Dr. Peter Attia
speaker
5,258 appearances
36 recordings
6 series
first heard Jan 2024
last heard Jun 2025
Dr. Peter Attia’s voice in public audio — every appearance, attributed to the second.
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It's kind of a picture. And then we've kind of talked about sleep and stress, obviously metabolic health in general. What are some of the other modifiable things that you see? The most common is a varicocele. Okay. Tell people what a varicocele is.
But sorry, there are no valves in that vein? Correct. So what's the head it has to climb? That's got to be this. 30 centimeters. So how is it doing that without a valve? I don't know. That's a pretty big distance to travel without a valve. They do it at night. I don't know. Yeah. Interesting. Okay.
Oh, it is? Okay. Yeah.
That's the most common thing.
So they're non-modifiable now? Right. Okay, so you talked about a few of those already. What are some other ones on the genetic side?
No phenotype.
Yeah. No phenotype. Normal. A Y chromosome deletion male?
I'm sorry. I thought you meant a complete deletion of the Y-chromosome. Yeah, yeah, yeah.
Partial.
And until they try to conceive, they would never know this. Right. Everything else is normal. Right. So then there's environmental lifestyle things. So I think obesity is a big one. And do you think that that's mostly propagated through the endocrine system then?
And what if, for example, a guy has prostatitis and the prostatic fluid has pus in it, then that could sabotage the whole thing. Right.
Have you done work with intratesticular PRP in stem cells? Just stem cells, but not PRP.
Yeah, I've had a very similar experience with a few of my friends and patients who have wanted me to talk with some of their stem cell docs. You're pretty evidence-based, Peter. Well, yeah. And so I accept the fact that they're not going to have remarkable peer-reviewed data, but it is amazing at how few individuals can provide even one cell layer of scientific reasoning. Yeah.
It's a topic I'd like to explore more deeply on the podcast. My guess is there are some indications for where it makes sense. I think I agree with that. But boy, I'd like to figure it out without people wasting so much money. There's a there there, but it's just not that easy. Yeah. Let's just say for every hundred guys that walk in your office who are struggling with infertility,
what percentage of them will be able to conceive, assuming they are able to fully comply with the prescriptions that you provide, be it lifestyle or pharmaceutical, for example, hormone modulation, et cetera, without requiring, and let's exclude the 40% varicocele because you're going to fix those guys and they're fine. So a hundred people who don't have a varicocele
who don't have a genetic condition. I'm going to really simplify this. Okay. So these are a hundred guys that presumably have showed up with some iatrogenic reason for infertility. How many of those guys are going to be able to conceive without resorting to IVF? I would say that's the goal of my practice.
Okay. What advice do you give a guy who comes in your practice? Maybe you don't see a lot of these guys, but let's say you get a guy who comes in and says, hey, look, I want to bank my sperm. I want to freeze my sperm. Now, presumably you'll get a lot of that if a guy's undergoing therapy for cancer or something like that. Is there anything a guy needs to know?
And would you recommend a guy do that if he's 40, doesn't have a partner, but says, look, I want to have kids. And isn't there something to the idea that my sperm are better today than they will be in a decade? It's a huge issue. Paternal age.
So you would advise any male that hasn't reproduced and who might want to, who's undergoing any chemotherapy for any cancer, just play it safe, bank. For cancer, yes.
Yeah, but they're shifted 20 years earlier or something like that.
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