Diabetes and Infertility in Females and Males

Diabetes is a typical medical condition in which the human body experiences the effect of insulin. Diabetes and Infertility in females and males are interrelated to each other where improper releases of insulin affect the hormonal balance in the body. Insulin, a hormone secreted by the pancreas, refers to the sugar level in the human body. A patient considers having diabetes either a patient suffers from type I diabetes where insulin doesn’t release inappropriate ratio or type II diabetes where insulin doesn’t justify its behavior. Other than type1 & type2, gestational diabetes also impacts fertility in both males and females. The hormonal unbalance causes infertility and other reproductive health issues. More than 180 million people have diabetes around the globe. 

Diabetes adversely affects the hormones and restricts conception or harms the implantation. Similarly, in males, diabetes affects sperm quality, embryo, and genetic mutations. In the human body, inulin manages to control the sugar levels in the blood and glucose requirements. But today, with modern artificial techniques of fertility, we can simplify the complications of diabetes. It is a common disease in both the gender and approximately brings the same effect and changes. 

It is not a disease, but it may be a root cause of many chronic diseases and lasting illnesses. One among the disabilities is Infertility that affects reproductive growth and balance in males and females. Diabetes diagnoses the type 1and type 2 syndrome, in which type1 is the most consistently increasing syndrome by 3% in the world population. In most cases, type 1 is severe than type 2 that affects fertility. Females and males can also achieve fertility with the help of advanced infertility treatments like IVF, IUI, ICSI, etc.  

Most health complications occur with an inconsistency of type 1, including infertility due to metabolic disorders result from unbalanced sugar levels. Type 2 diabetes is a non-curable disease that can only cure by controlling sugar intake. Both type 1 and type 2 diabetic persons can opt for IFV and other ways of fertility treatment to conceive and enjoy parenthood. 

Diabetes: The role of insulin

• The human body pancreas gland (below the stomach) secretes the insulin hormone that dissolves into the blood. This dissolved sugar (glucose) absorbs by the cells and produces energy for the body to function. 
• When the body’s immune system destroys the islet cells, it will limit the insulin secretion of no-Insulin will be produced. The lower the sugar level, the lower the insulin secretes from the pancreas out of the body. 

Diabetes: The role of glucose

• Glucose(sugar) is a source of energy in the human body for the cells. The glucose repairs the damaged cells and other tissues. Hyperglycemia refers to high glucose in the blood, and hypoglycemia is low glucose in the blood with less than 70mg/dL. 
• A human body diagnoses diabetes by blood sugar level, blood sugar concentration, blood glucose level, and glucose concentration. The standard glucose level is 140 mg/dL, and more than 200 mg/dL indicates diabetes. 

Diabetes and its effect on fertility

Genitourinary infections: a person with diabetes may also experience urinary infections. Especially in females, UTI is a common cause of diabetes than men. Due to high glucose level in the blood promotes the bacterial growth and results in urinary tract infections. UTI occurs in the urethra and bladder and later the growth in infection that affects the ureter and kidney passages. 

Decreased level of libido: poor management of diabetes affects people’s sex desire and lowers the rate of libido. A decrease in hormones is one of the major causes of decreased libido(sex drive) in males and females. If a person observes that their sexual desire is low, they should get a check-up for sugar evaluations.

Conception complication: many researchers confirm that diabetic patient risks conception. High glucose levels restrict the conceiving and growth of the embryo in the uterus. Also, it causes severe birth defects in children like neural tube defects, heart & brain defects, oral crevices,gastrointestinal defects, and limb deficiencies.

Hormonal disruptions: increase in sugar level in the body causes hormonal disruptions. Namely, a human body suffers from diabetes mellitus, a state in which insufficient release of a hormone (insulin) occurs. Later, the insufficient amount of hormone secretion turns up the sugar level in the human body and impacts reproductive growth and fertility in male/female both.

Insulin resistance: the increased sugar levels and obesity impact insulin resistance in the human body and causes type2DM. Insulin resistance refers to excess glucose in the blood that affects the cell’s ability to absorb sugar. The excessive use of blood sugar for energycauses insulin resistance and risks pre-diabetes and type 2diabetes in males and females. Furthermore, females are more sensitive to insulin resistance than males. 

