Diabetes and Infertility

Is there a connection between diabetes and infertility?

Diabetes is a chronic medical condition marked by elevated blood sugar levels, which occur either 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 normal physiological processes of producing and carrying eggs or sperm. This disruption can directly impact fertility, affecting conception and embryo implantation.

Moreover, fluctuating 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 the condition isn’t properly managed. 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 increase a woman’s chances of having type 2 diabetes 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 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.

Symptoms of diabetes include 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 requires injections for survival.

Type 2 diabetes

Type 2 diabetes, the most common type, occurs when the body doesn't use insulin effectively. This condition affects blood sugar levels and various other bodily functions, requiring careful management and regulation.

Gestational diabetes

This condition occurs during pregnancy when the body can't produce enough insulin to meet increased demands. It usually resolves after childbirth and does not have long-term effects 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 diabetes 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 like 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 the 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 blood sugar levels. The treatment strategies may vary depending on the type of diabetes and the individual’s specific health condition. Common treatments include:

• Disease management: Managing diabetes is essential for optimizing fertility. This includes lifestyle modifications, dietary changes, regular physical activity, and consistently monitoring blood glucose levels. Insulin therapy is essential for managing type 1 diabetes, while type 2 diabetes may require oral medications or insulin injections. 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 from diabetes to reproductive cells while also boosting sperm quality in men and the health of eggs in women.

Infertility treatments for diabetics

If you properly manage your diabetes but still have trouble conceiving, 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.

Therefore, patients with diabetes, or those who think they may have diabetes, should consult with a physician to ensure their condition is well-managed before attempting pregnancy. At the Reproductive Science Center of New Jersey (RSCNJ), when treating infertility in female diabetics, we always work closely with the patient’s other healthcare providers to ensure their 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 men with erectile dysfunction.

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

In some cases, 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. For some patients, a combination of treatments may be recommended to increase the chances of pregnancy.