Male fertility: optimizing reproductive health, treating infertility, & navigating TRT - MD Attia, MD Turek
-
This is part one of a two-part mini-series on fertility & reproductive health, with next week's guest, Dr. Paula Amato, focusing on the female side of the equation. Paul Turek is a world-renowned expert in male fertility & reproductive health, the founder & medical director of the Turek Clinic, & host of the Talk with Turek podcast. In this episode, Paul explores the topic of male fertility, offering a detailed look at the complex & highly coordinated process of conception & the many challenges sperm face on their journey to fertilizing an egg. He shares fascinating insights into how sperm work together to navigate the female reproductive tract, how environmental factors like heat, stress, & toxins impact sperm quality, & what men can do to improve their reproductive health. Paul also dispels common myths about testosterone replacement therapy & its effects on fertility, providing strategies for preserving fertility while on TRT. The episode also highlights cutting-edge advances in reproductive medicine, from genetic testing & sperm sorting to emerging treatments for infertility.
View show notes here: bit.ly/4dJCmSX
:::spoiler summerizer
351 ‒ Male fertility: optimizing reproductive health, treating infertility, & navigating TRT
In this episode, Dr. Peter Attia and his guest discuss male fertility, covering various aspects including the impact of testosterone use, lifestyle factors, the physiology of sperm production, and the effects of age on fertility. They dive into common issues affecting sperm health, such as varicocele, hormonal imbalances, and environmental factors, alongside the importance of proper diagnosis and treatment for infertility. The conversation highlights the significance of sperm health as a marker for overall male health and the evolving understanding of male reproductive health.
Key Points
Importance of sperm health
Sperm count and quality are critical measures of male fertility and overall health. Men's fertility issues are often overlooked, but they can signal health problems that need attention, making sperm health a vital area of focus.
Effects of testosterone therapy on fertility
Exogenous testosterone can suppress natural sperm production, often leading to azoospermia (absence of sperm). Recovery of sperm production can take months after stopping testosterone, with the potential for damage depending on therapy duration and dosage.
Lifestyle factors influencing male fertility
Factors such as diet, exercise, alcohol consumption, smoking, and recreational drugs (especially THC) significantly impact sperm quality. Regular exercise, managing weight, and avoiding harmful substances can help preserve fertility.
Varicocele issues
Varicocele, the enlargement of veins within the scrotum, can lead to decreased sperm production and quality. Surgical repair of varicocele can improve fertility rates in men.
Impact of age on fertility
Paternal age is associated with increased risks of genetic mutations and conditions like autism in offspring. After the age of 40, fertility issues may arise more frequently, necessitating considerations for banking sperm.
The role of hormonal balance
Hormones such as LH, FSH, and testosterone are crucial for healthy sperm production. Imbalances in these hormones can lead to reduced fertility. Clomid and hCG can be used to stimulate natural testosterone and sperm production.
Testing and treatment pathways
A thorough evaluation of male fertility involves semen analysis, hormonal assessments, and a review of medical history. Treatment can range from lifestyle modifications to medications and surgical interventions.
Epigenetic factors
Epigenetics, influenced by lifestyle and environmental factors, play a role in male fertility and can affect genetic expression in both men and their offspring.
:::
-
This is part one of a two-part mini-series on fertility & reproductive health, with next week's guest, Dr. Paula Amato, focusing on the female side of the equation. Paul Turek is a world-renowned expert in male fertility & reproductive health, the founder & medical director of the Turek Clinic, & host of the Talk with Turek podcast. In this episode, Paul explores the topic of male fertility, offering a detailed look at the complex & highly coordinated process of conception & the many challenges sperm face on their journey to fertilizing an egg. He shares fascinating insights into how sperm work together to navigate the female reproductive tract, how environmental factors like heat, stress, & toxins impact sperm quality, & what men can do to improve their reproductive health. Paul also dispels common myths about testosterone replacement therapy & its effects on fertility, providing strategies for preserving fertility while on TRT. The episode also highlights cutting-edge advances in reproductive medicine, from genetic testing & sperm sorting to emerging treatments for infertility.
View show notes here: bit.ly/4dJCmSX
:::spoiler summerizer
351 ‒ Male fertility: optimizing reproductive health, treating infertility, & navigating TRT
In this episode, Dr. Peter Attia and his guest discuss male fertility, covering various aspects including the impact of testosterone use, lifestyle factors, the physiology of sperm production, and the effects of age on fertility. They dive into common issues affecting sperm health, such as varicocele, hormonal imbalances, and environmental factors, alongside the importance of proper diagnosis and treatment for infertility. The conversation highlights the significance of sperm health as a marker for overall male health and the evolving understanding of male reproductive health.
Key Points
Importance of sperm health
Sperm count and quality are critical measures of male fertility and overall health. Men's fertility issues are often overlooked, but they can signal health problems that need attention, making sperm health a vital area of focus.
Effects of testosterone therapy on fertility
Exogenous testosterone can suppress natural sperm production, often leading to azoospermia (absence of sperm). Recovery of sperm production can take months after stopping testosterone, with the potential for damage depending on therapy duration and dosage.
Lifestyle factors influencing male fertility
Factors such as diet, exercise, alcohol consumption, smoking, and recreational drugs (especially THC) significantly impact sperm quality. Regular exercise, managing weight, and avoiding harmful substances can help preserve fertility.
Varicocele issues
Varicocele, the enlargement of veins within the scrotum, can lead to decreased sperm production and quality. Surgical repair of varicocele can improve fertility rates in men.
Impact of age on fertility
Paternal age is associated with increased risks of genetic mutations and conditions like autism in offspring. After the age of 40, fertility issues may arise more frequently, necessitating considerations for banking sperm.
The role of hormonal balance
Hormones such as LH, FSH, and testosterone are crucial for healthy sperm production. Imbalances in these hormones can lead to reduced fertility. Clomid and hCG can be used to stimulate natural testosterone and sperm production.
Testing and treatment pathways
A thorough evaluation of male fertility involves semen analysis, hormonal assessments, and a review of medical history. Treatment can range from lifestyle modifications to medications and surgical interventions.
Epigenetic factors
Epigenetics, influenced by lifestyle and environmental factors, play a role in male fertility and can affect genetic expression in both men and their offspring.
:::
Sperm has a sense of smell
74 days to make a sperm from "tip to tail" and see it in the ejaculate
TRT is really bad for fertility.
Only 5% of sperm is morphologically perfect, 95% is "abnormal" in a normal sample. Like pinhead, double tail, etc... but in marine life its 99% perfect. It is interesting, perhaps there is some biological advantage to a combined arms approach to fertility.
Every generation of humans have 50 mutations. Fluid evolution is, sperm driven, trans-generational. Sperm matter a lot more then we give them credit for.
1:03:00 Estradiol, via obesity, "you could say you need to lose 100lbs, which is the key secret for everything", but you could also give aromatase inhibitors, that weight lifters use, to keep their levels down.