Mariah Carey & Acupuncture

Dr. Amber Klimczak and Dr. Beverly discuss celebrities who credit their fertility success to acupuncture. Dr. Klimczak shares her personal experiences with acupuncture and they discuss whether acupuncture is helpful for IVF and fertility. They also discuss how laser acupuncture may be helpful for embryo transfers, stress reduction during IVF, and can help with improvement in sperm numbers.

Transcript

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Hi, I am Dr. Beverly Reed. And I'm Dr. Amber Klimczak. And we are Two Peaks in a Pod. Well, welcome back everybody. Dr. K, I wanted to run some celebrity stories by you. Oh boy. Okay, so I was looking the other day, And did you know multiple celebrities, including Celine Dion and Mariah Carey are claiming that their IVF specifically became successful because of acupuncture? I believe it. Okay. Okay. So today let's talk about acupuncture, um, in terms of its use for fertility treatment. And let's talk about whether we recommend it for our patients. And I also thought maybe we could share with our patients some of the things that we're thinking about adding to our practice too. Yeah, definitely. So Celine Dion and Mariah Carey used it when they were going through fertility treatment, kind of as an adjunct, right? Yes. Okay. Yep. And so they both did IVF and I think they even both had twins from what I understand. So it's like, wow, it must really work too well. Yeah. Okay. Yep. Yeah. So I bet a lot of our listeners out there, if you're going through fertility treatment or struggling with fertility, have heard about acupuncture for fertility. It's fairly common. I think that people have been introduced to it by friends or even their providers. Right. Yeah. Oh yeah, absolutely. Now I've never had acupuncture before, so I guess it's good to even talk about what is acupuncture. Yeah, so I have done acupuncture. I actually, uh, did it when I was trying to get pregnant with our second, and I'm actually doing acupuncture now, and I really enjoy it. So, traditional acupuncture is where they actually take small needles, they, you know, push them in, and they're not going deep. I'm a needle phobe. Everyone knows this about us. I was about to say, I am shocked right now, because you have been telling me The whole time I've known you, you are terrified of needles. So are you telling me you willingly signed up to let somebody stick needles in you? I don't The first time I did it, so obviously this must have been almost four years ago, the first time I did it, my heart was beating through my chest. I was like, I have no idea what to do. to expect, you know, and they really don't prep you that much because it's just, they're, you know, they do this like 20 times a day, you know, it's not no big deal to them. Um, and they, at least the experience that I have had when they're inserting them, there's like kind of like a flick next to it. I don't know if it distracts the nerve or something. And so it's very superficial. It's not enough to penetrate that you're going to bleed or really be stuck with a needle. Um, and it gets to these acupoints. Pressure points, um, and they stimulate, um, these certain points all over your body, you know. Sometimes it's your ears, your head, your shins, belly, a lot for, um, fertility stuff. So when you say they flick you, like they flick, they take their finger and they kind of flick right next to you. It feels like it. I have my eyes closed when I'm doing it. Yeah. You know. Obviously. So. Um, and one of them that I've been to was almost like a little device that they're using to do it. I think it has like a cup around it. Y'all should Google this so you can see the picture. But it's almost like a clear cup and there's a needle in the center of it. So that cup applies the perfect amount of pressure and then the needle is kind of deployed. And then, yeah, you feel like this little flick kind of next to it. And that's really all I felt. I have never felt a sharp pinprick ever. And I would say, if you are, that might not be right. Well, maybe if you would share with our listeners, maybe you can take a little video one time of like you getting it done. So we can just see what it looks like. So we can visualize it a little bit better. But, um, do you ever bleed from it? I've never bled. I have heard of people bleeding before, um, and you know, it probably has to do with what you're, I actually take aspirin, so I think that I would be more prone to bleed, but, um. Yeah, I've never had any spots really that are bleeding. After it says it doesn't seem like it's deep enough really to make you bleed. And you can see a little imprint at some of them where it was sitting and it's not almost, it's almost like not a full puncture. Okay. And so they, they stick all these needles in you and then you're just laying there, right? Yes. How long do you have to lay there? 