Paul Turek

Or at low levels, like low viral loads where there's no disease. I'm not sure. But these are concerning cases. But then it was transmitted at a low viral load, an even lower viral load. Right. So it's tricky. There may be bulbar urethral glands. Maybe it's somatovesical. It's hard to know. But yeah, it's getting away. But most viruses don't go there. So the big one would be COVID.

Or at low levels, like low viral loads where there's no disease. I'm not sure. But these are concerning cases. But then it was transmitted at a low viral load, an even lower viral load. Right. So it's tricky. There may be bulbar urethral glands. Maybe it's somatovesical. It's hard to know. But yeah, it's getting away. But most viruses don't go there. So the big one would be COVID.

What did COVID, there was a big deal about the AC receptor being in the lung and being in the testicle. And maybe COVID infection would make you sterile. There was one Zika paper in Nature that looked at if you infect mice or was it rats with Zika, the testicles shrivel up and they get infertile. And that caused a huge scare in the field. But we really didn't see it.

What did COVID, there was a big deal about the AC receptor being in the lung and being in the testicle. And maybe COVID infection would make you sterile. There was one Zika paper in Nature that looked at if you infect mice or was it rats with Zika, the testicles shrivel up and they get infertile. And that caused a huge scare in the field. But we really didn't see it.

maybe see it and see if we don't see it in fertility. And what is it about the Zika virus that does this? We're not sure. Why did it in rats? It's a blood testis barrier thing. It's an amazing barrier and nothing really gets through, including viruses, but mumps does, only at puberty. And Zika does. Zika doesn't in animals, but we didn't see it in humans.

maybe see it and see if we don't see it in fertility. And what is it about the Zika virus that does this? We're not sure. Why did it in rats? It's a blood testis barrier thing. It's an amazing barrier and nothing really gets through, including viruses, but mumps does, only at puberty. And Zika does. Zika doesn't in animals, but we didn't see it in humans.

But I thought you said that Zika was leading to anencephaly in cases. Yeah, but that could be seminal. That could be just in the semen itself, not in the sperm. Like Ebola is probably seminal, not testicular. It's not on sperm. It's around sperm or in the fluid. That's the conclusion so far. So...

But I thought you said that Zika was leading to anencephaly in cases. Yeah, but that could be seminal. That could be just in the semen itself, not in the sperm. Like Ebola is probably seminal, not testicular. It's not on sperm. It's around sperm or in the fluid. That's the conclusion so far. So...

COVID, the big worry was when this Chinese paper came out, like, oh my God, it's going to the lung, buying to the AC receptor. It's testicle has it too. It's going to make men sterile forever. And there were cases of infertility with bad infections. Was that just the fever, which typically does it even after a flu, or was that COVID specific? And we didn't know.

COVID, the big worry was when this Chinese paper came out, like, oh my God, it's going to the lung, buying to the AC receptor. It's testicle has it too. It's going to make men sterile forever. And there were cases of infertility with bad infections. Was that just the fever, which typically does it even after a flu, or was that COVID specific? And we didn't know.

A couple of colleagues did some papers. One which impressed me was out of Cedars was a bunch of men, maybe not reproductive age, died with florid COVID. So they got autopsies and they looked for virus in different locations in the body. And I think out of 10 men or seven men, one had it in the testicle. So these are the men with the highest viral load you can imagine, and only one of them had it.

A couple of colleagues did some papers. One which impressed me was out of Cedars was a bunch of men, maybe not reproductive age, died with florid COVID. So they got autopsies and they looked for virus in different locations in the body. And I think out of 10 men or seven men, one had it in the testicle. So these are the men with the highest viral load you can imagine, and only one of them had it.

So I believe that there is a risk of it. But I'd say in the thousand men I've seen since COVID, I think there were two cases that I would say were unexplained where men were either fertile or had normal semen quality, had a bad COVID infection, maybe hospitalized, and three months later, sterile. So I think there's a low perfusion rate there.

So I believe that there is a risk of it. But I'd say in the thousand men I've seen since COVID, I think there were two cases that I would say were unexplained where men were either fertile or had normal semen quality, had a bad COVID infection, maybe hospitalized, and three months later, sterile. So I think there's a low perfusion rate there.

So the third thing we do, history, physical semen analysis is a third. Fourth would be hormones. And that's what we check in men too, because production of sperm is driven by the brain. So nothing happens to sperm being made without the brain telling it what to do. Similar with eggs and controlling. It's all a homeostatic mechanism with negative feedback.

So the third thing we do, history, physical semen analysis is a third. Fourth would be hormones. And that's what we check in men too, because production of sperm is driven by the brain. So nothing happens to sperm being made without the brain telling it what to do. Similar with eggs and controlling. It's all a homeostatic mechanism with negative feedback.

I consider it sort of a poker hand. There's a volume, how much of the semen volume. There's a count, concentration of sperm. That's numbers per mil. And then there's motility, which is percent motion. You do a forward progression. So how good is the quality of motion? And typically some measure of shape called morphology. There's three liquid issues, liquefaction, agglutination, and viscosity.

I consider it sort of a poker hand. There's a volume, how much of the semen volume. There's a count, concentration of sperm. That's numbers per mil. And then there's motility, which is percent motion. You do a forward progression. So how good is the quality of motion? And typically some measure of shape called morphology. There's three liquid issues, liquefaction, agglutination, and viscosity.

And then you look for other cells that aren't sperm. They're called round cells. And either they're going to be pus cells or immature germ cells that are ejaculated early. And presumably you want to see fewer of those? There's a number, like less than a million is normal. Okay. So if you ask me, well, how do I look at a semen analysis? That's a little different.

And then you look for other cells that aren't sperm. They're called round cells. And either they're going to be pus cells or immature germ cells that are ejaculated early. And presumably you want to see fewer of those? There's a number, like less than a million is normal. Okay. So if you ask me, well, how do I look at a semen analysis? That's a little different.