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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.

There's a whole issue of what's the source of human evolution. It's really sperm. Yeah. Because they're constantly dividing. They're constantly influenced by the environment. And they're throwing off mutations and epigenetic changes. And what's most interesting for me for this talk is that whatever happens in sperm happens to offspring.

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

There's a whole issue of what's the source of human evolution. It's really sperm. Yeah. Because they're constantly dividing. They're constantly influenced by the environment. And they're throwing off mutations and epigenetic changes. And what's most interesting for me for this talk is that whatever happens in sperm happens to offspring.

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

That spermatogonial stem cell is actually the first and the bottom of a tube. There's 12 stages of spermatogenesis. That cell is remarkable. It's actually the human male embryonic stem cell. So I have a patent on that cell. Because if you take that cell and you put it in a niche environment like an embryonic stem cell, it'll become embryonic almost like it can become multipotent. It's pluripotent?

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

That spermatogonial stem cell is actually the first and the bottom of a tube. There's 12 stages of spermatogenesis. That cell is remarkable. It's actually the human male embryonic stem cell. So I have a patent on that cell. Because if you take that cell and you put it in a niche environment like an embryonic stem cell, it'll become embryonic almost like it can become multipotent. It's pluripotent?

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

Multipotent. We don't know about pluripotent, but you can form tumors and you can form bone, mesoderm, ectoderm, and endoderm. You can do all three layers of the body. with that adult spermatogonial stem cell.

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

Multipotent. We don't know about pluripotent, but you can form tumors and you can form bone, mesoderm, ectoderm, and endoderm. You can do all three layers of the body. with that adult spermatogonial stem cell.

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

No. I mean, there are stem cells in the bone marrow. There might be stem cells in fat, but none of this, we showed the capability of the cell is magnificent. I think it's the source. Women have eggs and embryonic stem cells. That's the male embryonic stem cell, in my opinion. It hasn't been taken advantage of yet with cell-based therapy, but it is really incredible what this cell can do.

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

No. I mean, there are stem cells in the bone marrow. There might be stem cells in fat, but none of this, we showed the capability of the cell is magnificent. I think it's the source. Women have eggs and embryonic stem cells. That's the male embryonic stem cell, in my opinion. It hasn't been taken advantage of yet with cell-based therapy, but it is really incredible what this cell can do.

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

So that starts out and it usually reproduces mitotically. And then in puberty, it'll go down the path of meiosis, which is a couple steps more than meiosis. There's mitosis involved with meiosis, but it's the having and the mixing up of the chromosomes and the newness of the genome introduces mutations and stuff. And most mutations are bad and some are good. You don't really think about that.

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

So that starts out and it usually reproduces mitotically. And then in puberty, it'll go down the path of meiosis, which is a couple steps more than meiosis. There's mitosis involved with meiosis, but it's the having and the mixing up of the chromosomes and the newness of the genome introduces mutations and stuff. And most mutations are bad and some are good. You don't really think about that.

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

But we could have a long talk about genetics versus epigenetics.

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

But we could have a long talk about genetics versus epigenetics.

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

So if you look at healthy human sperm for chromosomal content and what's correct and what's incorrect, probably 2% of them are off. They're still being made. They're just off because it doesn't really click the system to negate it. We don't know at what level of chromosomal abnormalities the system will say this is not. This is absolutely defective. Yeah.

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

So if you look at healthy human sperm for chromosomal content and what's correct and what's incorrect, probably 2% of them are off. They're still being made. They're just off because it doesn't really click the system to negate it. We don't know at what level of chromosomal abnormalities the system will say this is not. This is absolutely defective. Yeah.

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

But I would say if you look at making of sperm, it's very logarithmic. You're probably looking at one out of four that are being made go through the epididymis, which is the next 10 days, which is a collecting duck after the testicle where it matures, gets epigenetically modified, and you'll see these zones, different epididymosomes and things like that happening.

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

But I would say if you look at making of sperm, it's very logarithmic. You're probably looking at one out of four that are being made go through the epididymis, which is the next 10 days, which is a collecting duck after the testicle where it matures, gets epigenetically modified, and you'll see these zones, different epididymosomes and things like that happening.

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

And there's a lot of post-production modification, not of DNA essentially, but I think there's a filter going on where a lot of the bad aneuploidy comes out because If you look at the chromosome abnormality rate in testicular sperm before it goes through the rest of the system and compared to ejaculate, it's higher. It's two to three-fold higher.

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

And there's a lot of post-production modification, not of DNA essentially, but I think there's a filter going on where a lot of the bad aneuploidy comes out because If you look at the chromosome abnormality rate in testicular sperm before it goes through the rest of the system and compared to ejaculate, it's higher. It's two to three-fold higher.

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

There are some markers of paternal and maternal origin. It depends on where you're going back in mitosis and meiosis. So they can sort of ascribe it in the embryo. In the sperm, you're really going to have to look at the sperm. And if you see a translocation, some characteristic change in sperm, and you see it in the embryo, then you know it's paternal. But not usually.

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

There are some markers of paternal and maternal origin. It depends on where you're going back in mitosis and meiosis. So they can sort of ascribe it in the embryo. In the sperm, you're really going to have to look at the sperm. And if you see a translocation, some characteristic change in sperm, and you see it in the embryo, then you know it's paternal. But not usually.