30 minutes is, yeah. So when I read the studies about it, For traditional acupuncture to be efficacious, my understanding is 30 minutes is the amount of time that a lot of people use in the studies. I'm not sure how much benefit you get with doing it longer versus shorter than that, but that seems to be the number that a lot of people use, which I agree. It's a long time. I feel like I would. Later, I'd be like, I have to go to the bathroom now. Like, what do I do? You know? Like, that's Yeah. Well, this really magical thing happens to you once the needles are in. Okay, what happens? You start to feel kind of like this tingling energy kind of running through your body. I'm not kidding. And like, you know, like, I'm a scientist. No, I know. I believe you. So, you feel, I think it's because they know what they're doing, right? They, um, hit the needle. certain pressure points. And I really feel like the sensation going through and you're, it's very relaxing. I mean, a lot of the reason why I'm doing it is stress relief. You know, we're just like balls of stress. I just said that I can't live like this anymore. Yes, that's right. That's right. Okay. And then how many times a week would somebody usually get acupuncture? Just on average? Yeah. So a lot of the acupuncture clinics will bundle. And so they'll give you a price for 12 sessions or something like that. I would say what I've seen mostly is once a week, um, which is a time commitment, right? You have to drive to the clinic and take time away from your schedule and go there and then have the actual treatment, which altogether takes about 45 minutes right by the time you get in there and do it. So it certainly is time consuming. Um, and I think you can talk with your provider about whether they would recommend doing it. Yeah. less frequently than that or more frequently, but a lot of people who are doing it for chronic conditions will go on a regular basis. Okay. And then whenever they put the needles in, are they using the same spots every single time or is it different? And from patient to patient, do you think they're using different? So when I have had my consultations in the past, all the times it's, for fertility and they, it's, it's sort of interesting. They have their own version of what, what we fertility doctors call the HPO access and that's, you know, your brain talking to your ovaries. Right. Um, and they have to form kind of body parts for it, like, and based on what your ailment is, for example, fertility, then they have certain meridians or lines that run through these cells. systems that they're going to hit with the pressure points. And so it does seem to be tailored to whatever you're trying to treat. And of course, you know, everyone knows I struggle with fertility a lot. So I always get the same points hit, you know, but I think if you have something else going on, you know, I also struggle with sleep. So I think they have certain ones that are, um, helpful for like stress reduction and, you know, Putting your mind more at ease from stress. So, yeah, it does seem like they're trained to know which points go with which ailments. And sorry, I'm asking you all these questions as if you're an acupuncturist. I'm not a specialist. And honestly, it might be nice if you can ask your acupuncture person if they want to come be on our podcast so we can get more interested in them. But I'm sure when you signed up for this, they probably had you sign some kind of consent form. Is there any risk to doing acupuncture? Could it cause any problems? There, I do remember that bleeding is one of the things that is listed there. I'm trying to remember. Probably think maybe infection if somebody was immunocompromised or something, right? Yeah. Um, but I can't really think of anything. I mean, no one really reads consents like that. I'm a bad example. I just can't. Sign my life away. I don't know, maybe it kills me, but it's true. I, I had a patient recently who had, she didn't like one of the sentences we had in our consent form and I was like, oh, you read that whole thing? I'm like, I'm so impressed. Whenever I go to the doctor, I just sign my life away. I'm like, yep, yep, I'm right. Die. Okay, great. Alright. Next page, like you just signed. Yeah. I don't know. So I, I, to me I think the risk with, you know, traditional acupuncture Mm-Hmm. are exactly what like you're expecting. Mm-Hmm. pain at insertion site. Mm-Hmm. I'm sure. There is a chance of light bleeding, right? Discomfort. Um, but I don't think that there's really a lot of big risks. Yeah. Yeah. Well, I get a lot of questions about acupuncture in general. And usually of course, the biggest question people ask is, does this actually help my chances? of getting pregnant. And I've looked at so many studies throughout the years, and I'm sure you have too. And I think the biggest problem is you see conflicting results of the studies. I've seen some studies that show it helps and then some studies show that it doesn't. And usually I say, Hey, I'm okay with something as long as it doesn't cause any harm. But indeed, I have even seen a study showing acupuncture lower chances for success. And when I really put all of the studies together, What I really kind of came upon is that acupuncture