Author: Dr. Meghana Nyapathi, Clinical Head & Fertility Specialist

Infertility is one of the fast-growing health problems and it affects approximately 15% of reproductive–aged couples globally. And 30- 40% of all infertility cases are attributed to male fertility issues. Diabetes, obesity, genetic and epigenetic factors, environmental factors, stress and life style issues etc. are the major variables that lead to infertility in males.

Diabetes is a metabolic condition in which little to no insulin is produced by the pancreas. Insulin controls the blood sugar levels. It is a prevalent disorder that has detrimental effects on male fertility. An unhealthy lifestyle, lack of exercise, obesity, and genetics are linked to diabetes.

How does diabetes affect fertility in males?

In men, diabetes is associated with certain medical issues which cause difficulties in conception. A few conditions include:

· Erectile dysfunction: Men struggle to get or maintain an erection due to penile nerve damage or improper blood circulation.

· Retrograde ejaculation: A condition wherein the semen flows backward into the bladder instead of exiting the body.

· Retarded ejaculation: Characterised by a persistent inability to ejaculate due to nerve damage, stress, or certain medications.

· Low libido: Diabetes leads to a decline in reproductive performance.

· Low sperm quality: Diabetes has negative effects on certain sperm parameters – DNA integrity, motility, count, and structural components of sperm.

· Low semen volume: Diabetes lowers the volume of semen leading to difficulty in conception.

· Low testosterone levels: Diabetes leads to impaired testosterone hormone production and function affecting spermatogenesis and sperm quality.

Treating these conditions might help in increasing the chances of conceiving.

Treatment and management options for Diabetes

If you have a history of diabetes in your family, it is time to make some positive lifestyle changes such as a healthy diet, and regular exercise which can help in preventing or delaying the occurrence of diabetes. If you already have diabetes, consult with your doctor for suitable medical interventions.

Oral medications or insulin are mostly prescribed for the management of diabetes.

Fertility treatment options for men

Male infertility caused due to diabetic condition can be treated both medically and surgically based on the problem. Conditions like retrograde ejaculation, erectile dysfunction, low libido etc. can be managed with medicines.

Medications can help in restoring low testosterone levels.

Healthy lifestyle choices such as a healthy diet, good sleep cycle, stress management, regular exercise, proper medications etc. can help in the management of both diabetes and fertility issues.

The causes of male infertility which can’t be addressed with the help of medicines can still be managed by surgical corrective procedures, sperm retrieval procedures, and assisted reproductive technologies such as Invitro Fertilization (IVF), Intra Cytoplasmic Sperm Injection (ICSI), and Intrauterine Insemination (IUI).

Sperm retrieval procedures: These procedures are used in situations wherein sperm are absent in the ejaculate. Testicular sperm aspiration (TESA), Microdissection TESE (micro TESE), Percutaneous Epididymal Sperm Aspiration (PESA), and Micro Epididymal Sperm Aspiration (MESA) are a few sperm retrieval procedures.

Conclusion:

It is possible to achieve parenthood with Diabetes. It requires prior planning and an understanding of the risks involved. Schedule an appointment with a fertility specialist/andrologist to address your fertility issues.

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