Turek on men's health
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Award-winning urologist - and pioneer in Men's Health - Dr. Paul Turek blogs weekly about issues such as infertility, vasectomy and vasectomy reversal, sexual and hormonal dysfunction and more. Keep up with the latest on this fascinating field of medicine.

The Recipe for Man Made Sperm



Tried and true recipes from The Joy of Cooking book
Will stem cell "recipes" become as tried and true as the ones in this book?

Stem cells rock. While the stock market tumbles, stem cell science is sizzling. I know, you’re thinking: what is he talking about? No diseases have been cured with new stem cell technologies. But, from what’s being discovered almost weekly now, I can tell you that male infertility is likely to be one of the earliest boxes ticked on the “Diseases to Cure” list for stem cells.

Sperm from Stem Cells

Honestly, stem cells appear to be great to use to create sperm. Just a few posts ago, I shared the exciting findings from a group in Japan who took stem cells from newborn mouse testicles, placed them in an “organ culture” system (basically Jell-O), and grew mature, fertile sperm in the laboratory. Over the past 2 years, my colleagues at Stanford have also shown that human embryonic stem cells can be pushed along the path toward sperm in a dish. They also showed that adult stem cells from places like skin can also be driven in the same direction. Not all the way to mature sperm, but certainly more than half the way.

Overcoming Sterility in Mice

Last week, researchers at Kyoto University in Japan brought man made sperm closer to reality…at least in mice. I know many of you aren’t really worried about infertility in mice, but we have to start somewhere.

In a study published this past week, they took embryonic stem cells from mice, the mother of all cells, and watched them closely as they began to develop into other cell types (i.e. differentiate) in a dish. After several days, they plucked out rare and transient downstream stem cells called the primordial germ cells and transplanted these cells back into sterile baby mouse testicles. And sperm were made. Good sperm. Genetically intact and fertile sperm. Sperm that led to offspring that were also naturally fertile. And they did the same experiments with adult stem cells and got the same result, eliminating the need to use embryos at the start.

Please realize that this success did not happen overnight, but was the result of good, wholesome science and lots of sweat equity. And not all the results were rosy: primordial germ cells are rare, short lived and inefficient. In addition, when slightly different cells were injected into testicles, benign tumors formed, the scourge of stem cell science. So now you understand why mice experiments come first.

Stem Cells and Human Male Infertility

Imagine this: A boy has cancer and gets cured by being pounded with chemotherapy. Easily enough treatment to sterilize him for life. After that, his testicles could make sperm, but the “seeds” (early germ cells) that develop into sperm have been wiped out. Solution? A skin biopsy. Turn it into an adult stem cell and inject it right back into his testicles. And ta da! Sperm. I can’t stop thinking about how possible all of this is, as stem cell recipes are perfected. As Ted Allen, The Iron Chef once said: “There are two words to improve any dish: Ba-Con.” 


87 Responses to “The Recipe for Man Made Sperm”

  1. jusman

    Hi,..

    I interested with your topic, like it so much,.. talking about sperm.
    I have a question for you…???

    How to make the SPERM more health and faster ?

    Reply
    • turek

      Sperm want to be healthy and go fast. Just take better care of your body to help. Eat well, sleep well, all things in moderation and treat your body like a temple. Thats it.

      Reply
  2. Andrea J

    This is all fascinating stuff – yay to stem cells – I believe in you!

    Reply
  3. SarahKarlT

    Fingers, toes, and everything else crossed that one day this will become a reality!! Amazing stuff indeed. Thank you for sharing!

    Reply
  4. scf

    This is incredible research and a breakthrough has the potential to be the biggest breakthrough male infertility for those with azoospermia, when do you think that such treatment will actually be offered?

    Reply
  5. Foxy

    Incredible. and really brings tears to my eyes to think that we could be so close. While we were in the thick of dealing with azoospermia my mom always asked me what she could do to help. I always responded that I wished she could advance science by about 10 years. This gives me hope.

