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Dr. Peter Attia

👤 Person
11178 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.

So in other words, when you identify a man who does not have CF with a congenitally absent vas, there's a very good probability he's a carrier of CF. Yes. And you can usually define it. Which we can genetically test easily.

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

So in other words, when you identify a man who does not have CF with a congenitally absent vas, there's a very good probability he's a carrier of CF. Yes. And you can usually define it. Which we can genetically test easily.

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

Cancers, infections, epididymitis. Yeah. Tell me about epididymitis. Obviously, anything that interferes with that section of the journey is going to be critical. Remind me, is it EBV that we typically, or measles, mumps? What's the infection? Mumps.

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

Cancers, infections, epididymitis. Yeah. Tell me about epididymitis. Obviously, anything that interferes with that section of the journey is going to be critical. Remind me, is it EBV that we typically, or measles, mumps? What's the infection? Mumps.

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 some kind of, there's an open time. So just one more reason why everyone should really get the MMR vaccine when they're a child, notwithstanding the tragedy of children dying from preventable diseases. But this is another non-lethal but significant complication of the mumps. Absolutely.

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 some kind of, there's an open time. So just one more reason why everyone should really get the MMR vaccine when they're a child, notwithstanding the tragedy of children dying from preventable diseases. But this is another non-lethal but significant complication of the mumps. Absolutely.

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

Meaning the patient that survived Ebola, the virus managed to survive in the testes? Somewhere, but it was transmitted sexually a year later when he was well. When he was asymptomatic. He had already developed immunity.

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

Meaning the patient that survived Ebola, the virus managed to survive in the testes? Somewhere, but it was transmitted sexually a year later when he was well. When he was asymptomatic. He had already developed immunity.

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

But in that case, you have to think wherever the virus hung out, it had to be very, very immune privileged. Yep.

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

But in that case, you have to think wherever the virus hung out, it had to be very, very immune privileged. Yep.

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

What is the phenotype of their sterility? Aside from the presentation that says I can't get someone pregnant. So sterility means no sperm in the semen. And typically if you measured the signals to the testicle. Oh, that's literally what it means. I'm sorry. Okay. So literally no sperm in semen. They stopped. Understood. It's a primary problem.

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

What is the phenotype of their sterility? Aside from the presentation that says I can't get someone pregnant. So sterility means no sperm in the semen. And typically if you measured the signals to the testicle. Oh, that's literally what it means. I'm sorry. Okay. So literally no sperm in semen. They stopped. Understood. It's a primary problem.

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

Classically anabolic steroid users. Yeah, which I want to talk about in detail. Can we go back to semen analysis? You're looking for obviously the count and the motility. What else do you look for? So in the semen analysis, there's several features.

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

Classically anabolic steroid users. Yeah, which I want to talk about in detail. Can we go back to semen analysis? You're looking for obviously the count and the motility. What else do you look for? So in the semen analysis, there's several features.

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

obviously you rattled off a whole bunch of parameters that you can access there, but are there certain null states that don't exist where everything is amazing, but this one thing is horrible? Like, do you see scenarios where everything is remarkable, perfect motility, but bad morphology or perfect morphology? Isolated, isolated. You do see isolated things. Right.

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

obviously you rattled off a whole bunch of parameters that you can access there, but are there certain null states that don't exist where everything is amazing, but this one thing is horrible? Like, do you see scenarios where everything is remarkable, perfect motility, but bad morphology or perfect morphology? Isolated, isolated. You do see isolated things. Right.

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

I'm sorry, I'm still confused on that point. Are you saying that you would consider it perfectly normal if only 4% of the sperm are morphologically perfect and 96% are not? And that means the 96% that are not could be pinhead, could be double tail. Amorphous or tapering in it. As a mathematician, that's not a great number, is it? No. If you look at marine species, 99.9 look perfect in the wild.

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

I'm sorry, I'm still confused on that point. Are you saying that you would consider it perfectly normal if only 4% of the sperm are morphologically perfect and 96% are not? And that means the 96% that are not could be pinhead, could be double tail. Amorphous or tapering in it. As a mathematician, that's not a great number, is it? No. If you look at marine species, 99.9 look perfect in the wild.

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

Yeah. And presumably that's because their environment is so much more hostile. They're doing this all in the ocean. I don't know, but it's amazing that we're that good with 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.

Yeah. And presumably that's because their environment is so much more hostile. They're doing this all in the ocean. I don't know, but it's amazing that we're that good with the sperm.