Congenital disorder: NDM (neonatal diabetes mellitus) is a birth defect due to insufficient insulin release in neonates.  Insufficient insulin release impacts the glucose level in the blood and causes congenital disorders. Including CNS, renal system, skeleton system, and diabetic embryopathy affect the development of organs and other functions during pregnancy. 

Complicated pregnancy: inappropriate diabetes refers to an unbalanced hormone that complicates pregnancy mainly through gestational diabetes. Gestational diabetes increasesthe risk of preeclampsia, the high blood pressure that threatens mothers and babies during pregnancy. 

Autoimmune diseases: metabolic disorder and poor control of sugar levels may contribute to the pathogenesis of UTI in diabetic persons. Including UTI in females, it also causes celiac diseases, AIG (autoimmune gastritis), most common endocrinopathy ATD( autoimmune thyroid disease), PA(pernicious anemia), and Vitiligo. 

Diabetes and infertility in females

The metabolic and reproductive disorder subject to female infertility. Studies evidence the complications of diabetes cause reproductive health dysfunctions in females. Diabetes in females has broader studies that show various dysfunctions in female reproduction and function. 

Some common diabetes and infertility experienced in females are

• Delayed puberty & Menstrual abnormalities

The systematic studies of type 1 and type 2 diabetes mellitus indicate a metabolic effect on the HPO axis(hypothalamus-pituitary-ovary axis. The studies also reflect the relationship between the effects of TDM1 &TDM2 and menstrual cycle disruptions in females. 

Diabetes disturbs natural physiology and affects linear growth and puberty. Diabetes causes irregular menstruation cycles, heavy and long periods, and serious consequences. Other than menstrual cycle disorder, teenagers also face UTI problems and weight loss. 

• Hormonal disorders & Insulin resistance 

The rise in sugar levels causes hormonal disorders and insulin resistance. Insulin resistance causes the typical diabetic syndrome, including frequent urination, thirst, and hunger. When a body doesn’t release the appropriate amount of insulin hormone, it increases the sugar level in the blood and known as Mellitus diabetes. 

Experts and physicians claim that excess fat in the female body around the abdomen and other reproductive organs is due to insulin resistance. A female waist more than 35 and a male more than 45 indicates insulin resistance. Excess in sugar, carbohydrates, and fatty acids causes hormonal imbalance, especially in insulin and estrogen, leading to chronic health, fertility disorders, organ failures, miscarriages, and childbirth defects. 

• Subfertility & anovulation

Diabetes, either type1 &type 2 or gestational diabetes, causes an increased risk of late/absent periods. Obesity and overweight also play a vital role in increasing the risk of infertility in both females and males. 

On the one hand, women with lower BMI experience irregular menstruation, and on the other hand, obese women suffer from higher insulin and ovulation impairment. Higher insulin leads to weight gain that is related to PCOS and type 2diabetes.

• Miscarriages & PCOS

Insulin resistance affects the lining of the uterus and increases the testosterone secretion level in the female body. The increased level of testosterone (male hormone) causes PCOS, leading to miscarriages and lasting pregnancy.

PCOS(Polycystic OVARY SYNDROME)-type 2diabetes causes severe reproductive problems. Approx. 10% of women with PCOS and overweight develop diabetes. Females suffering from PCOS still can’t ignore food with sugar as eating less sugar reduces the glucose level in the bloodstream. The decreased insulin also reduces testosterone, and women crave highly added sugar food even after taking their regular meals. 

• Birth defect and pregnancy outcomes

Women having diabetes experience adverse fetal outcomes and neonatal losses. The most common adverse outcomes are congenital abnormalities, embryo malformations. Also, premature delivery, accelerated fetal growth, macrosomia, hypoglycemia, stillbirth refers to diabetic anomalies. 

Diabetic females often give birth to large babies due to the high glucose levels in the mother and high insulin release in the fetus. The combination of higher glucose levels and insulin releases results in a high-fat deposit in babies and concludes larger babies. 

Diabetic women have a threat to pregnancy with congenital disabilities like sacral agenesis (spinal defect), holoprosencephaly (brain defect), and limb defects, including 44 anomalies. Other defects include insulin imbalance, disrupted sugar levels, cardio-defects, oral clefts, etc. 

