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.”
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jusman
August 8, 2011
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 ?
turek
August 9, 2011
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.
Andrea J
August 9, 2011
This is all fascinating stuff – yay to stem cells – I believe in you!
SarahKarlT
August 11, 2011
Fingers, toes, and everything else crossed that one day this will become a reality!! Amazing stuff indeed. Thank you for sharing!
scf
August 29, 2011
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?
turek
August 30, 2011
Dear SCF,
If things progess as they have been, probably 5-7 years until routine clinical use.
Foxy
August 30, 2011
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.
Jeff
September 5, 2011
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
turek
September 8, 2011
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…
Jeff
September 20, 2011
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.
Josh
October 17, 2011
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?
turek
October 19, 2011
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.
SEZ?N KURBAN
December 14, 2011
I’M HAVING MY BAD ENGLISH IN TURKEY CAN HELP U.S. stem cell maturation arrest AZOSPERM BIG THANK YOU OLAB?L?RM?
ANKA
December 22, 2011
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
Will
January 6, 2012
Is it possible to try it from now. I have azoopspermia and willing to to try it in myself. And who I can approach?
Paul Turek, MD
January 7, 2012
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.
Pshtiwan
January 9, 2012
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
ANKA
January 10, 2012
Germany and israel dr’s. stem cell terapy and great. no:5-7 I think 2-3 years. yes dr thurek ?
Paul Turek, MD
January 10, 2012
Anka, It might be 2-3 years, but I really believe 5-7 to get a great, reliable product.
pshtiwan
January 12, 2012
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?
Paul Turek, MD
January 13, 2012
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.
Maverick
January 19, 2012
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.msnbc.msn.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.
Paul Turek, MD
January 19, 2012
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!!
joe
February 5, 2012
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
Paul Turek, MD
February 5, 2012
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.
janine sayed
February 12, 2012
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.
Paul Turek, MD
February 12, 2012
Janine, interesting statement about Islamic belief and infertility. Regarding your cousin, there may be help with modern techniques such as FNA mapping (http://www.theturekclinic.com/testicular-mapping.html). Feel free to contact us (www.TheTurekClinic.com) and set up a free call.
Sara
May 1, 2012
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,
Paul Turek, MD
May 2, 2012
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.
Sara
May 3, 2012
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?