Dr. Paul J Turek (born July 8, 1960, Manchester, Connecticut) is an American physician and surgeon, men's reproductive health specialist, and businessman. Turek is a recent recipient of a National Institutes of Health (NIH) grant for research designed to help infertile men become fathers using stem cells.
Early life Turek was born in Manchester, Connecticut, to immigrant parents. His mother was the administrative secretary in the Manchester public school system, while his father was a sheet metal mechanic and welder. He attended Manchester High School and graduated salutatorian in 1978.
Education and Training At Yale College he graduated summa cum laude, Phi Beta Kappa, received the Henry J. Belknap Prize in the Biological Sciences, and co-authored several scientific publications from work in the laboratory of Dr. Robert Handschumacher in the Department of Pharmacology at the Yale School of Medicine. While at Stanford Medical School, he participated in immunology research and developed an interest in the surgical discipline of urology. He pursued his internship and residency training in urology at the Hospital of the University of Pennsylvania. During this time, he developed an interest in urologic microsurgery and reproductive medicine and soon after pursued fellowship training in microsurgery and male reproductive medicine under the guidance of Dr. Larry Lipshultz at Baylor College of Medicine in Houston, Texas. After completing his fellowship, he was recruited to the faculty of the University of California San Francisco (UCSF).
Medical background Turek is a board-certified urologist and microsurgeon, specializing in male fertility. He has performed and published research in men's reproductive health issues including genetic infertility, ejaculatory duct obstruction, immunologic infertility, quality of life issues with infertility, testis cancer and stem cell science, and has developed several techniques for evaluating and treating male infertility. While at UCSF, he was Director of the Male Reproductive Clinical Laboratory, Program Leader of PROGENI (The Program in the Genetics of Infertility), Director of the UCSF Men's Reproductive Health Clinic and Research Program, and the director of a National Institutes of Health grant to train new faculty in men's reproductive health. He has authored more than 175 publications on clinical and scientific issues in reproductive health. Through his published work, he is a proponent of the theory that male infertility is an early marker for other diseases that occur later in life. He became a full professor, with an endowed chair in teaching funded by the Academy at UCSF, a chair he later abandoned in favor of starting his own private clinic.http://www.cpmc.org/providersearch/?sitecfg=49&vs=detail&action=providerdetail&masterid=19709&isLevelOne=1&recId=ps99848sp9984838171778&healthplans=0&physname=Paul J. Turek, M.D.|
He is now Director of The Turek Clinics, medical centers in California that specialize exclusively in men's reproductive health care. He was President in 2011 of the American Society of Andrology and the Society of Male Reproduction and Urology in 2013.
Research and inventions Turek has designed and led in numerous key research programs, as well as inventing several procedures, that have had significant impact on the science of men's reproductive health. Turek is an advocate for men's general health, and speaks about on the topic on television and at companies such as Google. He is on the medical advisory board for Fertile Hope, a LIVESTRONG Foundation initiative.
FNA Mapping Turek is the inventor of Fine Needle Aspiration (FNA) Mapping, also known less formally as sperm mapping, testicular cartography, or "GPS for the testis." FNA Mapping is a non-invasive office procedure that can be performed in a standardized, template fashion to identify men who qualify for, and assist in the planning of, sperm retrieval for IVF-ICSI.Turek PJ, Givens C, Schriock ED, Meng M, Pederson RA and Conaghan J. Testis sperm extraction and intracytoplasmic sperm injection guided by prior fine needle aspiration mapping in nonobstructive azoospermia. Fertility and Sterility. 71: 552-8, 1999| This technique has been important because it has improved identification of men who are likely to have a successful sperm retrieval while at the same time avoiding costly and unnecessary assisted reproductive techniques. FNA Mapping has become a fundamental procedure in the profession and has been adopted at most reproductive centers around the world.Shefi S, Kaplan K and Turek PJ. Analysis of spermatogenesis in nonobstructive azoospermic and virtually azoospermic men with known testicular pathology. Reprod Biol Med Online. 18: 460-64, 2009.|
The success of assisted reproductive techniques such as intracytoplasmic sperm injection (ICSI) encouraged reproductive clinicians to look beyond the ejaculate and into the male reproductive tract to find sperm. In men with no sperm count (azoospermia), it soon became clear that sperm could be found in the testes and used with ICSI, but sperm production was characteristically "patchy" or "focal" in azoospermic testes. FNA Mapping was designed to diagnose the degree of "patchiness" of sperm production in azoospermic men and determine, among other things, whether a sperm retrieval would succeed in a specific patient.Turek P.J, I. Cha, Ljung, B-M., and Conaghan J. Diagnostic Findings From Testis Fine Needle Aspiration Mapping in Obstructed and Non-Obstructed Azoospermic Men. Journal of Urology, 163: 1709-1716, 2000.| Prior to FNA Mapping, testis biopsy was the major procedure for determining the quality of sperm presence. Testis biopsy is a more invasive procedure than FNA Mapping, and studies have shown that FNA Mapping provides better and more complete information about sperm presence.Turek PJ, I Cha, and Ljung, B-M. Systematic Fine Needle Aspiration of the Testis: Correlation to Biopsy and the Results of Organ "Mapping" for Mature Sperm in Azoospermic Men. Urology. 49: 743-748, 1997.|