    Reply
  6. Jeff

    Dear Dr. Turek,

    I´m hypogonodal since a bilateral orchiectomy to treat cancer. I´m on TRT since then, but unsatisfied with current delivery systems .. will this treatment offers hope to androgen deficient male also?

    best regards

    Jeff

    Reply
    • turek

      Jeff, Glad to hear that you are a survivor, but unfortunate that you have to take testosterone replacement. Just to let you know that this field is a rapidly evolving one. For example, there are 2 new testosterone gel formulations on the market in the last 4 mos (one underarm and one between the legs). Also pellet implants are becoming very popular as they require you to do something every 4-6 months and not daily. Creating stem cells from Leydig cells should be possible but I do not think it is being actively pursued by too many groups at this point. Maybe I can focus on it with my new NIH grant on testis stem cells…

      Reply
  7. Jeff

    Thank you Dr. Turek. I think it would be great not to deal with injections and gels .. unfortunatelly TRT isn´t so effective in all cases .. i´ve used Nebido and it doesn´t work for me .. now i´m in weekly cypionate shots, that work.. but i´d rather be in long-acting treatments .. pellets aren´t available in my country.

    In my opinion, a funcional artificial testicle, would help man to deal with psychological aspects of being hypogonodal also.

    Thanks again, and sorry my poor English.

    Reply
  8. Josh

    Hi Dr Turek
    My question is will this sort of technological improvement help those suffering sertoli only cell syndrome, and how would this be implemented? Eg, would sperm be made totally outside the body or would the stem cells be placed in the testis, and realistically how long until this process is in use for the general population?

    Reply
    • turek

      Josh, This kind of treatment, derived from non-testicular cells such as embryonic or adult pluripotent stem cells, cold be a treatment for Sertoli cell Only syndrome. And, it might be possible to use cells by either transplanting them back into the testis and have them grow anew there, or to help them mature to sperm with tails in a dish. Realistically, I would say 5-7 years until clinical use.

      Reply
  9. SEZ?N KURBAN

    I’M HAVING MY BAD ENGLISH IN TURKEY CAN HELP U.S. stem cell maturation arrest AZOSPERM BIG THANK YOU OLAB?L?RM?

    Reply
  10. ANKA

    hello, Mr. Turek. 5-7 years, 2-4 years of clinical practice and we believe we are not. You can visit us here in the whole world will meet in the patients with azoospermia

    Reply
  11. Will

    Is it possible to try it from now. I have azoopspermia and willing to to try it in myself. And who I can approach?

    Reply
    • Paul Turek, MD

      Will, no it is not possible right now in humans. And if it were, safety issues need to be sorted out. The good news is that the animal model sperm appear to be developmentally competent.

      Reply
  12. Pshtiwan

    Dear doctor,
    It is really hard to have no baby! could you tell us to which stage the techneque of artificial sperm has so far riched? and howlong is it remaining to be used clinically? this is a common question of all infertile men!
    best regards

    Reply
  13. ANKA

    Germany and israel dr’s. stem cell terapy and great. no:5-7 I think 2-3 years. yes dr thurek ?

    Reply
  14. pshtiwan

    Some infertile men have Klinefilter Syndrome due to an extra X chromosome in their cells, by doing artificial sperm where will this extra X go? Will the baby have the same problem?

    Reply
    • Paul Turek, MD

      Mr P, Great question! Not sure is the answer. However, currently we have KS patients with sperm and, believe it or not, the sperm tends NOT to carry the same extra X chromosome as the rest of the body. So, in fact, most children born to KS patients have a normal number of chromosomes. This is nature’s quality-control mechanism at work. Bottom line: I would expect a dish-made sperm to develop similar to what we see naturally.

