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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.

It's just wildly compact, 10 times more compact than any other cell in the body. From a mitochondrial density standpoint? From a cytoplasmic standpoint and nuclear standpoint, it goes from histones, the protamines, the DNA is condensed a lot more because it's got to go on the road.

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 just wildly compact, 10 times more compact than any other cell in the body. From a mitochondrial density standpoint? From a cytoplasmic standpoint and nuclear standpoint, it goes from histones, the protamines, the DNA is condensed a lot more because it's got to go on the road.

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

So it's got to be packaged really well to survive outside the body and be in good shape because it's transgenerational. So a lot of energy in that. And then during the epididymis, which is a collecting duct.

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

So it's got to be packaged really well to survive outside the body and be in good shape because it's transgenerational. So a lot of energy in that. And then during the epididymis, which is a collecting duct.

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's going to bring the physics in. So then there's a two-week period where it stays in the epididymis, which is a 35-foot tubule with estrogen, and there's a lot of post-modification of the sperm.

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's going to bring the physics in. So then there's a two-week period where it stays in the epididymis, which is a 35-foot tubule with estrogen, and there's a lot of post-modification of the sperm.

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

Epididymis has been relatively understudied, but it has actually become very important. Epididymisomes, and there's a lot of modifications we don't really understand. I wrote the chapter for our textbook on reproductive physiology, and it really is a lot of work in the 50s and 60s, but now we're beginning to understand epididymis.

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

Epididymis has been relatively understudied, but it has actually become very important. Epididymisomes, and there's a lot of modifications we don't really understand. I wrote the chapter for our textbook on reproductive physiology, and it really is a lot of work in the 50s and 60s, but now we're beginning to understand epididymis.

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

DNA fragmentation and the quality of sperm is driven by the epididymis. A lot of the quality of sperm, not the shape and stuff like that. Meaning based on its residence time within the epididymis? And what other environmental influences that occur there? Because the epididymis is not as walled off from the body as the testis is. immunologically and otherwise.

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

DNA fragmentation and the quality of sperm is driven by the epididymis. A lot of the quality of sperm, not the shape and stuff like that. Meaning based on its residence time within the epididymis? And what other environmental influences that occur there? Because the epididymis is not as walled off from the body as the testis is. immunologically and otherwise.

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 more susceptible to drugs, exposures, heat, et cetera. Testis is very walled off. Very little happens in the testis because the sertolo cells that line the tubules have a blood-brain barrier, a blood-testis barrier. Same as the brain, it's highly protective. It's as protective? Yes.

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 more susceptible to drugs, exposures, heat, et cetera. Testis is very walled off. Very little happens in the testis because the sertolo cells that line the tubules have a blood-brain barrier, a blood-testis barrier. Same as the brain, it's highly protective. It's as protective? Yes.

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

Harvey Cushing at Yale did that in the late 18th century, took brain-dead patients, injected them with dye, methylene blue, I think, The blood-brain barrier came about when nothing went into the brain and nothing went into the testicle. Two areas of the body that were completely immune from normal transport processes. Wow. Blood-testis barrier.

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

Harvey Cushing at Yale did that in the late 18th century, took brain-dead patients, injected them with dye, methylene blue, I think, The blood-brain barrier came about when nothing went into the brain and nothing went into the testicle. Two areas of the body that were completely immune from normal transport processes. Wow. Blood-testis barrier.

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 two things that we know happen in the epididymis after production of sperm are motility improves. So sperm begin to learn progressive motility. So they start moving forward as opposed to not moving or moving in circles, which is important. And the most curious thing is they learn how to smell.

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 two things that we know happen in the epididymis after production of sperm are motility improves. So sperm begin to learn progressive motility. So they start moving forward as opposed to not moving or moving in circles, which is important. And the most curious thing is they learn how to smell.

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

So they actually detect follicular fluid. So if you take testicular sperm and inseminate it into a uterus with insemination technology, it'll just be killed. If you take an epididymal sperm and you do that from the top of the epididymis, it'll maybe run in circles and it'll be killed by the immune system of the female. It has to go through that whole epididymal cycle.

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

So they actually detect follicular fluid. So if you take testicular sperm and inseminate it into a uterus with insemination technology, it'll just be killed. If you take an epididymal sperm and you do that from the top of the epididymis, it'll maybe run in circles and it'll be killed by the immune system of the female. It has to go through that whole epididymal cycle.

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

Once it's at the end of the epididymis where it's stored. And that's how many weeks? Two, 10 to 14 days. 600 million sperm live in a bucket, a pot of soup to call it epididymis. And you ejaculate from that pot, which tells you a lot about sperm quality because it can get old.

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

Once it's at the end of the epididymis where it's stored. And that's how many weeks? Two, 10 to 14 days. 600 million sperm live in a bucket, a pot of soup to call it epididymis. And you ejaculate from that pot, which tells you a lot about sperm quality because it can get old.