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

That got me a little angry. So I did a study with USC and I took these men that I cleared and I called them up a year later. And I said, what happened last year after Turek cleared you? How did a resident do this? And the answer was 65% had conceived naturally. Another 15 to 20% conceived with IUI or IVF. These women were 35 years old, year and a half infertility.

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

That got me a little angry. So I did a study with USC and I took these men that I cleared and I called them up a year later. And I said, what happened last year after Turek cleared you? How did a resident do this? And the answer was 65% had conceived naturally. Another 15 to 20% conceived with IUI or IVF. These women were 35 years old, year and a half infertility.

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

They weren't going to wait around. Most conceptions occurred within six months. I didn't do anything for them. I didn't fix their varicoceles. I didn't touch them any medication. I just said, you're fine. So I published it as a lifestyle study. Not that I was right. And the idea was they probably made changes. They probably took a nutritional supplement. They probably timed their sex better.

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

They weren't going to wait around. Most conceptions occurred within six months. I didn't do anything for them. I didn't fix their varicoceles. I didn't touch them any medication. I just said, you're fine. So I published it as a lifestyle study. Not that I was right. And the idea was they probably made changes. They probably took a nutritional supplement. They probably timed their sex better.

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

They probably got out of hot tubs and all that stuff. And they were taking pills. I have a list of what they did. I had a table in that paper that said that 65% natural pregnancy rate, that is higher than anything I can offer as a treatment that we have published on. So if you fix their varicose seal, you rarely get a 65% natural conception rate.

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

They probably got out of hot tubs and all that stuff. And they were taking pills. I have a list of what they did. I had a table in that paper that said that 65% natural pregnancy rate, that is higher than anything I can offer as a treatment that we have published on. So if you fix their varicose seal, you rarely get a 65% natural conception rate.

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

So I had a table of all the published conception rates for the technologies that work, and I'm saying this is even better. So if that addresses your question, that's the only data I have.

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

So I had a table of all the published conception rates for the technologies that work, and I'm saying this is even better. So if that addresses your question, that's the only data I have.

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

paternal age and fertility, paternal age. So we can go there, but I don't place value judgments. I say, good idea. A disclosure, I'm on a board of legacy. I love their mission driven. I like the fact they're going for military and exposed patients and this and that and VA. I'm for that. I think it's the lowest hanging fruit in the field, obviously for cancer survivors and things.

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

paternal age and fertility, paternal age. So we can go there, but I don't place value judgments. I say, good idea. A disclosure, I'm on a board of legacy. I love their mission driven. I like the fact they're going for military and exposed patients and this and that and VA. I'm for that. I think it's the lowest hanging fruit in the field, obviously for cancer survivors and 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 don't care what you think might happen with your cancer. I would still bank it. I started a nonprofit called Banking on the Future. 16 year olds to 21 year olds with cancer. We'll do it for you. We'll pay for it for five years. Just give us a sample because it's so much harder afterwards or not.

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

I don't care what you think might happen with your cancer. I would still bank it. I started a nonprofit called Banking on the Future. 16 year olds to 21 year olds with cancer. We'll do it for you. We'll pay for it for five years. Just give us a sample because it's so much harder afterwards or not.

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

Now, should anyone do it for any reason? Probably not. But again, I don't pass the judgment. If they're worried about something, then they should. What paternal age do you worry about? And you look at national guidelines for sperm donation, 40 is considered older paternal age, 50 for sure.

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

Now, should anyone do it for any reason? Probably not. But again, I don't pass the judgment. If they're worried about something, then they should. What paternal age do you worry about? And you look at national guidelines for sperm donation, 40 is considered older paternal age, 50 for sure.

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

If you look at risks to offspring, miscarriages, stillborns, autism, birth defects, things immediately related to conception, prematurity, Those go up with paternal age. Then you look at birth defects. When they're born, those go up one to twofold. And then the worrisome ones are the single gene defects and the epigenetics like psychiatric morbidity.

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

If you look at risks to offspring, miscarriages, stillborns, autism, birth defects, things immediately related to conception, prematurity, Those go up with paternal age. Then you look at birth defects. When they're born, those go up one to twofold. And then the worrisome ones are the single gene defects and the epigenetics like psychiatric morbidity.

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

So the autism, schizophrenia, dyslexia, bipolar disorder, potentially Alzheimer's in offspring. And they're not detectable young. So big issues. I've written a lot about that, published on it. I was actually having my second child at 50 when I was writing this thing. Should I be doing this? Writing a paper on all these risks and with Alan Dechenko from University of Pittsburgh.

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

So the autism, schizophrenia, dyslexia, bipolar disorder, potentially Alzheimer's in offspring. And they're not detectable young. So big issues. I've written a lot about that, published on it. I was actually having my second child at 50 when I was writing this thing. Should I be doing this? Writing a paper on all these risks and with Alan Dechenko from University of Pittsburgh.

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 think it's a hockey stick curve for risk to offspring. And you think the inflection is 40 or 50? I think it's more like 60. I think there's a slow linear increase in risk to offspring from 25 to 50 or 60. And then there's an inflection and then there's the blade of the stick. And I think that's logarithmic. Same curve as women with chromosomal.

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 think it's a hockey stick curve for risk to offspring. And you think the inflection is 40 or 50? I think it's more like 60. I think there's a slow linear increase in risk to offspring from 25 to 50 or 60. And then there's an inflection and then there's the blade of the stick. And I think that's logarithmic. Same curve as women with chromosomal.