Paul Turek

So when you do anything to a man fertility wise, you're not going to expect to see anything change for at least two and a half months. And when you talk about full replacement of that semen, it's probably in the being 90 days when it's all replaced, the pot is replaced. That's a limitation of what we do. 42-year-old women want now. And we have three to six months.

So when you do anything to a man fertility wise, you're not going to expect to see anything change for at least two and a half months. And when you talk about full replacement of that semen, it's probably in the being 90 days when it's all replaced, the pot is replaced. That's a limitation of what we do. 42-year-old women want now. And we have three to six months.

When I did a study on fixing varicoceles, which is an infertility problem in men at surgery, and I looked at the mean time to conception, it was about seven months after repair, which is two cycles of sperm production.

When I did a study on fixing varicoceles, which is an infertility problem in men at surgery, and I looked at the mean time to conception, it was about seven months after repair, which is two cycles of sperm production.

Okay. Doesn't have to be timed intercourse, just has to be whatever the couple does when they think they're trying to conceive.

Okay. Doesn't have to be timed intercourse, just has to be whatever the couple does when they think they're trying to conceive.

There's a large bias in Western worlds about how infertility is evaluated. The reasons are complex, but I would say my practice is not typical. So most of my patients have been through a lot before they come to me. And typically, I think Keith Jarvie's data was good at about 23% of men get a formal evaluation for infertility before couples go through IVF in North America.

There's a large bias in Western worlds about how infertility is evaluated. The reasons are complex, but I would say my practice is not typical. So most of my patients have been through a lot before they come to me. And typically, I think Keith Jarvie's data was good at about 23% of men get a formal evaluation for infertility before couples go through IVF in North America.

And how does that differ from the rest of the world? I don't think it's been studied in the rest of the world. But there are countries like Germany and Spain with single insurers and government pays. And it's also recommended by society guidelines like American Society of Reproductive Medicine, WHO, et cetera, that both partners get evaluated simultaneously.

And how does that differ from the rest of the world? I don't think it's been studied in the rest of the world. But there are countries like Germany and Spain with single insurers and government pays. And it's also recommended by society guidelines like American Society of Reproductive Medicine, WHO, et cetera, that both partners get evaluated simultaneously.

But the bias is female gets very evaluated for lots of money. And the men typically may get a semen analysis, but may not. And it's very complex reasoning there. It's a different beast. They're not part of the problem. They refuse to do it. There's a lot of denial. It does get at your masculinity a little bit to get checked out and things. So it does go deep.

But the bias is female gets very evaluated for lots of money. And the men typically may get a semen analysis, but may not. And it's very complex reasoning there. It's a different beast. They're not part of the problem. They refuse to do it. There's a lot of denial. It does get at your masculinity a little bit to get checked out and things. So it does go deep.

For men, it can be a little bit of a problem. So I would say that lately with... large insurers coming in, Progeny, Maven, and things like that, you're seeing a lot more men up front, which is fabulous. And we can have long discussions about the biomarker concept, why that's good for the field and good for men's health and good for longevity.

For men, it can be a little bit of a problem. So I would say that lately with... large insurers coming in, Progeny, Maven, and things like that, you're seeing a lot more men up front, which is fabulous. And we can have long discussions about the biomarker concept, why that's good for the field and good for men's health and good for longevity.

Usually they're dragged in by their partners. Usually the partners come along to make sure they show up. For me, it's one visit. So we do one visit and I do everything else where they are, where they are. I don't ask them to come in a million times anymore. So it's a very different kind of practice.

Usually they're dragged in by their partners. Usually the partners come along to make sure they show up. For me, it's one visit. So we do one visit and I do everything else where they are, where they are. I don't ask them to come in a million times anymore. So it's a very different kind of practice.

But I try to get everything done in one visit because when you get them there, it's rare to get them there. And the physical exam, so you do a history, a very thorough history, which is usually preceded by a questionnaire. I give 200 questions and that has all the hot bath stuff and all the exposures they have. And they have to do that before they see me. That's a really important part of it.

But I try to get everything done in one visit because when you get them there, it's rare to get them there. And the physical exam, so you do a history, a very thorough history, which is usually preceded by a questionnaire. I give 200 questions and that has all the hot bath stuff and all the exposures they have. And they have to do that before they see me. That's a really important part of it.

If you could pick one in a multiple choice question, what matters the most is probably the history. History of paternity matters, a history of exposures matters, et cetera. Physical exam, very important. One to 5% of male infertility can be due to a major medical issue, testis cancer, diabetes, things like that. So physical exam, varicoceles, is very important.

If you could pick one in a multiple choice question, what matters the most is probably the history. History of paternity matters, a history of exposures matters, et cetera. Physical exam, very important. One to 5% of male infertility can be due to a major medical issue, testis cancer, diabetes, things like that. So physical exam, varicoceles, is very important.