Diabetes and Infertility

Is there a connection between diabetes and infertility?

Diabetes is a chronic medical condition characterized by high blood sugar levels due to the body’s inability to make enough insulin or because the body’s cells are resistant to insulin.

The hormones and processes involved in regulating blood sugar levels can disrupt the usual physiological processes of producing and carrying eggs or sperm. This disruption can have a direct impact on fertility, affecting conception and embryo implantation.

Moreover, high and low blood sugar levels can change how a person feels physically and emotionally. Low sexual desire (libido) is more common in men and women with diabetes than without, particularly when diabetes is not well controlled. Lack of desire relates to reduced frequency of sexual intercourse, which can contribute to difficulty conceiving.

It is also important to note that infertility can also increase a woman’s chances of having type 2 diabetes. This is particularly so in female infertility due to fallopian tube damage and ovulation problems.

Diabetes symptoms and types

According to the Centers for Disease Control and Prevention, about 1 in 10 Americans have diabetes and worryingly, 1 in 5 people with diabetes remain unaware of their condition. Left untreated or poorly managed, diabetes can cause a number of serious health problems, including infertility.

The disease manifests with such symptoms as excessive thirst, fatigue, frequent urination and unexplained weight loss. There are three types of diabetes.

Type 1 diabetes

In type 1 diabetes the body can’t produce insulin and will need injections for survival.

Type 2 diabetes

With type 2 diabetes, the most common type, the body doesn’t use insulin well, affecting blood sugar levels and various other bodily functions. This requires close management and regulation.

Gestational diabetes

This occurs during pregnancy when the body is unable to produce enough insulin to meet the increased demands. It typically resolves after childbirth and does not have a long-term impact on fertility.

Diabetes and infertility in males

In men, diabetes can directly or indirectly affect fertility in various ways. Men with diabetes are more likely to experience erectile dysfunction, which can hinder their ability to achieve or maintain an erection, leading to difficulties in conception.

Additionally, insulin resistance and changes in blood sugar levels can affect testosterone levels, resulting in a decrease in sperm production and quality. Studies have shown that the condition can lead to increased oxidative stress and DNA damage in sperm, potentially impacting fertility and the health of the offspring.

Diabetes and infertility in females

Several factors associated with diabetes can make it challenging to achieve pregnancy, including obesity, being underweight, diabetic complications, polycystic ovary syndrome (PCOS) and autoimmune diseases.

Women with diabetes are at higher risk of conditions such as PCOS, irregular or absent periods, premature menopause and endometrial cancer, all of which can harm reproductive health. Type 2 diabetes can result in anovulation, which is failure to ovulate. Women with type 1 and type 2 diabetes may also experience a reduced time frame of fertility.

Diabetes treatment and management

Generally, the treatments available to those suffering from diabetes, or diabetes-related infertility, focus on managing the blood sugar levels. The treatment strategies may vary depending on the type of diabetes (type 1 or type 2) and the individual’s specific health condition. Below are some common recommendations.

• Disease management: Managing the disease is essential to optimize fertility. This includes lifestyle modifications, dietary changes, regular physical activity and monitoring blood glucose levels. For type 1 diabetes, insulin therapy is the cornerstone of management, while for type 2 diabetes, oral medications and/or insulin injections may be prescribed. High blood glucose levels during pregnancy can increase the risk of complications for both the mother and the baby.
• Weight management: For individuals with obesity-related diabetes, achieving and maintaining a healthy body weight can significantly improve fertility odds. Weight loss through a balanced diet and exercise can enhance hormonal balance and increase the chances of conception.
• Antioxidant supplementation: Antioxidants can help reduce oxidative damage caused by diabetes to reproductive cells, while also boosting sperm quality in men and the health of eggs in women.

Infertility treatments for diabetics

If despite following the steps above conception remains challenging, it may be time to seek help from a fertility specialist. If the cause of infertility can be identified, there is a better chance of being able to treat the problem.

For this reason, patients with diabetes, or those who think they may have diabetes, should consult with a physician to ensure diabetes is well-managed before attempting pregnancy. When treating infertility in female diabetics, we always work closely with the patient’s other healthcare providers to ensure the woman’s blood sugar levels are in good condition to support conception and pregnancy.

Our doctors may recommend mediations or assisted reproductive technology (ART) procedures, such as in vitro fertilization (IVF) or intrauterine insemination (IUI), to increase the chances of successful pregnancy. Medications can help women with ovulation issues and help men with erectile dysfunction.

Hormonal therapy can counteract the hormonal imbalances or conditions like PCOS. Hormonal therapy may be prescribed for women in order to regulate the menstrual cycle and induce ovulation, increasing the chances of successful conception.

Sometimes surgery is necessary to clear up issues associated with PCOS in women. Sperm extraction may be necessary for some diabetic men. Intracytoplasmic sperm injection (ICSI) during IVF may also help.

Our specialists will discuss all treatment options with patients including their personal preferences before deciding on a course of action. In some cases, a combination of treatments may be recommended to increase the chances of pregnancy.