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.
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They'll never work naturally. And to get them to work with IVF, you have to single sperm inject them into the egg and then shock the egg with calcium, do a calcium or piezoelectrics to get it to actually fertilize. Because the sperm is important with fertilization, not only has to bind, but the calcium channels are regulated by sperm.
And what shuts the doors to polyspermia in an egg is calcium activation.
So morphology can matter a lot, but it's very rare. So I'd say twice a year in my practice, I'll see this Because everything's failing and everything looks normal. And they ask me what's going on. And I'll look at it really closely and say, you have this issue and there's not much we can do to treat it.
Now we're going to try sperm sorting technologies, which are out new in the market, microfluidics and things like that. And I've been throwing that at them. Sometimes it works, sometimes it doesn't.
PLZ's data deficiency is one of them recently discovered that runs the calcium channel, which tends to be associated with a certain look like globals of spermia.
That's one of the 50 we throw off each generation, 50 mutations.
I think what I would like to emphasize in this podcast is how fluid evolution actually is. And it's sperm driven and it's transgenerational. So if you ask me, what's the theme for today? I'd say sperm matter a lot, a lot, a lot more than we've given them credit for.
So I look at, in my poker analogy of the hand, if everything looks good but the motility is low, I think of short-term toxins. Severity. So things like exposures. So medications. I think about habits, pot, smoking, hot baths. I think about behaviors, lifestyle. So I look for an exposure in that individual. Basically picked up on the history. Varicoceles and exposure, things like that.
And if the count's down and the motility's down, I think of a large severe exposure. There's royal flushes and there's four of a kind. My goal when I see that semen analysis and see that patient is to figure out if he's not normal, why?
Either they give it to me or I get one. I want that there because that's when I look at them, I'd like to have that in front of me to say, what kind of poker hand are you playing?
And now it's done with hemocytometers. It's done with machines. Computer-assisted semen analysis does most of them in IVF groups. It's really standardized. Oh, yeah. I like the bespoke suit. So when I have mine repeated, I usually have someone do it by hand because there's observations I like, which is, hey, you know what? 1% morphology, but all the others look like this.
Those comments are incredibly valuable. that you don't really get from a computer-assisted semen analysis. But it's faster, and you don't have a lot of human effort involved with a computer. Are they using AI for this yet? Yeah. I mean, some people are for sperm selection a little bit. But yeah, there's a lot of stuff to help out.
And that will be really helpful for morphology to standardize it, because one man named Kruger in South Africa... correlated bad sperm shape with IVF outcomes and did not find that they were good when the sperm looked bad. That's where the 4% came from. But it's really hard to do that every time and do it well because it's so hard to do.
Hoping AI and machine learning can help standardize the look because sperm is hard.
So to make normal amounts of sperm, you need proper amounts of testosterone and FSH. Think of it as flowering a plant. You need the water and you need the sunlight. So testosterone and FSH are key. To get normal amounts of T, testosterone, you're going to need LH, which drives it. Same in women. These are all named in women. In females. So that signaling is really important.
So there are cases of genetic infertility like Kalman syndrome where men aren't making any sperm, but they're just not sending the signals down and you can just give them the signals with injections.
So HCG, FSH injections, and they will be fertile.
No, it's the olfactory node in the hypothalamus. So they don't smell either.
No. No. Pituitary is not working. Yeah. The GNRH is the essential pituitary. Okay. Got it.
Yeah. So estradiol is sort of a mild poison for male infertility. So everyone needs estradiol level, female hormone levels. Testosterone gets converted to estradiol. So that's a byproduct of it along with DHT. And then estradiol goes back to the brain and is a feedback. So if it's there, the brain knows how much testosterone it's making.
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