      Reply
  15. Maverick

    Do the adult stem cells have to come from a male? I read an article that female stem cells actually have a better opportunity for growth.
    http://www.nbcnews.com/id/18022291/ns/health-livescience/t/sex-differences-found-stem-cells/

    And if this is true, then wouldn’t our next step be to allow for perhaps two women to genetically have a child? Could the DNA be tweaked to allow for different sex’s for Y and X?

    Thank you kindly for your information, I have been following this type of research since 1995.

    Reply
    • Paul Turek, MD

      Maverick,

      Not sure if the stems cells have to come from a male. We are just starting with what we think has the best chance of working. Certainly a fascinating and early research trajectory would be to take female stem cells and and create X sperm. And producing a sperm with a single X chromosome is not theoretically out of the question as: a) women go through a similar process (meiosis) to make an egg that men use to make sperm, and b) half the sperm that men make are X sperm anyway. Keep in touch!!

      Reply
  16. joe

    Hi Doctor,

    My friend has been tried to have a kid, but unfortunately, the doctor said that he has sertoli only syndrome and there’s impossible to produce sperm. I read about the stem cell treatment and just wondering if the stem cell treatment in sertoli cell only syndrome can be done?

    If it’s possible how long does it take to be able to produce sperm?

    Thanks Doctor

    Reply
    • Paul Turek, MD

      Joe, You are a good man to look after your friend. Validated and authentic stem cell treatments for male infertility are currently not available. However, your friend may still have the possibility of having sperm at this time; it depends on how hard the doctors looked for sperm. Think of sperm production as apples on a tree branch. Depending on which branch you look at you may see apples or not. Be happy to talk with him; call 415-392-3200.

      Reply
  17. janine sayed

    The stem cell cultured from own body greatly interests me as under Islam any intervention from any external donor system is proscribed and liable to many future problems as Koranic inheritance laws would be breached.
    I have a cousin in Egypt who has no viable spermatozoa, only spermocytes present in his ejaculate. He is desperate for his wife to conceive his child. Is there any hope for his treatment in England or even USA for a viable foetus.
    Any thoughts please.

    Reply
  18. Sara

    Hi Dr. Turek,

    My husband has unobstructive azoospermia. He had a MicroTese in March 2011. The doctor gave us some tissue, but the embroyologist could not any viable sperm. The tissue is currently frozen. What would you suggest at this point? Do we have any hope? Is our only option those clinical trials that are going to be availalbe in 5-7 years, or is that even an option? Thank you,

    Reply
    • Paul Turek, MD

      Sara, this is unfortunate. However, some options may still exist.
      1) Depending on the experience of the surgeon and the lab that looked for sperm, FNA mapping has found sperm in cases of failed MicroTESE
      2) Depending on the histology of the tissue at MicroTESE, medical therapy with FSH injections or varicocele repair can “convert” cases of early maturation arrest to mature sperm (generally found in the testis and not the ejaculate).
      3) Stem cell technology will probably be best for those men without sperm and whom have testis germline stem cells (early spermatogonia), but you are right, it will be 5-7 yrs.

      Reply
      • Sara

        Thanks for the quick response doctor. He already had the FNA mapping, and the results came back as inconclusive. His FSH and LH are 10 times what they should be, and he had two variococele surgeries as a teenager. Regarding option number 2, do you reexamine the tissue?

        Reply
        • Paul Turek, MD

          Cases of maturation arrest may respond to FSH therapy and to varicocele repair. If ejaculated sperm do not return, then I often look at sperm production in the testicles with another (repeat) FNA mapping procedure after such treatment for 6-9 months.

