Scientific research has established that uncontrolled diabetes can affect fertility and reproductive health in both men and women. It is linked to hormonal disruptions, poor sperm quality and DNA damage, often resulting in irregular or absent menstrual cycles in women, while men could find it difficult to achieve and maintain erections.
What effect does diabetes have on fertility?
Diabetes can have different repercussions among women and men in terms of affecting fertility.
In women:
Infections: Women with diabetes are more prone to infections and damage to their reproductive organs, most commonly, the fallopian tubes.
Complications with pregnancy: Uncontrolled blood sugar levels can lead tomiscarriage or congenital defects in the foetus or even to ‘big baby syndrome’ or macrosomia.
Subdued libido: Most women with diabetes would suffer from fatigue, increased anxiety and depression, which could lead todecreased sexual desire. They can also feel pain and discomfort during sex because of decreased vaginal lubrication.
PCOS: Type 2 diabetes and obesity are also linked to PCOS or Polycystic Ovarian Syndrome, a metabolic disorder characterized by an excess of male hormones.
Anti-sperm antibodies: Diabetes can produce antibodies which may attack the sperms and even her eggs.
In men:
Sexual dysfunction: Men with diabetes often find it difficult to maintain an erection leading to infertility.
Decreased libido: Diabetic men also suffer from fatigue, weakness and loss of sexual drive, since certain areas of the brain don’t receive enough glucose, which is the only source of energy.
Damage to sperm DNA: Men with diabetes can experience impaired reproductive potency because of increased nuclear, mitochondrial and DNA damage.
Poor sperm quality: Type 2 diabetes is linked to poor sperm concentration in semen and also sub-par motility. Structural damage to the sperm and its DNA are also commonplace.
How is diabetes-related infertility treated?
A more holistic approach involving the couple’s respective family and medical histories is the ideal strategy. The aim is to achieve better control over the glycemic level and reproductive hormones and functions.
Some of the treatment options available are:
Medications: Treatment approach often startswith medications to stimulate ovulation in women, besides treating infections. Medications (sometimes coupled with hormonal supplements) are also used to treat issues like erectile dysfunction and premature ejaculation in men.
Surgical management: Surgical management often becomes a necessity to treat some cases of PCOS, uterine fibroids, trauma injuries, etc.
Advanced reproductive technologies (ART): For men, ART experts use procedures forsperm retrieval and intracytoplasmic sperm injection. For women, the methods generally deployed are in-vitro fertilization, intrauterine inseminationand assisted laser hatching.
However, it’s not all gloom and doom if you have diabetes and planning to start a family. It just requires early and comprehensive planning involving multiple specialties including endocrinologist, gynecologist and andrologist. The goal is to maintain your blood glucose levels at an optimum range to facilitate conception and maintain pregnancy till full-term. It’s all about cutting risks, watching your weight, eating right and meticulously following the advice of the doctors. Sometimes it will be absolutely necessary to seek help from a fertility expert as well.