seems to be most helpful if you find it as a stress reliever. If you're lowering all those stress hormones in your body, then that is going to help your fertility. But in some women who have a needle phobia, like you said, your stress hormones might go higher during and after acupuncture, right? Or if you are really stressed, cause you don't even know how you're going to work into your schedule or if the financial part is really stressing you out because you don't know how you're going to pay for it. If all those things are creating a lot of stress for you, then acupuncture can actually work against you as well. And so my recommendation is usually, Hey, If you're feeling stressed and you feel like this really works for you, go for it. If you feel like the thought of it is stressing you out, I don't think you need it. Um, is that kind of similar to what you talked to your patients about? Yes. Yes. So I agree. I think there's a lot of, um, heterogeneity out there in the data that we know about acupuncture and your expertise. Explanations are exactly right. Right. It depends on the patient and whether they find it relaxing, and I agree, like we already throw a lot of stuff at you as fertility physicians. And then if we say also you have to drive to this other clinic one time a week and you're gonna fit in an hour break in your schedule to do this. That's a lot. You know, a lot of our patients are very busy and already. have a lot of time commitment. So I think it can be really stressful, but other patients really find it as a reprieve. They scheduled me time, you know, it's time away. You get to sit still and no one can talk to you. We're not trying to call you. I'll probably text you. It's okay, we got this. Yeah, so, um, yeah, I think it depends on the patient for sure. But, um, you know, I think we're going to discuss this more, but there definitely have been some good studies for acupuncture. Are you allowed to have your phone in there? Can't like, can you text or no? Um, the place that I used to go in the northeast was much smaller and all my stuff was like kind of, um, close to me. I've never moved with them in me because, again, I'm paranoid. I'm sure you could. Um, but you, the one that I'm doing here, they give you a little button if you need anything you can press it. So I feel like I would go crazy if I had to lay there for 30 minutes without my phone. I think it's very therapeutic for us in this day and age that we live in. I think we should not look at our phone for 30 minutes. You're right. You're right. Um, okay. Well I wanted to share just a few anecdotal stories about acupuncture. So, um, I've had maybe about two or three cases happen over, you know, Let's say five, seven years or so, or so where I've had a patient and we did IVF and unfortunately IVF did not work. And in those circumstances, sometimes we suspected or thought there might be egg quality issues. And while we were trying to work on egg quality, which would include a lot of things, trying to make sure they're getting better sleep, working on diet, nutrition, taking fertility supplements and everything. But as part of that, sometimes we would do acupuncture. Um, well, when I say we, I mean, I don't do it. I said them to somebody I recommend and all of a sudden they're pregnant naturally on their own without IVF, which then of course I get jealous. I mean, of course I'm so happy for the patient, but then I'm also jealous because I'm like, Hey, I did IVF on this person and it didn't work yet. You could do acupuncture and it worked. And. Of course, maybe it's just a coincidence that it happened, but I'm always kind of fascinated by that. And I do kind of take that as a moment too, to tell patients if they did have an IVF cycle work, look, it doesn't mean it's hopeless. It can still happen. Right. Um, have you ever seen that happen before? Yeah, absolutely. I mean, I truly, yeah, like I think I can ensure helped me conceive my second child for sure. Um, and I attribute a lot of that success to it, but again, I think it has a lot to do with survival. stress reduction and IVF can be really stressful, right? We know that IVF can work for patients, but I think it does help to combat a lot of the stress that we put on our patients, right? It's all about balance. And I actually think this is a lot about what peak fertility is. Like we really focus on how can we make your life easier going through fertility treatment. And I think, If acupuncture is one of those things, like we're going to support you with that. 100%. Yeah, I mean, I think we both really favor the more natural side of things. We're both a little more crunchy, crunchy plus science maybe together. But, um, but yeah, um, okay. But then I do want to complain a little bit about acupuncture. So my only complaint is that when I send my patients to some of the acupuncture specials, which I love and I have been impressed by, Sometimes they're trying to add on some extras besides just acupuncture. So acupuncture, you've got me sold. I'm like, yes, let's do it. But then sometimes they're trying to tell