ConceiveOnline.com: What's the number-one misconception you hear in your office from men and couples that come to see you who want to get pregnant?
Dr. Turek: One misconception is that infertility is the woman's fault; if a couple is infertile, both partners need an evaluation, not just the woman. But a bigger misconception is that the semen analysis is a good indicator of a man’s fertility. A man’s fertility evaluation is not just a semen analysis; the semen analysis is a very good biomarker of health but doesn't predict fertility, unless the level is zero. More important, men need a good history and physical examination by a specialist.
ConceiveOnline.com: Your bio says you're a "founder of the male fertility and male sexual healthcare movement." What do you see as the successes of that movement? What still remains to be done to help men?
Dr. Paul Turek: You may ask why there is even a need for such a “movement.” Well, reproductive-age men are one of the largest medically underserved populations in the U.S. This is true for a variety of reasons, including the fact that we exist in a culture where men are taught not to complain, to work hard, and to shut up. There's also a lack of monthly biology in men, so there are no obvious biomarkers for them to use to judge their health [the way women use their menstrual cycle]. Also, most lethal diseases begin silently, such as high cholesterol and high blood pressure. Finally, healthcare for men is divided up among several kinds of doctors; no physician "owns" a man's health care like a gynecologist owns a woman's. Thus, relative to young women, young men are relatively ignored in a medical sense.
But we have made some headway. What I've been trying to do is to nurture the idea of promoting men’s health specialists. Let’s provide a medical "home" to young men; that's certainly how my practice is trending. In a strange way, I view myself as a pediatrician for men. If you're a young man and you come to my office, the entire experience is geared to making you feel comfortable and getting you to relax so you open up (like a book) and talk about the issues in your life. I also try to maximize the medical opportunity of each visit for both parties. For example, if a man seeks fertility care, I treat much more than that with the belief that one has to to take advantage of each and every visit to do everything you can to help men.
ConceiveOnline.com: There are more male fertility kits showing up on drugstore shelves lately -- worth the money or a waste of money?
Dr. Turek: I wrote a blog post about this recently. This came up years ago with a European brand that I helped introduce in the U.S., but the product flopped. More recently, other products are now being marketed in the U.S. One issue with these kits is that the semen analysis is not a great measure of fertility. If a home fertility kit tests normal, that can be false hope for the couple. There may still be a problem that the kit cannot detect and that problem might be ignored because the semen analysis looks OK. So one downside of using such kits is that a couple that needs further evaluation postpones it.
The upside is that more people may get testing when they might not have otherwise had any testing. Since a low sperm count can indicate a medical problem, like testis cancer, home testing could help us diagnose serious underlying medical conditions earlier. My overall feeling is that there's more benefit than risk with at-home male fertility kits for the simple reason most infertile men in the U.S. don't get the medical care that they deserve. In my view, if it brings more people into the fold of medical care, then it's a good thing.
ConceiveOnline.com: What's the one piece of information or advice you wish more men who are TTC understood?
Dr. Turek: I think of sperm production as an engine that wants to run as hard as possible at top speed. Sperm production and fertility really do want to happen. Unfortunately, men can do things to hurt production, like smoke, do drugs, take hot tubs, eat poorly and push their bodies to the limit. If you want to conceive, take great of yourself and treat your body like a temple.
