The Good Side of Bad News

Not sure about you, but I like to see the good in the bad. By focusing on the flipside of adversity, I get stronger instead of weaker. Hey, I’m the first one to fess up to the unpleasant, abominable and awful, but there’s gotta be a way to make silk…or something…out of a sow’s ear. I believe, like author Richard Llewellyn, that “bad news has good legs.”

What’s Missing?

Here’s an example. A decade or two ago, when I was up against the wall trying to figure out how to help men with no sperm (azoospermia) have kids, I developed sperm mapping. Today, it’s a workhorse of a technique that, as legend has it, can “find sperm from a rock.” Although safe, noninvasive and very precise, alas it’s not perfect, as many men do not have sperm on mapping. And that’s awful news for fatherhood.

Here is where the cup is half full, though. Compared to other sperm finding techniques like testicular sperm extraction (TESE) or microdissection testis sperm extraction (mTESE), sperm mapping has a unique advantage: it’s forward looking. Its hard for me to count how many times a week I hear from patients that their sperm retrieval procedures failed to find sperm and that they have lost hope. My first response is: “I’m sorry.” My second response is the flipside: “What did you learn from what happened?” Typically, the answer is “nothing, really…”

What’s in There?

Sperm mapping gives you a good answer to the “Yes-sperm-No-sperm” question, just like other, larger surgical procedures. But as a “liquid biopsy,” its much more versatile and informative. Here’s how:

  • It’s archival. Sperm production is a multistep process that begins with a stem cell and ends with a sperm. Sperm mapping can identify what, if any stages in this sequence are present before sperm. Down the line, as technology progresses and sperm are made from stem cells, knowing what’s in there can inform us of who qualifies for what technology and when.
  • It’s global. With sperm mapping, all regions of the testicles are examined. And this picks up things like tiny pockets of stem cells, tumors,and inflammation. And by finding these things early, before they become clinically obvious, mapping can help keep men healthier longer.
  • It “sees ”things. Mapping sees whole organ patterns, and recognizing patterns leads to better diagnoses and better treatments. For example, mapping detects several patterns of “arrested” development during the sperm making process. Although mature sperm may not be present, some arrest patterns respond to hormonal treatment, varicocele repair or lifestyle changes that lead to sperm being present. And that means more Dads.

I’m not all that techy but I am all for getting all the information you can when you poke at men, especially down there, where it counts. You never really know when this information might turn into knowledge, and then into wisdom, and then into babies. You just gotta believe that it will, as I do.

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Dr. Paul Turek, Medical Contributor

View posts by Dr. Paul Turek, Medical Contributor
Dr. Paul Turek is an internationally known thought leader in men’s reproductive and sexual health care and research. A fellowship trained, board-certified physician by the American Board of Urology (ABU), he has received numerous honors and awards for his work and is an active member in professional associations worldwide. His recent lectures, publications and book titles can be found in his curriculum vitae.
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