Dr. Andrew Sun in Dallas: Understanding Male Fertility and Infertility Solutions

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madman

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* in general it takes 68-72 days to make a new sperm, so 2-3 months

* the sperm are very delicate you have to take care of them, the testosterone generating cells (leydig) in the testicles are fairly resilient, the sperm generating cells (sertoli/germ) are fairly delicate



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Welcome to The New Health, where we bring you insights from leading experts to help revolutionize your approach to wellness. I'm Jessica Preston, and today we delve into a crucial and often overlooked topic: male infertility and how lifestyle factors impact reproductive health.

Joining us is Dr. Andrew Sun, men's health urologist from Urology Partners of North Texas. Dr. Sun shares his expertise on the rise of male infertility, contributing factors, and practical solutions to boost reproductive health.





Key Discussion Points:


* The alarming global decline in sperm counts and its connections to overall health.

* The impact of lifestyle factors like obesity, heat exposure, and smoking on male fertility.

* truth about testosterone: why external testosterone supplements can harm sperm production.

* Post-viral impacts, including those related to COVID-19, on sperm health and erectile function.

* New at-home testing options and how involving men earlier in the infertility journey can support both partners.





Support Resources and Next Steps:

Dr. Sun emphasizes the importance of early testing, healthy lifestyle choices, and open communication between partners. Find out how his approach is changing the landscape of male fertility and improving outcomes for couples.


Want to learn more or need professional guidance? Reach Dr. Sun and the team at Urology Partners of North Texas for expert advice on men’s health and fertility.
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Welcome to the New Health: Navigating Modern Challenges with Industry Leaders

As people are encountering health issues at increasingly younger ages, we are committed to bringing thought leaders in healthcare directly to you. Our aim is to share their revolutionary approaches and impactful changes in the healthcare industry. I'm your host, Jessica Preston. Today, we are rejoined by Dr. Andrew Son, a renowned Men's Health urologist from Urology Partners of North Texas. Dr. Son, thank you for being here with us again.
Addressing Low Sperm Counts: A Complex Medical Challenge
Indeed, low sperm counts are a significant issue and unique in that treatment often involves both partners simultaneously—a rarity in medicine. This aspect makes the field both challenging and deeply rewarding. Unfortunately, male infertility is increasing, with notable coverage like Time Magazine’s article on the so-called "spermggedon," indicating a global decline in sperm counts, likely linked to broader health declines.
The Crucial Role of a Healthy Lifestyle in Male Fertility
Dr. Son, could we revisit the lifestyle factors affecting male fertility, particularly those related to urology?
Certainly. Sperm production occurs in the testicles, which are quite sensitive to conditions like heat and radiation. Factors such as obesity, smoking, and exposure to toxins can significantly impact sperm health. Maintaining a cool temperature is crucial, hence the advice against prolonged hot tub or sauna use when trying to conceive.
Innovative Solutions and Everyday Precautions
Could cooling packs for testicles be beneficial for those exposed to significant heat, like a truck driver, for example?
These cooling solutions can indeed be advantageous in such situations, helping to maintain an optimal temperature for sperm production. It's also important for men to have their hormone levels balanced naturally. External testosterone supplements, while beneficial for other issues, can actually hinder sperm production by suppressing the body's own testosterone production.
Post-COVID-19 Impacts on Male Reproductive Health
Dr. Son, there's been talk about COVID-19 affecting sperm counts. Could you elaborate on that?
Certainly. Any acute viral illness can temporarily degrade sperm quality, especially if accompanied by fever, as it heats the body and impacts sperm production. Interestingly, we've also seen an increase in erectile dysfunction post-COVID, possibly due to vascular issues caused by the virus. Recovery from such viral impacts on sperm takes about two to three months.
Engaging Men in the Fertility Conversation
It’s striking that men often participate in the fertility process only after significant delays. A simple semen analysis could spare many unnecessary procedures and stress. It’s vital for men to be proactive about their health, not only for family planning but for their overall long-term wellness.
Supporting Men Through the Fertility Journey
Dr. Son, in your practice, how do you support men dealing with the psychological impacts of infertility?
The psychological aspect is often overlooked but is crucial. We work closely with counselors and sex therapists to support men through these challenges. It’s about holistic care—addressing both the physical and emotional well-being.
Looking Ahead: Innovations in Men’s Health
Dr. Son, please share with us what you are currently working on and how our listeners can reach you.
Our practice, Urology Partners of North Texas, located across seven sites in the DFW area, focuses on a range of men’s health issues, particularly fertility. We are excited about the new at-home fertility tests that make it easier for men to engage in their health care early in the process.
Thank you, Dr. Son. We look forward to having you back next week. Please stay tuned for our next guest after these messages.
 