          Reply
  19. ornela

    dr turek

    my husband have NOA. the biopsy showed 50% sertoly cells, mature arrest arrest of the spermatids and hypospermatogenes. the doctor prescribed choriomon profertil and vitamin e. after three months of this cure he added merional because he had a low level of FSH and LH and after three other months he will repeat the analysis. my question is: Are there any hope that this cure will make possible to find any mature sperm?

    kindly regards ornela

    Reply
  20. J

    Dr Turek, I have been diagnosed with sertoli only cell syndrome but in 3 of 4 SA tests I had small amounts of sperm in my samples. Since then I have had a testicle removed due to a leydig cell tumour (non cancerous) about 12 months ago. Histology reported that there were no germ cells in my removed testicle. 2 SA taken around 3 months after my surgery revealed no sperm. Therefore I have been on pregnyl injections for last 2 months In hope of getting sperm in my samples for icsi. My question is, is it likely that the sperm were produced from my “good” – non tumerous) testicle, and if my removed testicle showed no sign of germ cells and SOCS, that my good testicle is identicle?

    And is it likely that i will see any results from taking this medicine, or is it the likelihood that I will need to wait until the reproductive technology mentioned in this article to come into commercial use to father my own genetic children?

    Reply
    • Paul Turek, MD

      Dear J, More twists and turns here than a winding road! Answer: Hard to know. We published that 19% of time, FNA mapping found sperm in the opposite testicle when its mate did not have any, pointing to a real variation or “patchiness” to sperm production between testicle sides. Clearly that sperm came from somewhere! Hopefully that “somewhere” is still there after your procedure. Hormonal stimulation may or may not help. If it doesn’t, there is still the possibility that you are making sperm in your remaining testicle at a level that is too low to get into the ejaculate, but could be obtained by sperm retrieval. Consider FNA mapping! http://theturekclinic.com/services/male-fertility-infertility-doctor-treatments-issues-zero-sperm-count/sperm-mapping-testicular/

      Reply
  21. J

    Dr Turek in my earlier post I mentiOned I had SOCS and was on pregnyl after having a tumour and testicle removed. I have since done a S.A and they found a few sperm, but they were poor quality and probably dead. My hormone levels did not change much also with the medication and my specialist said its not worth taking anymore. Is it likely that I may have some “good” sperm that may be retrieved through the use of sperm mapping? And at what stage is a sperm good or bad for use in ICSI?

    Reply
  22. Karl

    Dr. Turek, I’m a 28 year old male who was diagnosed with non-obstructive azoospermia, my FSH was 14 and I did a testicular biopsy (TESE) only to discover that I have sertoli-cell only syndrome and that no sperm were found or can ever be found. My doctor told me I was born this way and that I can never father a child. Please help. What are my chances, if any?

    Reply
  23. Kheira

    Dear Dr. Turek
    We had several discussions and try to keep me regularly informed of the latest developments. Unfortunately, this case is very difficult but still we always keep the hope that science will overcome.
    My husband is homozygous for the aurora kinase C gene which causes the formation of all abnormal sperm with chromosomal excess.
    The cause is due to consanguineous marriage of his parents who sent her two failed mutations.
    Do you think that treatment will be available for my husband in the years to follow?
    What treatment would be most appropriate in his case?
    Do you have a colleague to advise me?
    Thank you again for your answers.

    Reply
    • Paul Turek, MD

      Kheira, I remember vividly. I am still thinking of what can be done. Germline gene therapy with stem cell technology comes to mind…but not yet possible.

      Reply
  24. Stefan

    Dear doctor Turek,
    could you tell us to which stage the techneque of artificial sperm has so far riched? and howlong is it remaining to be used clinically?

    Reply
    • Paul Turek, MD

      Stefan, to date no one has made a believable human artificial sperm in the world. Many groups are trying, as are we. I predict 3-5 years before a sperm is made and more time after that to ensure that safety studies confirm that they are genetically “healthy.”

      Reply
  25. Stefan

    So what are your predictions when it will be available in practice? Hurry up please we all wish to have our bioligical children :(

    Reply
  26. Jonny W

    Hi,

    Following this research, I am interested in the next steps available to men with Sertoli Cell Only syndrome. I have sarcoidosis which has affected the testes. In 2010 I was diagnosed with azoospermia, but shortly after produced a few sperm in the ejaculate. Every subsequent test showed no sperm, and the hospital did not freeze the few that they initially found. I had a normal testicular biopsy which showed Sertoli Cells only. I was put on Clomifene for 18 months and the doctors performed a micro TESE a month ago, which showed Sertoli Cells only. They did not perform FNA mapping. After the procedure, they mentioned that it might be possible to use a PET scan to look for sperm. Is this something that you know about? Are there any further treatment options for a man in my position?