Mothers having gestational diabetes have the risk of obesity and type 2diabetes afterbirth. Untreated, gestational diabetes can leads to fetal death or infant death. 

Early menopause and amenorrhea 

Yes, diabetes causes early menopause. The latest research and studies indicate diabetes causes increases the risk of menopause. The natural estrogen falls by normal due to diabetes and risk cardio, bone disease, and hotflashes in females; on the contrary, diabetes at the age of 50 delays the onset of menopause. 

Amenorrhea decreases in androgens and estrogens and increases in α-hydroxylase deficiency, deoxycorticosterone, progesterone, and aldosterone.

Women with type 1diabetes experience a significant prevalence of dysfunctions and menstruation irregularities. Menstrual irregularities namely are oligomenorrhea and secondary amenorrhea. 

• PCOS- polycystic syndrome 

• Oligomenorreha- irregular periods

• Secondary amenorrhea- absent periods

• Premature menopause- (premature ovarian failure)

• Endometrial cancer- (uterine cancer)

• Cardiovascular & Micro-vascular complications 

Due to changes in climatic conditions and lifestyle, diabetes manifested female reproductive disorders and fertility growth. Now women are not just typically prone to type 1 diabetes. They are consistently inclined to type 2 and gestational diabetes. The latest research and data indicate earlier females were affected by type 1 diabetes causes by genetic and environmental factors. Where males are more prone to type 2 diabetes, women with type 2 diabetes have high complications and risk of death.

Type 1 diabetes complications:

Type 1diabetes complications occur when the immune system hits and destroys the beta cells(insulin producers) out of the pancreas.  The primary factor expert’s claims for type 1diabetes are environmental and genetic factors, including climatic changes.

Commonly type 1DM is known as juvenile diabetes (insulin-dependent). It is a chronic condition when insulin secretion goes lower. Insulin is an energy-producing hormone that allows glucose from food absorbs by cells to generate energy into the body. 

Type 1DM is dangerous if left untreated or delayed for a long time, and life expectancy reduces ten years to everyday life. Also, type1 diabetes is a non-curable disability that any medications or therapy cannot treat. Only practicing a good lifestyle can reduce the risk of diabetes type1. 

Type 1 diabetes diseases:

Type 1 DM causes can be parental diabetes, demographic factor, and age trigger occurrence of diabetes. Type 1diabetes shows severe damages to organs, the blood vessels, cardiovascular diseases like angina pain, heart stroke, coronary arteries, atherosclerosis, and high BP. 

Neuropathy is the leading causes of diabetes type 1 that affects the nerves of the brain. The body experience numbness, inflammation, and loss of senses while poor blood sugar control. The poor sugar level also affects the gestational tract, leading to vomiting, nausea, diarrhea, and constipation. 

Other diseases like eye damages(blinding or retinopathy), foot damages(leg amputation), kidney damages(kidney failures), skin & mouth conditions (gum infections), lists as pregnancy complications. 

Type 2 diabetes complications:

Sugar (glucose) is a fuel to regulate the body. Type 2 diabetes refers to high sugar levels in the bloodstream that lead to chronic disorders. When cells in muscles, fat, and liver resist insulin, they do not correspond with insulin appropriately and do not perfectly absorb the sugar that causes type 2DM. Sedimentary lifestyle and obesity fall under type 2 diabetes.  

Type 2 is less severe than type 1diabetes still; it affects health and body functions. Type 2 diabetes mainly occurs by insulin resistance, and the pancreas releases less insulin. The insulin secretion correlates to cells functioning where less insulin doesn’t support cells and cells responses below par to insulin. 

Type 2 diabetes diseases: 

Diabetes type 2 is common in adults and older ones. But the increased rate of obesity in children hikes the type 2 diabetes in younger as well. For more information, type 2DM is a non-curable illness. 

The symptoms of type 2diabetes are primarily similar to type 1diabetes. The female body experiences frequent urination, UTI & other bladder infections, increased thirst and hunger, fatigue, unintended weight loss, slow healing, and impassiveness. 

Type 2 diabetes is a concrete medical condition that lasts a lifetime. If tyep2 DM not get treated in time can severely damage the parts of the body and internal organs. The human body experiences nervous system, immune system, and circulatory system impairment if having type 2 DM. 

