Paul Turek
speaker
358 appearances
1 recordings
1 series
first heard Jun 2025
last heard Jun 2025
Paul Turek’s voice in public audio — every appearance, attributed to the second.
Trend
recordings per month · last 12 monthsNo recordings in the last 12 months.Older appearances are listed below; set an alert to hear about the next one.
Appearances
Two-thirds will improve, one-third or more will conceive naturally. So you could take guys with low sperm counts and you can fix them or not, but the driver's genetics. And the phenotype in offspring is simply inherited as a Y chromosome deletion. It'll either be, I just had a couple from Texas, actually. He had a Y chromosome deletion. He conceived with help of technology with a low sperm count.
Sons have it. They have no sperm. So you can inherit the deletion, but it might increase. So you're going to get what your dad had, or it might be worse because mutations tend to get larger.
Yeah, that's a big one. in terms of the percent of sperm with the lifestyle issues. And then lousy diet is probably something that, so obesity and diet, lifestyle, recreational drugs. What else do I review with them? Toxic exposures at work. So any smelly solvents, I'm really worried. Some airport fuels, airline stuff, machine shop oils, anything benzene derivatives.
Used to be pesticides and stuff like that, but they're pretty well controlled. So environmental exposures are kind of an unknown. I think viruses have a role. That's how you recently wrote about HPV. And I've been thinking about that for years because there are men, it used to be half the men who came in when I entered the field 30 years ago, we didn't know what was going on with them.
But now it's probably 10 or 20% with lifestyle issues and stuff like that. You can pretty much sort it out. It's not that unknown. But there are men who are like, what is going on here? He's a perfectly healthy guy. Practicing in California is incredible because everyone's so healthy, you have to look elsewhere. You have to ask other questions.
And when there's obesity, it's always the elephant in the room, but everyone is so healthy in eating. So I get to poke around places where no one else goes because I have to explain it and there's nowhere to go. But I did a study. So HPV is the most common. You wrote about that. Is that What's the link? It's hard to know. There's herpes, very common.
The STDs that we know about, like the 11 common beasts, chlamydia and gonorrhea and syphilis, those we know a little more about, and they're pretty obvious. But some of these trichomonas and stuff are pretty subtle. really concerned about this because one guy 20 years ago, and now it's a professor at UCSF, he sent me a picture of electron photograph of a sperm with a hexagonal herpes virus in it.
And I don't even know if it was Photoshop, but there's this virus in a sperm. I'm like, yeah, it looks like there's a virus in that sperm. You think that's what's causing it? I said, I don't know. I don't know. But normally when you see infections as a cause, viral or bacterial, as a cause of semen analysis, you'll see pus cells.
So you'll see what's called pyospermia, leukocytospermia, the round cells we talked about. And the semen analysis will show up in higher numbers. They tend to be destructive and they tend to lower motility. So you tend to see a certain look to the semen analysis, volume, normal count. Motility is really low.
A lot of the sperm are dead because they've been wiped out by these cytokines and all the white cells. And then maybe you'll find the pathogen somewhere. But culturing, mycoplasma, CMV, all these viruses. So Joe DeRisi, really bright guy, UCSF, went to MacArthur Ward. He took my patient's semen. This was back when microwaves were popular in the 2000s.
And he had like 2,000 all mammalian viruses on his chip. Everything. And we ran fertile guys and we ran infertile guys and looked at semen, not sperm. And 99% of the infertiles were positive for something and 98% of the normals were positive for something. So ubiquitous was the word. And so it left us high and dry because you can't really do much with that. So it's out there.
But I do agree with your assessment that the pathologic phenotypes, the worst ones, are probably doing something. The question is, how do we measure it? What do we look for? And with semen analysis, as I said earlier, it's a blunt instrument. It varies a lot. It's tough to do it, but I'd love whether we do genotyping on recent sperm, probably not. I don't know.
And when you look at HPV, it's probably one of those things that might be in the ejaculate after ejaculation. might be coming from another fluid source and not in the sperm itself. So its effect would be post-ejaculation, which could still have a fertility effect, but it won't be probably as deep.
I mean, the problem with the male system is it's all through the same tube. So urine comes through that tube and semen comes through that tube. So you have to look for infections in the urinary tract and anything like that when you're doing fertility because pus cells kill whatever they see. So if your urine's infected, that's a big deal.
Not a big fan. As a trained stem cell biologist and someone trying to make sperm from skin and working with some of the best stem cell scientists in the world, I have a lot of respect for them, but it's not that simple. There's 560 offshore stem cell companies in the world that will take your money and do things like stick PRP in there. They'll stick bone marrow aspirates fat in your testicle.
And I'd say my experience has not been favorable. Some of the toughest cases in the world and they come to me after that and I do my techniques and I don't find anything and the trials aren't really real. come here, we're going to do this, and then we're going to do a microdissection on your testicle, but they didn't have one beforehand.
So the chance of finding it even without that is X and they're finding X. So it's just not well done. And I have my patients investigate all that. And I say, you do the work. You tell me who you found. Let me call them. I'll let them be the workers. And then I'll call them and I'll say, hi, I was just wondering about, do you have any papers or what's the science behind it?
And they usually hang up or it's really interesting. But so far I'd say it's unfounded.
And I would say the answer is most. Wow. But the caveat is you got to tell me about the woman because I will defer. This is the only data I can give you. So I did a paper where I saw men for their infertility evaluation, got it done. And I thought they were fine. They had varicoceles and stuff, but their semen analysis was normal. And my investigation of their risk lifestyle, everything was good.
And I said, you're fine. You're cleared. No one's ever said that before. And they went home and they said, Turk couldn't figure out what's wrong with us. I said, that's not what I said. I don't do women. My expertise, I'm saying something positive here. Most people would say, I'm not sure why you're not conceiving. I said, I'm pretty sure you're not the problem. Didn't get interpreted like that.
Showing 301–320 of 358 · page 16 of 18
← Previous
Next →