Male fertility: optimizing reproductive health, treating infertility, & navigating TRT

madman

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1:13:54-Testosterone replacement therapy (TRT) & male fertility
1:35:50-Restoring fertility after prolonged use of exogenous testosterone






This is part one of a two-part mini-series on fertility & reproductive health, with next week's guest, Dr. Paula Amato, focusing on the female side of the equation. Paul Turek is a world-renowned expert in male fertility & reproductive health, the founder & medical director of the Turek Clinic, & host of the Talk with Turek podcast. In this episode, Paul explores the topic of male fertility, offering a detailed look at the complex & highly coordinated process of conception & the many challenges sperm face on their journey to fertilizing an egg. He shares fascinating insights into how sperm work together to navigate the female reproductive tract, how environmental factors like heat, stress, & toxins impact sperm quality, & what men can do to improve their reproductive health. Paul also dispels common myths about testosterone replacement therapy & its effects on fertility, providing strategies for preserving fertility while on TRT. The episode also highlights cutting-edge advances in reproductive medicine, from genetic testing & sperm sorting to emerging treatments for infertility.




Chapters


0:00:00-Intro
0:01:12-The complex & hostile journey sperm must take to fertilize an egg
0:08:15-How sperm are made & the continuous renewal influenced by environmental factors
0:14:53-The built-in filter that weeds out genetically abnormal sperm
0:18:57-How sperm are finalized in form & function
0:28:33-How to optimize conception through the timing of sex, ejaculation frequency, & understanding the sperm lifecycle
0:37:03-Male infertility & Paul’s diagnostic approach: detailed history, a physical exam, & identifying red flags
0:44:43-Viral infections that can affect the testes & potentially lead to sterility
0:50:50-Semen analysis: morphology, motility, & hormonal clues to male fertility
1:03:53-Effects of medication, microplastics, stress, & exercise on fertility
1:13:54-Testosterone replacement therapy (TRT) & male fertility
1:35:50-Restoring fertility after prolonged use of exogenous testosterone

1:48:24-Effects of heat & cold exposure on fertility
1:55:05-How different levels of exercise—especially cycling—affect male fertility
2:00:00-How alcohol, marijuana, & nicotine affect male fertility
2:04:31-Why type 2 diabetes is a risk factor for male infertility
2:05:54-How varicoceles—a common cause of male infertility—are diagnosed & treated
2:09:10-Genetic factors that affect fertility
2:12:08-The impact of lifestyle & environmental exposures on fertility
2:16:44-The evidence (or lack thereof) behind stem cell & PRP therapies for male infertility, & how lifestyle & non-invasive interventions often lead to successful conception
2:22:14-Considerations for sperm banking, & how paternal age impacts fertility & offspring health
2:33:35-Semen quality as a biomarker
 
 

hCG Mixing Calculator

HCG Mixing Protocol Calculator

TRT Hormone Predictor Widget

TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

ℹ️ Input Parameters

Normal range: 300-1000 ng/dL

Predicted Hormone Levels

Enter your total testosterone value to see predictions

Results will appear here after calculation

Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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