    Any help would be gratefully appreciated!

    Reply
    • Paul Turek, MD

      Jonny, your story is unfortunate. The term “PET scanning” that the doctors told you about is probably our work with magnetic resonance spectroscopy of the testis which is still awaiting clinical trials (but we are working hard on it). Consider reading what others have done in you situation at TheTurekClinicSupport.com.

      Reply
  27. JG

    Dr Turek
    How is the artificial testicle and the endeavours to make man made sperm progressing? Do you have any updates on the progress of this exciting project!
    Wishing you and your team all the best with your work!!

    Reply
  28. A josef

    Hello dr.Turk I have been following this issue eagrly hopibg for such advancemwnt to happen really soon I have some questions
    My husband is 31 he has NOA He had a TESE done no sperms were found and his histopathology reads: good number of seminiferous tubules all of which show much thickening and hyalinization of their wall. About 10% contain primary spermatogonia with no further maturation.leyfig cells are prominent.
    Now I read ur comments about FNA mapping do u think ww should give it a try? If we do do risk any further damage to what could be salvagable with stem cell treatment?
    About stem cells treatment what r the risks for cancer ?? And I read that some centers in germany are actually doing stem cell treatment on humans , I actually cobtacted some but felt funny about it , r u by any chance familliar with their work and what do u think of it…
    Thanks in advance..

    Reply
    • Paul Turek, MD

      Dear Josef, If you diagnosis of early maturation arrest was made based only on a simple TESE that sampled only a few sites of each testis, then yes you may benefit from FNA Mapping or a microdissection TESE. Importantly, a map is very noninvasive and will not “damage” the testis and prevent either a) further sperm retrievals from being successful or b) remove important stem cells for future use.

      You ask a great questions regarding stem cells and cancer. Yes, there is a risk of cancer. If stem cells are injected into the testicle and it is done in the wrong place (in the interstitial space and not in the tubules) then cancers could arise. This is because stem cells respond to their environment and putting them in the wrong environment for them could get them confused and they could become cancerous and lose their focus. I have heard of stem cell work in humans being done in Germany, and have known patients who have done it and it has not worked for any of them. It is quite expensive as well. Based on applying sound and safe scientific principles of medicine, these types of “experiments” are not allowed in the U.S.A.

      Reply
  29. arifa

    My husband suffer from klinefelter syndrome he recently underwent micr tese surgery… this was unfortunately unsuccessful. .. 7 sperm of maturity level 2 and 3 were found…. is there any other way we can have biological children

    Reply
    • Paul Turek, MD

      Arifa, I am not sure of what you mean by maturity “level 2 and 3″ as I think of sperm as mature or not. However, if no mature sperm are present, then stem cell technology is your best hope in the future.

      Reply
  30. MVC

    Hello Dr.Turek
    My Fiancé and I have been trying to conceive for almost 4 yrs and finally went to the Docs to get our SA twice No Sperm found both times, our urologist ordered blood work for testosterone LH and FSH
    Both testosterone and LH were normal but FSH was high the Urologist said that my fiancé has sertoli cell only syndrome . Is it possible to give a diagnosis this on just one blood test ordered ? We are both so shocked and in disbelief our world has just been turned upside down. His family history has no one that has this problem and he has siblings as well and they have healthy children and so do I. We have thought of homeopathic remedies because we so desperately want to have our child naturally but if not we are not opposed to IVF . please help. thank you
    My fiancé is 31 and times running out for me I’m 32

    Reply
    • Paul Turek, MD

      Dear MVC, There are many possible diagnoses besides “Sertoli cell only” syndrome for the finding of azoospermia and an elevated FSH. You have been given a testis biopsy diagnosis in the absence of a testis biopsy. Not only that, men with Sertoli cell only syndrome can have islands or patches of sperm admixed with other areas of Sertoli cell only seminiferous tubules. It might be worth looking a bit harder here as up to 60% of men in your situation will have sperm for IVF-ICSI, REGARDLESS of what you have been told. FNA mapping is a nice first choice to figure this out.

