Diabetes and Fertility


Quick Bites

  • Diabetes if uncontrolled can affect your chance of having a baby
  • Diabetes causes menstrual cycle problems in women
  • In men Diabetes causes erection problems and lower testosterone
  • An increased risk of miscarriage, cesarean delivery, stillbirth, and intensive baby care after birth is seen in uncontrolled Diabetic conditions
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Introduction

Diabetes_and_Infertility

Diabetes shows a great impact on the fertility and reproductive health of both males and females. Your ability to get conceived and have a baby is affected if you have Diabetes. In this article, we shall discuss Diabetes and its effect on fertility.

Diabetes: This is a condition where you have higher than normal levels of sugar or glucose in your blood. The pancreas is an organ that produces insulin, a hormone that helps our body cells to take glucose and use it as fuel to perform activities.

According to a survey given by the International Diabetes Federation (IDF), the number of adults that were affected by Diabetes [1] was 415 million in the year 2105. It is also proved that Diabetes is becoming a global burden, as the victim number is expected to increase to 200 million by 2040.

In this article

 

Symptoms of Diabetes

There are some symptoms [2] associated with increased glucose blood sugar levels like:

  • Polyuria: Abnormally increased production and frequent passage of urine
  • Polydipsia: Excess drinking of water due to increased thirst.
  • Weight loss: Unhealthy reduction of body weight.
  • Blurred vision: Not able to see normally.
  • Growth impairment: Reduced growth.
  • Increased risk of getting certain infections.
  • Serious life-affecting issues if Diabetes is uncontrolled: hyperglycemia with ketoacidosis or non-ketotic hyperosmolar syndrome.
Read more:Amenorrhea - Absent or Irregular Periods
 

Types of Diabetes

The inability of your body to keep blood sugar levels in a normal range is said to be a Diabetic condition. This is of three [3] types:

Type 1, Type 2 and gestational Diabetes

  • Type 1: When your pancreas does not produce any insulin or if the insulin is produced in very low quantity which is not enough to fulfil the needs or requirements of your body, then you are said to be having Type 1 Diabetes. In this type of Diabetes, the own immune system of your body starts attacking the cells of the pancreas which produces insulin. There is a global increase of Type 1 Diabetes globally at 3% per year.
  • Type 2: It is a progressing disease where your body may not use insulin properly that is produced by the pancreas and this causes an unusually increased blood sugar level in your body. This is known as Type 2 Diabetes. It is also called adult-onset diabetes, as it starts in your middle and late adulthood. You can manage this type of Diabetes by proper diet, exercise, and medications
  • Gestational Diabetes: This is a condition where your body will develop high blood sugar levels only during pregnancy and usually disappears after you give birth to a baby. This is well managed by practising a healthy lifestyle along with a good diet and exercise. You may need medications, if necessary.

Long back, around a few decades, only those people aged above 45 used to have Diabetes and related infertility. But, in recent years, starting from children to young people, many are becoming victims of Diabetes. Most unfortunate happening is when your Diabetes reduces your fertility levels.

Let us know how Diabetes reduces female fertility.

Read more:Cervical Stenosis and its effect on fertility
 

Diabetes and Female Fertility

Female fertility is affected in many ways with Diabetes. you may have few of the following problems:

  • Infection of genitals and urinary tract: there are increased chances of getting an infection and the resulting damage to reproductive organs. The main organs involved are your fallopian tubes.
  • Complications related to pregnancy: You may have increased susceptibility of miscarriage or birth defects in the baby due to the presence of high blood sugar levels. With increased blood glucose and supply of more than needed nutrition to the fetus, it results in a condition called as Macrosomia or big baby syndrome.
  • Decrease of sex drive: Diabetes causes general tiredness, anxiety, and depression, which indirectly reduce your sexual drive. Pain and discomfort are also seen during sex due to the vaginal dryness caused by less vaginal lubrication.

Type 1 Diabetes and Female Fertility

When you have Type 1 Diabetes, you may notice a few of the following problems, like:

  • Disturbed puberty and menstrual cycle: You may have longer cycles lasting for more than 31 days, lengthy menstrual bleeding lasting for more than 6 days, heavy menstrual flow, and problems related to your menstruation at a very younger age of fewer than 29 years. When a girl child has Type 1 Diabetes, also known as Juvenile Diabetes, she may show symptoms of delayed puberty. The reproductive period of a woman having Diabetes is decreased [4] due to the delayed onset of puberty and premature menopause.
  • Anovulation: It is a condition in which reproductive-aged women (from the onset of puberty to premenopausal stage) fail to produce eggs or do not ovulate. Diabetes is one of the various factors causing Anovulation. Diabetic women show a low BMI and have irregular periods. It results in the disturbed secretion of gonadotropin-releasing hormone, and this disturbance causes a decrease in the secretion of gonadotropins. The final outcome of this would be lowered LH and prolactin levels, which play a major role in reproduction.
  • Anti-sperm antibodies: Diabetes also causes auto-immune response and antibodies thus produced will attack our own eggs and sperms of your partner.