you, you need all these other special supplements that only they sell that you can't get from anywhere else. And. I mean, number one, I don't like that. I feel like there's a conflict of interest when you're trying to directly sell somebody, you know, something that you say that they need that only you make. Right. Right. Um, and two, I honestly have some serious concerns about what these supplements contain. Um, so I am curious when you went to get acupuncture, did they tell you you needed any supplements? No, but I think, you know, they're probably weary of celebrating. Do they? Do they know you're recording? Yeah, yeah. So, I mean, like, I don't have time ever to like change out of stuff so they know what I'm doing. So they probably, you know, wouldn't do that. But I agree. You know, I would say I'm actually very, very weary of supplements. And, you know, my patients know this and we go through their supplement list and supplements are not regulated. We don't really know what's in them. Um, so I would definitely advise against that. The other thing that my patients sometimes experience when they go see an acupuncturist is they give them a lot of lifestyle recommendations that they feel like are unobtainable. And I think that that can be really challenging. Some of the things my patients have told me is that. They were told they could never drink any type of cold fluids. Um, so they can't have ice in their beverages. They need to be drinking warm, lukewarm beverages all the time. And I think it is like, it's, you know, cold going near the uterus and it needs to be warm and. They needed to have socks on their feet at all times. Warm socks, because they didn't want their body using extra energy to heat them. And I mean, it's Texas. People want to drink cold water and not wear socks on their feet. You know, and I really have had, and recently I've had a lot of patients complain to me about that. And they're like, do you think there's anything behind this? Because I'm killing myself trying to keep socks on. You know, and I agree. Again, it goes to that point of, is this stressing you out, right, or is this going to be beneficial to you? So you kind of have to take it for what it is, I think. Yeah. Well, and I would think, too, I mean, let's even just point out, okay, stomach is way up here, uterus is way down here, and really, too, if you even think about it, if you've ever thrown up, you know, the throw up comes out, body temperature, you know. your body heats it up pre say beverages are fine. Y beverages are fine. The d in terms of cold beverage body expend energy to hea into your body? The answe Um, there's been studies A lot throughout the day actually can promote weight loss because you're using more energy. Yeah, that's why I drink my diet coke every day. I don't shake my legs. Yeah, yeah, exactly. Um, so I think are you expending more energy than when you're drinking warm liquids? Yeah, absolutely. And if the idea is you need to retain more energy to procreate, yeah, no, I think it's a bit of a stretch. I've never seen any. you know, high level evidence. Well, what I want patients to know is, you know, and I will say too, look, some supplements we love, like I think we both love Coenzyme Q10. We love folic acid. You know, there's, there's a lot of supplements we love, but the ones that concern me are ones that are sometimes marketed as cortisol support or adrenal support, thyroid support and everything. Because when you look to see what is in those, I mean, y'all might be shocked to hear this, really, they take an animal such as a pig and they grind up the adrenal glands and the thyroid gland, that's your supplement. So you're taking, you're literally putting ground up animal organs in your body to try to fix an issue. And I mean, number one, I hear that already and I'm like, nope, I don't like it. Right. But number two, in fact, I have a patient right now, I just checked her, she's got a Blood test and everything is totally wacky in her body right now. And I think it's probably because she's taking this, this supplement. And so we're going to stop it and see if it all gets better. But I'm like, look guys, I mean, and who knows, you probably feel great. If you're essentially swallowing adrenal glands, you probably feel great, but that is not good for you. You should not be doing that, right? Totally. Yeah. Yeah. Yes. I mean, we've talked about supplements before. You just have to be careful, you know, it is a phenomenon out there, right? We're all advertised all of these different supplements, um, that potentially can help whatever, you know, ailment we're dealing with. You just have to be careful because these people don't always have your best interest in mind. They really want some money from you and you might be desperate. So you're willing to pay for them. So, yeah. And I mean, sometimes it's hard to, cause they'll send me a list of like 30 things and it's like, root, berry, that and I'm like, I've never heard of this before. I, and I just say, look, I don't know, I haven't heard of it, but if I don't know