Type 2 diabetes syndrome causes weight gain, inactivity, lower blood lipid levels, age, prediabetic symptoms, PCOS, after pregnancy effect, nerve damages, sleep apnea, dementia, etc. 

Gestational diabetes and its outcomes

If diabetes detects during pregnancy, it is entitled to gestational diabetes. Similar to type1 and type2, it also causes high blood sugar and affects your baby’s (fetal) health. By eating a proper diet chart and making minor changes to their daily routine, pregnant women can overcome gestational diabetes. Proper medication and controlled sugar levels help pregnant deliver a healthy child safely. 

In most cases, sugar levels get back to normal after delivery. If not, then visit a doctor else; it turns to type 2 diabetes. Gestational diabetes has no appropriate signs and symptoms. But frequent urination and untimely hunger reflect in having gestational diabetes. 

Gestational diabetes affects fertility and fetal growth:

Generally, gestational diabetes causes excess birth weight and leads to heavier babies. The large babies jammed into the uterus and seek for C-section birth. Pre-term birth, breathing difficulties, low blood sugar, obesity, stillbirth, and afterbirth type2DM are significant effects of gestational diabetes. 

Also, it causes complications like preeclampsia (high blood pressure), C-section surgery to deliver a baby, and future diabetes and other chronic diabetes. The rate of gestational diabetes increases with aging and excess weight gain. 

Treatment of diabetic infertility:

Diabetes and infertility males/females can seek fertility treatment services and a full complement of diagnostics. No doubt IVF treatment encourages infertile persons to become a parent by controlling diabetes. Usually, the specialists suggest you some diet and work plan to normalize the sugar and diabetic features in the body. Before starting an IVF treatment, they educate patients to manage their blood pressure, weight gain, and sugar levels. 

At the same time, the specialists diagnose the infertility inferiorities and incompetency. Once they know the causes and flaws, they plan out a proper medical diagnosis, including the client’s best suitable treatment. The doctor suggests the best treatment to follow to achieve pregnancy and overcome infertility. 

Infertility treatments for diabetic females

• The specialist prescribes blood tests, urine tests, and other infertility tests on the initial stage of diagnostic treatment. Patients need to follow the tests to get the best diagnosis. The tests will help examine the sugar levels, effects of insulin, hormonal disruptions, symptoms of hidden disorders(if any), and other complications that restrict conceiving. 
• As per diagnosis, the experts will move towards suitable IVF treatment. The IVF procedure includes the natural cycle IVF(less/no drugs), mild stimulation IVF, and standard IVM(maturation).  
• Most controlled prediabetic females prefer to undergo natural IVF with no prescribed drugs. Just the eggs are mixed with the sperm in the lab and observe the growth of the embryo.  In case of the embryo doesn’t respond, the common ways switch to mild stimulation IVF. 
• During mild stimulation IVF, few drugs induce the body to reduce the IVF time and make ovaries stimulate faster. Mild stimulation IVF has few risks and side effects, but the patient can cope with it. If mild IVF doesn’t respond well, then go for standard IVF treatment or IVM. 
• During IVF, the drugs stimulate hormones to mature, but in IVM, the eggs are previously taken out of the uterus and observed maturation in the lab. For the same males undergo ICSI treatment. 
• If you have diabetes, you have to keep track of your conceptions and pregnancy until the delivery period. A proper diet is a must to ensure a safer pregnancy, even with IVF/IVM. 

• Ovulation Induction, 

• HSG(hysterosalpingogram)

• IUI, ART, PGD, FET, fertility preservation 
• Egg/sperm donor treatment services 

Infertility treatments for diabetic males

Similar to males, the treatment starts with educating males to reduce or control the diabetic symptoms. We know it’s still not easy to achieve pregnancy and gain adequate fertility; one must do it. 

Infertility specialists may suggest planning and following a diet chart, avoiding alcohol/ other toxic drugs, and changing sedimentary lifestyles. Exercising and minor changes in eating habits can bring beautiful things to your ways. 

