my girls went off and did IVF and she didn't realise that I could actually aid that process and I'd got her a lot healthier. And she ended up with 17 eggs where in the past she got three. And she was just in a rush. She was just, she's going, "Doctors are telling me I'm nearly 40, I've got to do this." And I said to her and then they implanted two, and they didn't work. So she came to see me going, "Oh, no." And I said, "That's okay, that's all right. I know the health of the embryos would be there. But we've got to set up, set up properly." 
So I gave her herbs before she ovulated. She ovulated, and gave her herbs after she ovulated and she just told me she was pregnant first go. So, in those cases, all the time it makes a massive difference, because if you can keep them healthy, if you can keep their liver supported while they're getting bombarded with these drugs. You're supporting them mentally, emotionally, and all the rest, and making sure that their stress levels are kept under control. 

So you've got all these other things as well, as the nutrient levels, I mean, as the nutrients come… that's where it's being great to get the before and afters, these constant tests, I love it. You know, I've had so many doctors go, "I don't understand, she can't drop FSH. How did she do that?" And then gets these results where it drops off. You know, you can't increase estrogens and then they've increased. 
Andrew: I love that. 
Elizabeth: It's been great. You see, they go, "Yeah, you can." Yeah, yeah. And that's really just by, you know, I never give estrogens, you're not giving them hormones. You're just stimulating their own production. 
Andrew: Yeah, it's a really interesting concept. And I remember it being really alien to me as a nurse. This concept of nourish, of support, rather than inhibit, block. You know, the pharmaceutical thing that we're so used to. And it's a real alien mentality to get your head around, but once you get your head around it's like, "Oh." 
Elizabeth: Because for me, the inhibit part is support your natural inhibitions of that particular hormone, you know. Like let your body do what it should be doing, it should be reading hormones. Which is why doing the whole DHEA stuff is, for me, not the best way to go. Because your body is going, "Oh, okay. So you got a heaps of DHEA in your bloodstream. We'll just shut down now, we're in production." Really cool. 
Andrew: You've done biochemistry physiology, which is the perfect pre-requisite to reproductive medicine. Then you've done natural therapies which is the practice, if you like, you know, as you say, the tools that you use, that you choose to use. There are so many that haven't done those pre-requisites of biochem physiology. There are so many that haven't done reproductive medicine as a specialty. As a responsible practitioner, what should we be really doing when we're seeing these people, mainly women, presenting to your practice with recurrent miscarriages or recurrent fertility issues. What should be their action? 
Elizabeth: I think unless you've got a really deep understanding of what happens here, you need to refer on to people who do. Because what's going to happen with, you know, this is what I was saying before, often you're encouraging health. So they might become just a bit more fertile, but you're not fine tuning. So what you're going to end up doing is where they went from infertility, they might become fertile but miscarrying now, because you didn't fine tune. And that could be a whole range of things to fine tune. So if you don't know, then you've got patients going through five miscarriages. And that's what's happened to me, where they've come to me going, "Oh, yeah, I've seen the naturopath and I've had three miscarriages now and I don't know what's happening." And then yeah, there's all the fine tuning stuff there but it's just otherwise it's going to be more heartache. It's risky, it's very risky. 
Andrew: And I've got to say, I love the way that you question then question and question your patients to really fine tune, as you say, you know, to really do that detective work so that you have a real clear picture of what's going on. It really impresses me, thank you so much. 
Elizabeth: Oh, thank you. 
Andrew: Well, no. I really am impressed but to me it's care. It's got to do with the responsible care of your patients. And as you say, you know, they're going through a heartache. 
Elizabeth: A hundred percent. 
Andrew: It's not something that they can go, "Ah, we'll just do it next month." No, they've been doing this for years. So, I really thank you for taking us through the important aspects of that and I’ve got to say, I look forward to chatting with you again on FX Medicine, Elizabeth Mucci. 
Elizabeth: Oh, thank you, Andrew. I appreciate that. 
Andrew: This is FX Medicine, I'm Andrew Whitfield-Cook.

Additional Resources

Elizabeth Mucci
Life on the Inside
Boehringer Biochemical Pathways Poster


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