about it, I probably wouldn't take it because could it help maybe, but could it harm maybe. And so let's just not do anything risky. Let's stick with things that we know that are proven to be safe. Absolutely. And I will say too, in some of my patients who have chosen to do these supplement, a lot of them will tell me they end up with ovarian cyst and or irregular cycles and things like that. So I, I really think you can just politely decline any of the cortisol thyroid supplements or anything like that. You know, if you're seeing us, we will have already checked your thyroid. You should be in good shape as far as that goes. And we can recheck it if you need to. Um, but really kind of just stick more with the acupressure, right? Yeah. Yeah. Okay, good. So, okay. Because we've talked about acupuncture over the years, one of the things we had thought about to try to help our patients is should we offer acupuncture here? And when we looked into it, it's actually just a big undertaking. There's acupuncture school that you have to go to to become a licensed acupuncturist and everything. And then we even thought about, should we hire an acupuncturist to come in and offer services? That's been hard to find somebody. Um, but you recently shared with me what you did at your last clinic. And so I wanted you to kind of share your experiences, um, with an alternative to acupuncture. Yeah. Um, so there can be traditional acupuncture, like what we're talking about with needles. But then I would say an alternative to that is laser acupuncture therapy. And I think it's becoming more common because there's a lot of advantages to it. And this is actually what we did at the last practice that I was at and patients really loved it. Um, and it's really interesting. So the way this works is it's L. L. L. T. So low level laser therapy. And this is a cold laser and it's the same concept. It penetrates the depth the same amount than a needle. Well, sometimes people call this needleless acupuncture and it stimulates those acupressure points in a very similar way. So it's a But there's a lot of more, I would say, um, just approaches that there's a lot more advantages to it to make it more practical maybe is what I would say. So it's a lot quicker, right? Um, so you know, it's a, it takes maybe five minutes even to do it. So you, and so finally there, and maybe for people like Dr. Reed, who can't sit still for 30 minutes, yeah, exactly. You see, you can have the benefits. much quicker, um, it's needleless. So it does have that advantage to patients that actually maybe you do have a true phobia and it's anxiety, you know, provoking for you to even see needles. Like I said, from my experience, it doesn't hurt, but there are people that are like, I could never do acupuncture because there's needles. So it really allows you to have those benefits without being inserted with needles. Um, it's a lot more mobile, right? So you can, we can have it here at our clinic. We don't have to make you drive across town to a different center to have it done. So it makes it a lot more accessible to patients and we can really. Possibly integrate it into the routine that we already have for them. Well, it sounds really awesome when you're telling me about it. I definitely wanted to know more And one thing that of course was really important to me as I know is important to you is If we purchase this Very expensive piece of equipment, by the way. I'm telling you, Dr. Faye has expensive taste. But if, but if we were to purchase this expensive piece of equipment, what, what is the benefit to our patients? Will it increase their chances of getting pregnant when, when we do an embryo transfer? And so of course I went ahead and researched this and did a literature review and There's only about three studies that I could find, but I did think it was really interesting, and so I thought we could kind of talk through, um, each one of the studies. Um, the first study that I saw was on patients who did an embryo transfer, and I think they did the protocol you're used to, right? Where they did it before and after the transfer? Is that right? Yes. So, like, all on the same day? Yes. Twice. Exactly. Yep. You lay there, you get ready for your transfer, they administer it, then you have your transfer, you lay there afterwards and they administer it. Okay, great. And the study did actually show a higher pregnancy rate when compared to the other treatment groups. And I was pretty impressed by the study too, because they compared it to traditional acupuncture. And they compared it to a group that did no treatment at all. And then they even did a laser sham group, which I really thought was great. Because that was essentially making the doctor and the patient think they got the laser, but then they, you don't really know if they got it or not until it was unblinded for the study results. And the laser acupuncture group did have, I actually agree with that control of the sham acupuncture, the laser acupuncture because that's actually my concerns and my beef with a lot of the traditional