      Reply
  31. NJ

    Dear Dr Turek,
    My husband (age 29, height 1.82m, weight 110kg) was diagnosed with Sertoli cell only syndrome with no spermatogenesis via TESA.
    His results read:
    “Testosterone 6.0
    FSH 8.7
    Both testis are homogenous and measure rt:29mmx19x22
    Lt:32mmx16x22, left side varicocoeles
    3 biopsies on the testes showed majority of tubules have Sertoli cells only with a smaller population being totally sclerotic and acellular. The testicular interstitium is oedematous with small clusters of normal appearing leydig cells. No evidence of vasculitis. No evidence of intra-tubular germ cell neoplasia, unclassified (IGCNU) or malignancy. Johnson’s score is 1.9″

    Could you please doctor look into the results and see any available options i.e. FNA, mTESE (no harm on testicles), homeopathic treatments or stem cell therapy?

    Thank you so much in advance

    Reply
    • Paul Turek, MD

      NJ, If I read you correctly, you had 3 biopsies per testis and all 6 showed Sertoli cell only pattern. This is reasonably good sampling for sperm. I would predict that either FNA mapping or microdissection TESE would have a 20-25% chance of finding pockets of sperm. Homeopathic treatments do not create stem cells in the testis which is what you need to get started. Stem cell therapy is still several years away.

      Reply
      • NJ

        Dear Dr Turek,
        I’m not sure if it means 3 biopsies in each testis, so you think there is no point of doing FNA?
        I mentioned that he is considered obese and has left side varicocoeles, do you think losing weight and removing varicocoeles might help?
        please doctor we are desperate to have a biological child and any help is much appreciated.
        any advances in stem cell therapy?
        Thank you kindly

        Reply
  32. ahmad

    Hello Dr Fidel

    What is your thoughts on stem cell bone marrow clinics. I have sertoli only cell and I was wondering what your thoughts are on this.

    Thanks

    Ahmad

    Reply
    • Paul Turek, MD

      Ahmad, I have heard of these through the grapevine but not in academic circles where we present and publish amongst peers. Patients have told me that there is a 20% success rate in finding sperm after bone marrow transplant when microdissection TESE is used to look for sperm in testicles. That is about the same rate of success that I would expect without a bone marrow transplant. Go figure.

      Reply
      • Noor

        I have heard that a Jordanian doctor called Dr Adeeb Al Zoubi has started doing stem cell therapy using bone marrow. Have you heard any success from them?
        My husband has the same condition

        Reply
        • Paul Turek, MD

          Noor, I mentioned this a week or so back. Here are my thoughts (again): “I have heard of these through the grapevine but not in academic circles where we present and publish amongst peers. Patients have told me that there is a 20% success rate in finding sperm after bone marrow transplant when microdissection TESE is used to look for sperm in testicles. That is about the same rate of success that I would expect without a bone marrow transplant. Go figure.”

          Reply
  33. Paige

    What about the treatment of seritoli only syndrome? What treatment do you have for that? We’re very interested even if just for research!

    Reply
    • Paul Turek, MD

      Paige, The treatment of Sertoli Only Syndrome depends on how the diagnosis was made. If it was made based on a single testis biopsy, then there is a strong chance that pockets of sperm exist elsewhere, like apples on an apple tree. If it was made based on an extended FNA mapping procedure or a well-performed microdissection TESE, then the likelihood of finding pockets of sperm is much lower, maybe 1-10%. In this case, metabolomics technology (pending) or stem cell technology (pending) may help in the future. Updates on these will be posted on the blog.