In addition, FNA Mapping has been used to determine the effectiveness of mapping in patients after sterilizing chemotherapy,Damani MN, Master V, Meng MV, Turek PJ, Oates RM. Post-chemotherapy ejaculatory azoospermia: Fatherhood with sperm from testis tissue using intracytoplasmic sperm injection. J Clin Oncology 20: 930-936, 2002.| the ability to find and diagnose small testis tumors,Freedland SJ, Cha I, Turek PJ. Non-Palpable Leydig Cell Tumors Diagnosed by Fine Needle Aspiration. Journal of Urology, 158: 543-544, 1997| and the ability of mapping to precisely define subsets of infertile men for more accurate phenotyping for molecular biology and genetic studies.,Black LD, Nudell DM, Cha I, Cherry AM and PJ Turek. Compound Genetic Defects as a Cause of Male Infertility. Human Reproduction. 15: 449-51, 2000. |Nudell DM, Castillo M, Turek PJ, and Reijo Pera, R. Increased frequency of mutations in DNA in infertile men with meiotic arrest. Human Reproduction. 15: 1289-1294, 2000.|
Ejaculatory duct obstruction and ejaculatory duct mamometry In a series of papers, Turek and his team made a significant advancement in the diagnosis of ejaculatory duct obstruction (EDO) as a cause of male infertility by studying and investigating the approach and limitations of current treatments for this condition.,Turek PJ, Magana JO, Lipshultz LI. Semen Parameters Before and After Transurethral Surgery for Ejaculatory Duct Obstruction. Journal of Urology, 155: 1291-3, 1996|Kadioglu A, Cayan S, Tefekli A, Orhan I, Engin G, Tellaloglu S and Turek PJ. Does response to treatment of ejaculatory duct obstruction in infertile men vary with pathology? Fertility and Sterility. 76:138-42, 2001 | This led to a prospective, comparative study of currently used techniques to diagnosis EDOPurohit R, Wu D, Shinohara K, and Turek PJ. A comparison of three diagnostic methods in the evaluation of ejaculatory duct obstruction. J. Urol. 171: 232-36, 2004 | followed by the invention and publication of a dynamic, physiologically relevant test, termed ejaculatory duct manometry, to definitively diagnose this surgical condition.Eisenberg M, Walsh TJ, Garcia M, Shinohara K and Turek PJ. Ejaculatory Duct Manometry in Normal Men and in Patients with Ejaculatory Duct Obstruction. J. Urol. 180: 255-60, 2008. Published online 20 May 2008 |
Evolving the hypoosmotic swelling test The Hypoosmotic Swelling Test is a laboratory test to measure the functional integrity of the human sperm membrane. In this test, the sperm is exposed to a hypososmotic solution consisting of a 50:50 mixture of 150 mosmol fructose and 150 mosmol sodium citrate. The tails of normal sperm will swell when exposed to this solution, whereas damaged sperm with low motility will not swell measurably.
Although a moving or motile sperm was traditionally required for use with this technique, some infertile men have genetically immotile sperm and are unable to take advantage of this technology to become fathers.Turek PJ and Smikle CB. Viability of Non-Motile Sperm. Assisted Reproduction Reviews. 7: 34-38, 1997 | In early research in this area, Turek tried to understand more about how sperm "viability" relates to "motility."Bachtell N, and Conaghan J. and Turek PJ. The Relative Viability of Human Spermatozoa from the Testis, Epididymis and Vas Deferens Before and After Cryopreservation. Human Reproduction. 14: 101-104, 1999 | Subsequently, his team evolved the Hypoosmotic Swelling Test into a therapeutic tool that harmlessly and physiologically "pokes" a non-moving sperm to determine whether it is alive and therefore able to be used for ICSI.Smikle CB and Turek PJ. Hypoosmotic Swelling Can Accurately Determine the Viability of Nonmotile Sperm. Molecular Reproduction and Development. 47: 200-203, 1997 | This technique was subsequently applied to men with genetically immotile sperm with successCayan S., Schriock E, Conaghan J, and Turek PJ. Birth after intracytoplasmic sperm injection using testicular sperm from men with Kartagener/immotile cilia syndrome. Fertil Steril. 76: 1-3, 2001 | and this technique is now used routinely in many reproductive centers worldwide.
New approach to genetic testing for male infertility Concerned about the risk of transmitting genetic male infertility or other genetic issues to offspring with the use of modern assisted reproductive techniques such as ICSI, Turek founded a unique, trademarked program called PROGENI (Program in the Genetics of Infertility) at the University of California San Francisco. PROGENI's methodology is based on the classic genetic counseling philosophy that advocates non-prescriptive testing for genetic disease (an approach which is based on informing the patient of risks and then letting the patient decide whether he will undergo testing to delineate risk). Turek has published over a dozen papers on improved patient outcomes and decision making from over 800 patients that have entered the program since inception.,Black LD, Nudell DM, Cha I, Cherry AM and PJ Turek. Compound Genetic Defects as a Cause of Male Infertility. Human Reproduction. 15: 449-51, 2000 |Cayan S, Erdemir F, Ozbey I, Turek PJ, Kadioglu A, Tellaloglu S. Can varicocelectomy significantly change the way couples use assisted reproductive technologies? Journal of Urology 167:1749-56, 2002 |
Using testis stem cells to create embryonic stem cells