acupuncture studies because I think it's. Very difficult to have a true randomized controlled trial for acupuncture because you know if you're getting acupuncture It's very hard to do a sham, especially if anyone has ever experienced acupuncture You're gonna know that you're not really getting it but laser, right? It doesn't hurt You can definitely do a sham. And so I do yeah, that was a nice control and very encouraging. Yeah Yeah, so I thought that was really interesting And I will say to you, I mean, I think that's what we know from studies on anything that, you know, oftentimes they use a placebo. So if it's a pill you're taking, Half the people may take the pill with the active ingredient. The other half may take just a sugar pill. And then you look to see, um, you look to compare the results. And what we know is even when people take a sugar pill, they oftentimes will have better results because the power of the mind is amazing, really. If you believe it's going to work, you actually do have higher chances of it, of it working. So, I mean, I think that's an important component to address and I love that they included that. That was a very thorough study. So, um, so they have higher pregnancy rates. So I felt like that was really encouraging, but then importantly, whenever we look at a treatment study, we need to look at the live birth rates and the live birth rates were really pretty similar all along the way. But I was saying sometimes you see that when there's just not enough people in the study to really discern that. So I don't know. I was kind of thinking, is it just that it was too small of a study to really be powerful enough to see the difference? Or is there truly just not much of a difference? Do you have any thoughts on that? Yeah. I feel like a lot of the studies out there, this is a really common finding in fertility studies. studies, right? Just so let you guys know this. Whenever we're talking about data, many, many studies will observe a difference in pregnancy rates, but then ultimately not like birth rates. And so we have, we see this diminishing effect and that's one of the questions. Do we need a larger sample size? Do we need to be studying more patients? Um, and, or, you know, what's considered clinically significant. A lot of times we're looking for really big differences between the two groups. So, um, yes, um, I agree. I think that having increased pregnancy rates are encouraging, right? You have a chance. You're in the game. You have a pregnancy. So, um, you know, and then you have to look at loss rates after that really. Um, but I am very encouraged by the data. Yeah. Yeah. And then, but the next thing I looked at is I said, okay, well it helps, but how much does it help? So I was trying to compare, for example, the laser acupuncture to the no treatment group. And I really only saw about a three percent difference, um, in that study. And they said it was just statistically significant. So great, it passed the stats. But really I had to ask myself, is that clinically significant? Is a three percent difference enough to ask a patient to do additional treatment, to essentially, Hey, you know, more for laser acupuncture. And for that, I was kind of like, I don't know if I would sign it up and sign up for it if it were me, but I honestly think we could always. Leave it up to the patient and, and see, there may be other people who say, if it's one print higher, I want to do it, you know, it's a very personal thing, right? Yeah, and I think it depends on the patient and who you're counseling. You know, I've been on the other side of things as a desperate fertility patient myself, right? And I do think that for some people, if you tell them, hey, this can, if this is the chance between it being, you know, 60 percent or 63%. You know, I, I think that that can be meaningful to the patient. So it just, it really depends on who you're talking to. Yeah. So after I got done with that study, I was kind of like, well, I don't, I don't know if I'm sold on it. But then I saw a couple of other studies that I thought were interesting. So one was on patients who were going through the IVF process. So the first one was just looking at people who did their embryo transfer. Okay. This next one looked at patients who did IVF and they did know and notice that for patients doing it throughout their IVF cycle, they had much lower stress levels, um, from the acupuncture and that seemed very significant. And so I did really like seeing that aspect of it, even if it doesn't change very much, the overall pregnancy rate, if you're changing the patient's overall experience and just helping them feel more at peace and more calm and, and, And really just safer, um, then I think that is definitely something that is impactful. Yeah, and I think that that can't be underestimated in terms of a barrier to treatment. Yes. I often have patients that see me and they say, I'm here for fertility treatment, but I can never do IVF. I mean, they sit down across from me at the desk and I'm like, well, why do you feel that way? Well, you