      Reply
  34. thebos

    ı have certoly cell only and ı had mikrotese in 2011 nofind sperm what would you advise me can ı do again mikrotese how many times will we wait stem cell treament is herbel treatment useful whwt do you think about it thanks for reply

    Reply
    • Paul Turek, MD

      Dear thebos: microTESE for Sertoli cell only pattern histology can be very complete and accurate, depending on surgeon and laboratory experience. Extended FNA mapping can find sperm in cases of failed microTESE but its ability to do so varies alot but is generally low at 0-10%. I believe that stem cell treatment for making sperm has great potential, although the timeline is still unclear.

      Reply
  35. A.ali

    Hello Dr.Turek,
    I have sertoli cell only syndrom and my urologist has prescribet me brevactid 1500iE. I shoukran inject it for 1 Year. Have you any experiences with this therapy on this diagnosis?
    FSh 13
    Testosteron 3,45

    Reply
    • Paul Turek, MD

      Dear A.ali, Brevactid is another name for human chorionic gonadotropin (hCG) which is another name for the hormone LH. It is given to increase (generally low) testosterone levels and may or may not help in your situation by improving the hormone balance in the testicular itself. Generally it is recommended for 3-6 mos and then the semen is checked for sperm and a sperm retrieval can be attempted. A thorough examination of the testicles for sperm by either FNA Mapping or microdissection TESE is more important than a course of this therapy to find sperm in the future.

      Reply
  36. A.ali

    Hi Dr. Turek
    I have already made a biopsy an a Tese by a prof. here in Germany. Both diagnosed with sertoli cell only Syndrome. So I try it with this therapy. How often can I make a Tese? And how does the FNA Mapping work? My LH is about 5-7 is it normal? Thanks for your answer

    Reply
    • Paul Turek, MD

      Dear A.Ali, Whether or not you have sperm depends on how hard they looked. Typically the most sites the better. However, testicles cannot endure repeat TESE procedures very much without paying the price of low testosterone. Mapping does not affect testosterone levels, for the most part, as it is much less invasive.

      Reply
  37. sertoli cells only

    my husband has sertoli cells only…and he made an operation to search in.hos tests about sperms and we dodbt find….what is your advice ?????. especially that we going to visit usa after 3 monthes …

    Reply
    • Paul Turek, MD

      Dear sertoli cells only, If your diagnosis of Sertoli cells only is based on a testicular biopsy, then you should wait at least 6 months before taking another look with a potentially different technique (i.e. FNA mapping).

      Reply
  38. ayman

    Dr. hello., I married 3 years ago and I am suffering from a shortage of sperm 1 million and was described by a doctor are Tmaxvin 10 mg and Faatmit e400, but did not improve well only 2 million please help

    Reply
    • Paul Turek, MD

      Ayman, You have severe oligospermia. Sounds like you are taking antioxidants, which may or may not help. Consider a formal male infertility evaluation that includes a history, physical exam and reproductive hormones. Possibly, lifestyle issues, medical (hormonal) or surgical therapy may be of benefit. This could also be genetic and due to Y chromosome or karyotype issues. Consider a Second Opinion with us to learn more.

      Reply
  39. Mike Zaim

    Dear Dr. Turek.
    I am married since one year and half and discovered recently that I have azospermia when i did semen analysis.

