Diabetes and infertility

Diabetes continues to be an ever- increasing chronic disease across the globe, with over 460 million people living with diabetes. Approximately 4.2 million people died from this disease as at 2020, and it is estimated that by 2045, over 700 million people will have the condition. Diabetes is responsible for some cases of infertilities both in male and female.

Diabetes mellitus is a group of metabolic disorders in which there are high blood sugar levels over a prolonged period. Elevated blood sugar is known as hyperglycaemia, which creates a toxic environment around cells and tissues and eventually causes organ damage.

Symptoms of high blood sugar may include frequent urination, increased thirst, increased hunger, visual blurring, poor wound healing, unexplained weight loss, fatigue and recurrent infections. Diabetes, if left untreated, may result in acute complications like diabetic ketoacidosis (a condition in which the body produces too much acid which may lead to coma); hyperosmolar hyperglycaemia, when the sugar is dangerously high; kidney disease; heart disease; stroke; nerve damages; amputation; and blindness.

Causes of diabetes

The pancreas is responsible for producing insulin, a hormone that makes it possible for the cells of the body to utilise the sugar the foods consumed.

Diabetes may occur due to insufficient insulin production or to the cells of the body not responding properly to the insulin produced.

Types of diabetes

Type 1 diabetes occurs when the pancreas fails to produce enough insulin. This form of diabetes is also referred to as insulin dependent diabetes mellitus or juvenile diabetes.

Type 2 diabetes begins with insulin resistance, a condition in which the cells fail to properly respond to insulin. As the condition progresses a lack of insulin may develop. The most common cause is excessive body weight and physical inactivity, unhealthy diet, excessive alcohol and tobacco consumption.

Gestational diabetes occurs when a pregnant woman, with no previous history of diabetes, develop high blood sugar level.

Effect of diabetes on male fertility

Men can suffer erectile dysfunction or difficult erection of the penis, delayed ejaculation, reduced sperm quantity, and even reduced testosterone (or sexual desire). Men who suffer infertility from diabetes have difficulty with erections, caused by nerve damage and slower circulation in the small blood vessels.

When the nerves of the penis are damaged, there is lack of sensitivity and the ability to ejaculate or eject. The sperm is also impaired and, in some cases, there is delayed emission. Backwards or retrograde ejaculation also occurs when the nerves of the penis are damaged. This occurs when the bladder remains open during ejaculation and the sperm enters the bladder instead of exiting normally from the penis.

Effect of diabetes on female fertility

Polycystic ovarian syndrome (POS) occurs in women that have multiple cysts in the ovaries leading to missed periods and infertility. Studies have shown that females with Type 1 and Type 2 diabetes are prone to POS.

Oligomenorrhea, medical term for infrequent menstrual periods, affects many women.Because it makes timing ovulation difficult, it may make conception a challenge.

Women with diabetes may also experience long intervals of no periods, referred to as secondary amenorrhoea. This is as a result of the pituitary gland hormones losing its control of the reproductive organs.

Women who suffer premature menopause, especially at a very young age, are at risk for infertility. While menopause generally starts around 45-55 years, some may experience this in early 30s.

Obesity drives diabetes, so in addition to hormonal disruptions in obesity, diabetes in obese women also come with attendant risks that may cause infertility.

Most infertility issues can be handled with ease through assisted reproductive technology, using in vitro fertilisation techniques and other fertility treatment options.

Close collaboration with your private doctor or fertility specialist will help with the understanding of the proper medications and lifestyle changes needed to be at the peak of reproductive health even while living with diabetes.

Contact Dr Maxwell on 363-1807 or 757-5411.