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Paul Turek

👤 Person
716 total appearances

Appearances Over Time

Podcast Appearances

The Peter Attia Drive
#351 ‒ Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D.

So reproduction is an incredibly highly evolved million-year process and remarkably conserved among mammalian species, even among land species and water species of animals. vaginas, cervixes, uteruses. And the question is, why is it so much work for a sperm to get into the vagina, especially in, say, water, and then have to go through a cervix?

The Peter Attia Drive
#351 ‒ Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D.

So reproduction is an incredibly highly evolved million-year process and remarkably conserved among mammalian species, even among land species and water species of animals. vaginas, cervixes, uteruses. And the question is, why is it so much work for a sperm to get into the vagina, especially in, say, water, and then have to go through a cervix?

The Peter Attia Drive
#351 ‒ Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D.

And then the immune system in the uterus is very active because there's a hole in the woman to the peritoneum, to the abdomen. So it has to be highly protected. And then you have to go through the uterus. So there's a 10-inch, 12-inch swim, which is equivalent to about a 20-mile swim for a human. Based on the size of the sperm. And how much distance they have to go.

The Peter Attia Drive
#351 ‒ Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D.

And then the immune system in the uterus is very active because there's a hole in the woman to the peritoneum, to the abdomen. So it has to be highly protected. And then you have to go through the uterus. So there's a 10-inch, 12-inch swim, which is equivalent to about a 20-mile swim for a human. Based on the size of the sperm. And how much distance they have to go.

The Peter Attia Drive
#351 ‒ Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D.

And they do that in minutes, which is crazy. So it's an interesting challenge that nature has kept in place for a million years. And I really respect evolution. And it is why we're here for, you know, eat, sleep, reproduce. So basically, with ejaculation, the penis is shaped to fit into the cervix. Everyone wonders, is it getting to the right spot?

The Peter Attia Drive
#351 ‒ Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D.

And they do that in minutes, which is crazy. So it's an interesting challenge that nature has kept in place for a million years. And I really respect evolution. And it is why we're here for, you know, eat, sleep, reproduce. So basically, with ejaculation, the penis is shaped to fit into the cervix. Everyone wonders, is it getting to the right spot?

The Peter Attia Drive
#351 ‒ Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D.

It's also interesting that the semen is coagulated and then it liquefies. And that's because there's a lot of species of lower phyla. that they have to leave as soon as they have sex, otherwise they'll get killed, like praying mantises and black widow spiders. So you got to get out of there as a guy. So our ejaculates in humans are sticky.

The Peter Attia Drive
#351 ‒ Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D.

It's also interesting that the semen is coagulated and then it liquefies. And that's because there's a lot of species of lower phyla. that they have to leave as soon as they have sex, otherwise they'll get killed, like praying mantises and black widow spiders. So you got to get out of there as a guy. So our ejaculates in humans are sticky.

The Peter Attia Drive
#351 ‒ Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D.

I have no idea, Peter. I have no idea why you would do that. I don't know why one queen bee and the bees in the hive die after mating. I have no idea why that's an advantage. But I guess females are prioritized in evolution. And that makes sense. The anatomy is perfectly defined. So a lot of men think they're having trouble placing things.

The Peter Attia Drive
#351 ‒ Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D.

I have no idea, Peter. I have no idea why you would do that. I don't know why one queen bee and the bees in the hive die after mating. I have no idea why that's an advantage. But I guess females are prioritized in evolution. And that makes sense. The anatomy is perfectly defined. So a lot of men think they're having trouble placing things.

The Peter Attia Drive
#351 ‒ Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D.

I usually don't worry about it because the cervix and the penis expands. It forms a seal. Then there's a crypt. Sperm have to go through a crypt, a channel, which is only a few sperm make it. So 100 million sperm may start out. Maybe 5 million make it through the first barrier, which is the cervical barrier. The vaginal fluid is acidic. How acidic? 5, pH of 5, and the semen is a pH of 7.

The Peter Attia Drive
#351 ‒ Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D.

I usually don't worry about it because the cervix and the penis expands. It forms a seal. Then there's a crypt. Sperm have to go through a crypt, a channel, which is only a few sperm make it. So 100 million sperm may start out. Maybe 5 million make it through the first barrier, which is the cervical barrier. The vaginal fluid is acidic. How acidic? 5, pH of 5, and the semen is a pH of 7.

The Peter Attia Drive
#351 ‒ Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D.

It's all buffered as a hostile environment, so it has to get out of there quickly. As soon as it liquefies, there's sugars in there, and then they go through the cervical path. So 5 million will make it. One out of 20 makes it through the cervix. Then 100 make it to the fallopian tube, and then one will make it to the egg. Literally only 100? Right.

The Peter Attia Drive
#351 ‒ Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D.

It's all buffered as a hostile environment, so it has to get out of there quickly. As soon as it liquefies, there's sugars in there, and then they go through the cervical path. So 5 million will make it. One out of 20 makes it through the cervix. Then 100 make it to the fallopian tube, and then one will make it to the egg. Literally only 100? Right.

The Peter Attia Drive
#351 ‒ Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D.

And this Settlage studies in the 50s had women have sex before hysterectomies. And then he swabbed different parts of the reproductive tract. These are young women for different reasons, not infertility, and found these numbers. And that's the basis for our move to technology from 5 million moving sperm is when we start doing inseminations versus sex, et cetera.

The Peter Attia Drive
#351 ‒ Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D.

And this Settlage studies in the 50s had women have sex before hysterectomies. And then he swabbed different parts of the reproductive tract. These are young women for different reasons, not infertility, and found these numbers. And that's the basis for our move to technology from 5 million moving sperm is when we start doing inseminations versus sex, et cetera.

The Peter Attia Drive
#351 ‒ Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D.

So those are based on numbers of sperm that reach the uterus and reach the thing. What's really interesting is there's some fascinating research. Everyone thought the Vanguard sperm wins, right? So it's the Phelps sperm that's going to make it. And there's a company out of Boston called Eric's Biosciences, and I'm consulting with them, disclosure.

The Peter Attia Drive
#351 ‒ Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D.

So those are based on numbers of sperm that reach the uterus and reach the thing. What's really interesting is there's some fascinating research. Everyone thought the Vanguard sperm wins, right? So it's the Phelps sperm that's going to make it. And there's a company out of Boston called Eric's Biosciences, and I'm consulting with them, disclosure.

The Peter Attia Drive
#351 ‒ Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D.

But they've discovered that sperm work in phalanxes. So because the immune system is so vibrant in the uterus, the first round of sperm gets through the cervix

The Peter Attia Drive
#351 ‒ Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D.

But they've discovered that sperm work in phalanxes. So because the immune system is so vibrant in the uterus, the first round of sperm gets through the cervix

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