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Defy Medical TRT clinic doctor
 
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* truth about testosterone: why external testosterone supplements can harm sperm production.






Key point here!

* Accordingly, one should not generalize our findings and propose that hCG/FSH therapy would benefit all infertile male patients.




The inherent limitation of our study is its retrospective nature without strict inclusion criteria, randomization, or patient monitoring (i.e., some data, such as hormone levels, are not completely captured). Specific limitations and selection biases also include the following: 1) exclusion of patients not undergoing a subsequent semen analysis after initial prescription of hCG/FSH therapy (n=102, potentially missing those patients unable to afford the high cost of hCG/FSH), 2) exclusion of patients without a documented history of testosterone use (n=39, raising the question of whether hCG/FSH therapy would benefit testosterone naïve infertile patients), and 3) exclusion of patients documented to be normospermic (>15 M/mL) despite being treated for infertility (n=8, highlighting whether gonadotropic therapy could improve not only sperm quantity but quality). Accordingly, one should not generalize our findings and propose that hCG/FSH therapy would benefit all infertile male patients.

Our study is also limited by its relatively short follow-up. Although the median time on hCG/FSH reboot to achieve the highest documented sperm concentration was 4.7 months, the upper quartile of therapy duration ranged from 8.7 to 29.4 months. Within this upper quartile, however, 73% of patients still demonstrated an improvement in their sperm concentrations vs. 74% of patients in the lower three quartiles. This raises the possibility that some patients may take longer to respond to hCG/FSH reboot therapy. Longer follow-up will be required to better understand this regimen’s safety and efficacy profile. Finally, we did not assess fertility outcomes in patients undergoing hCG/FSH reboot therapy as our IRB did not include calling patients for follow up. However, men with isolated hypogonadotropic hypogonadism treated with human Menopausal Gonadotropin ,a combination of urinary purified LH and FSH, can reliably achieve pregnancy despite having severe oligospermia or oligospermia(31). Thus, we posit that any improvement in sperm concentration secondary to hCG/FSH therapy represents a means to restore fertility in men with prior testosterone use.

Key to implementing standardized, guideline-based treatment protocols for the treatment of infertility secondary to testosterone use are prospective trials. To confirm these data, the authors are currently designing a multi-center, randomized, and controlled trial to assess hCG/FSH therapy in infertile men with prior testosterone use. Studies of importance should also include prospective trials comparing the efficacy of hCG monotherapy or hCG/Clomiphene to hCG/FSH, as well as the efficacy of hCG/FSH therapy in testosterone naïve patients(18).

Ultimately, the strength of this study is its size, representing the largest study to date investigating the utility of gonadotropic hCG/FSH therapy in restoring spermatogenesis in men with a history of testosterone use. Subjects followed a consistent medication regimen throughout the study, allowing appropriate analyses with semen analyses and hormonal testing at 3-month intervals. With hope of increased availability and reduced cost, hCG/FSH gonadotropic therapy may represent the optimal regimen for spermatogenic recovery in infertile men with a history of testosterone use
 
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