Can Nature and Nurture Work Together?
I’m sorry, but after delivering hundreds of lectures worldwide over the past two decades, this invitation is different. It’s from the Feds, the National Institutes of Health (NIH) to be exact. They want me to speak at a think tank in Washington about the future of men’s health. It’s a great honor, but a very intimidating one.
Yes, I’ve been talking for several years about how young men need biomarkers to signal health issues or predict disease, something akin to the female ovulatory cycle. Now the Feds want me to crystallize my vision so they can decide whether to act on it on a grand scale. I haven’t been this nervous about a lecture since my high school graduation speech.
What’s a Biomarker?
Let’s get science-y for a moment. In medspeak, a biomarker is “any substance, structure or process that can be measured in the body or its products and influence or predict…disease.” Whoa, now there’s a mouthful. In plain English, a biomarker is a measurement that says something about your health. In a primitive sense, many current tests, like blood sugar levels, are biomarkers of health. But the Feds are looking for a different set of biomarkers, ones that address the health of humans as a species, which don’t exist right now.
I’ve been asked to talk about what biomarkers could possibly predict male infertility. Simple, you might say: it’s the semen analysis. Not so. Except when it is zero, it really doesn’t correlate that well with fertility. And it varies quite a bit over time. To boot, many men with perfectly normal semen quality still have trouble conceiving. So, although its relevance is high, its validity is low.
Ok, then, how about erectile dysfunction? If you can’t get it up, then how can you have a kid? Good thought, but ED is limited in biomarker value as many men with perfectly normal erections are infertile.
A Vision Revealed
As a male fertility specialist, I’ve come to believe that good reproductive health requires good overall health. So whatever biomarker ends up mattering most, it will probably incorporate measures of overall health. Not only that, we know that many infertile men have clearly defined genetic causes of infertility. And you really can’t discuss genetics nowadays without including epigenetics, transcriptomics, proteomics and metabolomics. So, the vast universe of genetics must also be part of the biomarker equation for male fertility.
So, I am really envisioning a male fertility biomarker that incorporates not nature or nurture, but nature and nurture. The destiny of our species is a combination of both. Come join us next week!