Diabetes, a chronic health condition, significantly influences reproductive health and fertility in both men and women through various mechanisms.
How diabetes affects fertility in women
Dr. Monica Kumbhat from Neuberg Diagnostics explained, “In women, diabetes, especially Type 2, can lead to hormonal imbalances that impact ovulation and menstrual regularity, making conception more challenging. Insulin resistance associated with diabetes can increase androgen levels, which may disrupt reproductive hormones. In men, diabetes can lower testosterone, contribute to erectile dysfunction, and reduce sperm quality, impacting the chances of successful conception.”
Hormonal Imbalances and Menstrual Irregularities:
Both Type 1 and Type 2 diabetes can interfere with hormonal balance, leading to irregular or missed periods and affecting ovulation due to interactions between insulin and sex hormones.
Higher Risk of PCOS:
Women with Type 2 diabetes are more prone to polycystic ovarian syndrome (PCOS), a condition characterized by irregular ovulation, elevated androgen levels, and insulin resistance. PCOS is a leading cause of infertility, and its overlap with diabetes can compound fertility issues.
Increased Risk of Miscarriage and Complications:
Poorly controlled diabetes elevates risks of miscarriage, preterm labor, and congenital anomalies due to high blood glucose levels during early pregnancy.
How diabetes impacts male fertility
Dr. Kumbhat highlighted, “In men, diabetes can lower testosterone, lead to erectile dysfunction, and reduce sperm quality, all of which affect the likelihood of successful conception.”
Reduced Testosterone and Erectile Dysfunction:
Diabetes is associated with lower testosterone levels, causing erectile dysfunction (ED) due to damage to nerves and blood vessels from high blood sugar.
Sperm Quality Issues:
Elevated blood glucose induces oxidative stress, potentially damaging sperm DNA and increasing risks of unsuccessful fertilization or genetic anomalies in offspring.
Retrograde Ejaculation:
Neuropathy caused by diabetes may result in retrograde ejaculation, where semen enters the bladder instead of exiting through the urethra, complicating natural conception. Assisted reproductive techniques like IUI or IVF can help in such cases.
Managing diabetes during pregnancy
Effective management of diabetes is essential for a healthy pregnancy.
Preconception Planning and Blood Sugar Control:
Women with diabetes should target optimal blood glucose levels before conception, with an HbA1c goal generally below 6.5%, tailored to individual health conditions.
Monitoring and Treatment Adjustments:
Pregnancy necessitates careful monitoring of blood sugar levels, as insulin requirements often fluctuate. Gestational diabetes, which develops during pregnancy, requires specific attention to minimize risks for both mother and baby.
Specialized Care for Gestational Diabetes:
Gestational diabetes typically resolves after delivery but increases the risk of Type 2 diabetes later in life.
Supplements and Additional Tests:
Diabetic patients may benefit from supplements such as folic acid, omega-3 fatty acids, and antioxidants to improve egg quality and fetal development. Routine HbA1c testing, as well as kidney, liver, and heart screenings, help maintain stable health.
Tips for healthy pregnancy outcomes
Maintain effective blood sugar control.
Follow a balanced diet and regular physical activity.
Monitor potential complications like high birth weight, which may necessitate caesarean delivery.