• Expert prescribes for few tests and check-ups to diagnose the actual cause of infertility and other hormones, semen analysis, sperm morphology, and insulin levels.  Then the treatment is prescribed, proceeding with the treatment. And diabetic patients are suggested to keep track of the food intakes to balance the weight and sugar to support implantation and IVF. 
• ICSI is an IVF procedure where sperm is directly injected into a female egg in the uterus to reduce sperm morbidity. But the ICSI is successful when the body efficiently supports the nutrient required to achieve the process. 
• During IVF, males undergo other infertility treatments like sperm disorders, varicoceles, retrograde ejaculation, immunologic infertility, and obstructions. Other complications for diabetic persons are hormonal disorder, chromosomes anomalies, depression, chronic disorders, arthritis, and the effect of post-partum surgeries. 
• TESE (Testicular Sperm Extraction Technique), TFNA (Testicular Fine Needle Aspiration Technique), PESA & MESA Micro-surgical Techniques, Basic Sperm wash Technique, premiums per wash technique, swim-out sperm wash Technique, IUI(Intrauterine Insemination Technique), Donated sperm
• To conceive, a person may choose donor egg/sperm services, egg/embryo freezing, and sperm preservation treatment refer to achieve conceptions. 

How to get pregnant with diabetes type 2

Of course, with extra care, a safe and healthy pregnancy is possible while having type 2 diabetes. The expert gynecologist or fertility specialist may help to get pregnant even having type2 complications. Expert physicians have some guidelines for safer pregnancy and childbirth. Read below some important suggestions:

• Timely intake of a healthy diet
• Proper exercising and adequate physical activity 
• High fiber food and less sweetened beverages like juices 
• Keep track of sugar levels, cholesterol, and blood pressures
• Track of UTI and other vaginal yeast infections 
• Referring to a nutritionist or diabetes specialist may help you better.

An obligation to mentions above can help you conceive during type 2 diabetes. If a person having diabetes tyep2 ignores any of the suggestions, it concludes to infertility. 

Vaginal thrush, more prolonged yeast infections damage the vagina and tracts that affect conceptions. Types of infertility include blockage of the fallopian tube, pelvic inflammation and disease, endometriosis, irregular periods, premature ovarian failures, etc. 

Can a diabetic male have a baby?

No doubt, diabetes can causes severe infertility in both men and women. Diabetes can gradually affect the male body, and if not revived, it can make you less fertile or severe diseases. 

The male body suffers from sexual abnormalities like erectile dysfunction, poor sperm quality, and hormonal unbalance. Diabetes impacts the sexual drive in men and reduces interest in sex due to lack of glucose supply (energy) in the brain, increase in fatigue and anxiety affects the male strength to ejaculate. 

Effect of type 1 diabetes: male reproductive ability decreases with increased nuclear, mitochondrial, and DNA damage.

Effect of type 2 diabetes: male body experiences sperm morbidity, poor semen concentration, sperm motility, structural and DNA damages noticed in type 2diabetes. 

Treatment for males and females infertility

Controlling sugar levels, reproductive hormones, and their functions as per doctor’s instructions. Taking timely medication and prescribed drugs on time and taking extra care of your health will help treat infertility due to diabetes in both males & females. 

• Corrective procedures 
• Timed intercourse
• Following medications 
• ART & micro TESE
• DONOR egg/sperm fertilization
• Weight loss surgery
• Associated Insulin and drugs

Can a diabetic woman get pregnant?

If a woman is healthy but diabetic, she can still conceive just by following some doctor’s advice and proper medications. Switching to a healthy lifestyle from an inactive routine increases the chances of getting healthy and normal pregnancy, including safe birth.  Uncontrolled diabetes during pregnancy harms the initial growth of the embryo and the baby’s growth in later pregnancy periods. 

If a woman is earlier diabetic: it may raise the chances of larger babies with hypoglycemia with a raised insulin level. The child may get affected and birth defects like brain and heart problems, spinal cord defects, oral clefts, kidney and gastrointestinal effects, and limb deficiencies. 

If a woman has gestational diabetes: women experience obesity and get exposed to type 2 diabetes after delivery during gestational diabetes. Also, avoiding gestational diabetes disorders can lead to infant/fetal demise that is more heartbreaking and causes trauma and mental disorder. 

Does type 2 diabetes affect fertility in females?

Unfortunately yes! Type2diabetes affects fertility in females as well as males too. Diabetes is a complicated pack of types of diseases that occurs due to unbalanced insulin hormone. Insulin disruptions initiate severe health deficiencies and lasting sickness. 