know, my sister went through IVF, my best friend went through IVF. I saw what she went through and I just, I know I could never do that. Right. So there's this huge barrier to care for some patients where they just feel like the stress level that would be on them going through IVF too much to bear. So anything that we can really do to lower that, I think ultimately increases success rates, right? We know IVF often has the highest success rate of any treatment we can offer. And if we can help you to get through it, yeah, that's, that's pretty encouraging. So yeah, that's a really good point. Um, okay. And so then the third study I saw was very interesting. So it looked at men. low sperm counts and they did a series of laser acupuncture and it increased their sperm counts and increase the motility of the sperm too. And I was really shocked to see this one cause I've heard of this before. I thought that was really interesting. And I know that some of our male patients are so proactive. You know, if they have an abnormal semen analysis, that's a common question we're getting. How can I make it better? How can I, You know, and a lot of times again, we're recommending lifestyle modification and supplements and seeing a urologist and everything. But gosh, it would be really nice to have again, a more natural way of letting them potentially make some improvement. Yeah, this was news to me. I haven't seen this study, um, cause I just haven't looked for that treatment facet really. And yes, I agree. I have a lot of partners that, you know, they, They feel like they're struggling when they get this information. They want to do everything they possibly can to improve their sperm. And so that it is a nice thing to be able to offer them something else. Yeah, absolutely. So I thought that was great. Now, of course I was trying to process this too, because I'm like, okay, so. Where do you do the laser acupuncture for the guys? I mean, honestly, I was like, dude, do you have to laser the testicles? Like, how's this going to work here? Right. So, but I looked it up in the study. I know they have specified points, just like for acupuncture. If you're treating for certain conditions, they have certain points on the body that you want to do it. So they have the same thing for the guys. So I just don't want to scare any of the guys. If we ever have We will not laser the testicles or anywhere near there. These are points all throughout the body. We might actually have been signing up for that. Um, and then, you know, so I saw those three studies, I didn't really see many other studies, and so I have a lot of questions going on in my mind, like what, you know, could, laser acupuncture helps somebody going through an IUI cycle. You know how we're very into that concept of a spa IUI. Um, we're trying to help our patients feel very relaxed during their, their insemination. Maybe that could be a good option to add on for them. Um, or even just if they're trying naturally, or if they're doing you know, just ovulation, induction, and time of intercourse. Could laser acupuncture help in those cases? And there's just no data there. And so I'm thinking we're trying to decide if we're going to add laser acupuncture to our practice, but if so, maybe we need to do some studies, right? Yeah, I definitely think this is what's missing because this is what I've experienced. experience, you know, throughout my journey is that it's something that I feel like we need to be consistent with. It's an add on maybe throughout your whole treatment cycle because the data, the randomized control trials that look at embryo transfers, it was just two times they got this right before and after, and it made a difference, but how much of a difference could we make if we start from the beginning of a cycle or maybe you try a few cycles in a row, you know, I think it could really have. accumulation of effect. And so, you know, we only have anecdotal stories like myself, but I would love to be able to get some of that data. Right. Um, and it's something that we could potentially research. Yeah. And then also if anything, we could just laser acupuncture each other. I think I can see the laser. I mean, you and I are both major stress balls. Could you imagine how in our new life we might just be relaxed all the time? I'm here for it. So we want to hear from you guys. Um, please give us some feedback. Should we, should we get laser acupuncture? Um, you know, yes or no. Is this something you would be interested in? Do you want it? Do we have the patient demand for it? Or does it seem like, uh, not really interested, or do you guys want us to try to work harder to get actual acupuncture in the clinic? You know, we definitely want to hear from you guys and see what y'all's thoughts are too. And then I guess, should we wrap it up for the week? Yeah. Thanks for listening. Thank you guys, everybody. If you would be so kind to leave us a review on the podcast or for our practice or for our individual physician sites, we would be so appreciative to you guys. And we hope you have a great day.