    My blood tests showed irregular prolactin , once high and once low .. but also the FSH level was high. I also found I have varicocele , 2 to 3rd level in the left and 1st level in the right.
    I did the varicocele surgery 8 days ago, Saturday 11.1.2014. Before the surgery I did blood test which showed the following results: Prolactin (15.2), the test result was 9.1 six months ago ( the prolactin test is up and down once some how near 17 and once some where near 9
    . FSH (27.15) , the test result was 25.6 six months ago LH (6.45) , the test result was 6.7 six months ago Total Testosterone (4.10) , the test result was 3.9 six months ago
    ->>>> Now I would like to come to you for the FNA mapping and the sperm extraction . To increase the chances of finding sperms while doing the FNA , I consulted a doctor who prescribed tamoxifen and proxeed plus to me to take for three months to 6 months before doing any surgery. He also adviced me to do the FNA with you.

    will that help ? should I start them or do you have any suggestions ? I want to do the surgery in the summer
    Also, will doing the FNA mapping make the next stage easier should sperms where found ? I mean will i still do MESE or what ?
    looking forward to hearing back from you ASAP.

    Reply
    • Paul Turek, MD

      Dear Mike, Please see my response to your query in another post. Be happy to help!

      Reply
  40. miranda

    Dear Dr. Have you got any news yet about stem cell treatment in case of sertoli cell only we are getting a little depressed seems like everyone gets to have children of their own but us i am from the netherlands.

    Reply
  41. Gemma

    Dear Dr Turek
    My husband has been diagnoised with Klinefelter disease and is currently on testogel treatment.
    However after recent fertility tthereit has been confirmed he has no sperm.
    We are desperate to have a child of our own and have granted fertility treatment with a donar but I know my husband really is deverstated.
    Is there anything we can do with all this modern medical miracles?
    Many thanks

    Reply
    • Paul Turek, MD

      Gemma, there are several things that you can do. Waiting is one. Think about circling back after your first (donor) child if your husband feels the same way after his child is born as he does now. Think about freezing eggs, a gift of hope that you can give him understanding that someday sperm may be made from other types of stem cells.

      Reply
      • Gemma

        I dont think having a donar child will change how he feels and wouldn’t want to bring a child into the world for my husband not to love and care for it as his own.
        What are the several options?

        Reply
        • Paul Turek, MD

          Gemma, Of course, donor children are not right for all people. Adoption after birth and adoption before birth (embryonic adoption) are also alternatives, as are foster parenting and child-free living. Hopefully time, faith and love will give you the guidance you need going forward.

          Reply
  42. Miranda

    Dear Dr. Have you got any news yet about stem cell treatment in case of sertoli cell only we are getting a little depressed seems like everyone gets to have children of their own but us i am from the netherlands.
    Greetings

    Reply
    • Paul Turek, MD

      Miranda, This must be a trying time for you. Stem cell treatments are not yet available in the US, although many of us are working on it.

      Reply
  43. BostonCouple

    Hi Dr. Turek,
    My fiancé had neuroblastoma as an infant/child and underwent two rounds of chemotherapy. He doesn’t have any motile sperm. We haven’t yet done a dissection procedure to determine whether or not he produces any sperm like material (to be used for IVF), but it seems unlikely. We want to explore options now and potentially enter into any clinical trials for using adult stem cells. Do you know of any studies that would be interested in our participation. We are not in an absolute rush to have children (he is 33 and I am 28) but would be open to it now and are very excited to get the ball rolling so that it would be possible in the next few years. Any tips or information you could provide would be greatly appreciated (please email me back with your response). Thank you so much.

    Reply
    • Paul Turek, MD

      Dear Boston Couple, Good that your fiance is alive and well. Given his story, there is still a reasonable chance that he may have sperm in the testicle despite having no ejaculated sperm and despite all of the treatment that he has had for his cancer in the past. We have published on the ability of a simple technique such as FNA Mapping to detect pockets of sperm that can be later retrieved through sperm retrieval. Often, after mapping, the large “dissection” (microdissection) procedure may NOT be necessary if you “know before you go.” This saves testicles! Consider a call with me to learn more and help you make your family building plans!

      Reply
      • BostonCouple

        Hi Dr. Turek! That is great news. The FNA Mapping technique is something we would definitely consider as a first step. We will definitely schedule a call in the near future to discuss options. Thank you so much!

        Reply

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