Usually, if diabetes gets treatment on time or worked up to reduce the causes of occurrence, it can be controlled and overcome. 

Prolonged diabetes contributes and leads to major infertility complications. The elevated blood sugar and insulin resistance mainly impact ovulation and infers to unpredicted/untimely periods or menstrual cycle disorders. 

Men and women facing challenges to conceive or childbirth can achieve fertility by slightly changing their eating habits and daily life routine. Also, if suffering from major diabetic complications, following a good practice prescribed by an expert doctor can help you gain successful pregnancy. 

Diabetes mellitus and male infertility

Referring to diabetes mellitus is a kind of recent cause of infertility. Diabetes mellitus affects male pre-testicular, post-testicular, and testicular functioning. High blood sugar impairs the male immune system to respond to insulin hormone causes diabetes mellitus—elevated glucose levels, the sugar present in the blood and urine, results in abnormal metabolism of carbohydrates.

Diabetes mellitus is a type 2diabetes syndrome. Often, males are more prone than women to type 2diabetes Mellitus. Muscular cells (myocytes), fat cells (adipocytes), liver cells (hepatocytes) get resistant to insulin. When cells don’t normally interact with the insulin, they affect the pancreas secretions and restrict sugar level management. Finally, unmanaged sugar leads to diabetic conditions, especially in males. 

Effect of diabetes mellitus 1:

• Low volume ejaculation
• Altered epididymis emptying
• Mitochondrial damage
• Declination in sperm motility

Effect of diabetes mellitus 1:

• Increase in leucocytes
• Oxidative stress
• Elevated sperm fragmentation
• Decrease in sperm vitality 

Males experience lower fertility hormone testosterone during DM2 and poor sperm concentration with poor sperm morphology and less progressive motility. Managing your diabetes includes no smoking, less alcohol intake, timely vaccinations(if advised). Keeping track and intact levels of cholesterol and sugar level, checking blood pressure status, working to stay fit, exercising, and practicing a healthy fitness routine can help a diabetic person remain fertile for long. Adopting an adequate diet, eating habits and schedule, proper medications, and following the best fitness regime helps deal with diabetes and infertility.

Conclusion

Infertility caused by diabetes can be improved in males and females by following proper treatments including IVF, IUI, ICSI, IVF with donor eggs, surrogacy, donor sperm and cryopreservation. The above description of all the ways to treat infertility in diabetic patients is a part of theoretical researches. Also, the details are drafted into the best way to understand diabetes and its effects on infertility. I hope the perspective serves your needs. Thanks!

FAQ:

What are the 3 main signs of diabetes?

Urination, thirst, and frequently getting hungry impact your appetite; these are some early symptoms of diabetes but are not likely to occur together.

Can a diabetic mom have a healthy baby?

Yes, a diabetic mom and ultimately deliver a healthy baby, but once she’s aware that she’s pregnant, her only aim should be to keep her blood glucose level in control and follow some healthy exercise and meals.

Can diabetes make you infertile?

Diabetes in women and men can impact their fertility and reduce the chances of having a baby. But there will be reduction in the infertility risk with proper medical assistance and well-controlled diabetes. But according to the research, diabetes can cause a reduction in sperm quality, but diabetes is likely not to impact sperm motility or give rise to infertility as a result.

Why is it hard for diabetics to get pregnant?

Your ability to get pregnant must not be affected by diabetes. If you plan to get pregnant, check with the doctor before 2 or 3 months and discuss with them if you have agitation about your infertility.  Your doctor will come up with various therapies which will guide you both mentally and physically and make it possible for you a healthy pregnancy.

Can diabetic females get pregnant?

Yes! Why not? But with some extreme care, undoubtedly, diabetic females can get pregnant. Care to check with your doctor first and ensure to follow some precautions and necessary measures. Consistently track and keep your blood sugar in control. 

References

https://www.tandfonline.com/doi/abs/10.3109/01485019008987617

https://www.jci.org/articles/view/24059

http://scholar.sun.ac.za/handle/10019.1/106380

https://academic.oup.com/aje/article/178/8/1219/82549?login=true

https://www.diabetes.co.uk/pregnancy-complications/infertility-in-men.html

https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339

Effects of diabetes on male & female fertility