Type 2 Diabetes and Female Fertility

Generally, women who are in the post-menopausal stage will get affected with Type 1 Diabetes. But due to present modern lifestyle changes and dietary modifications, obesity is increasing in women of reproductive age and so they are at risk of getting type 2 Diabetes.

When you are obese, you may have irregular periods and sometimes even develop PCOS, which is a metabolic disorder. In PCOS, you have an increased secretion of male hormones, cysts forming on ovaries, irregular periods, and disturbed egg production (ovulation). You may also have insulin resistance when you have PCOS.

With PCOS, you have low adiponectin, a hormone that helps in improving insulin sensitivity and prevents obesity. So, low adiponectin means, you have poor sensitivity to insulin with less fat breakdown and thus Diabetes and obesity. Thus, PCOS, Diabetes and obesity [5] together are a big threat to your fertility and reproductive health.

Not only Diabetes affects your reproductive health, but also it has a major impact on your pregnancy, if untreated. Let us know how Diabetes will cause issues during your pregnancy.

Read more:Complete guide to hypothyroidism and infertility
 

Diabetes and Pregnancy

If you have Diabetes you can still get pregnant successfully. Many women diagnosed with Diabetes do conceive successfully. Diabetes may not directly impact your fertility but can cause problems with your pregnancy in other ways. Few of such problems are:

  • Implantation issues: Your egg will be normally fertilized with sperm to produce an embryo, but when you suffer from Diabetes, implantation of the embryo does not take place. Repeated miscarriages in the starting stages of your pregnancy are common, as the embryo is not able to implant itself onto the uterine lining. This is because Diabetes makes your uterus very unresponsive and this prevents you from getting pregnant.
  • Disturbs pregnancy hormones: Apart from the embryo implantation issues, diabetes also causes a disturbed balance in the level of hormones that are highly important in the process of your pregnancy. Diabetes is said to affect progesterone, testosterone, and estrogen levels.
  • Birth defects for babies: There is an increased risk of birth defects if you are pregnant and if you have Diabetes. High blood glucose causes damage to the cells of the embryo leading to birth defects in the baby.
  • Risk of Cesarean delivery: The delivery process is usually complicated with Diabetes and you may have to undergo a cesarean section. This C-section surgery may increase the chances to get infections and healing of surgical incision sites is slower.
  • Highly prone to gestational Diabetes: If you already have Diabetes, then there is a higher chance of getting gestational Diabetes while you become pregnant. If you do not have Diabetes and get gestational diabetes while you are pregnant, then no need to worry, as Gestational diabetes usually goes away after delivery.

Diabetes does not spare even men and is associated with many reproductive health issues. Below, we talk about male fertility and the adverse effects caused by diabetes.

Read more:Ectopic Pregnancy and Infertility
 

Diabetes and Male Infertility

Diabetes does not spare males and it is common among men globally. Few men may be normal and have the potential to have their own baby, while few may suffer from conditions leading to infertility.

The following are some of the effects that Diabetes has on male fertility.

  • Problems with erection: If you are a male having Diabetes, then you may have problems getting an erection or may have issues maintaining the erection. These problems with your erection are due to [6] nerve damage and lowered blood circulation caused by Diabetes.
  • Retrograde Ejaculation: In this condition, your semen flows back into the bladder instead of going into your partner’s vagina. Nerve damage is the main cause of your backward flow of semen. Though it is not considered harmful to you, it can stop your sperm from being entering into your spouse's body, thus making pregnancy difficult to occur.
  • Delayed or Impaired Ejaculation: This problem of impaired ejaculation is due to decreased or lack of nerve sensitivity [7] and damage to your nerves of the penis.
  • Lower Testosterone level
    : This hormone is called the male hormone and is needed in the production of sperm. Diabetes results in low levels of testosterone and thus low sperms. If sperm quantity is reduced your fertility is affected.
  • Reduced Sperm Quality: Your quality of sperm is affected if you have Diabetes, whereas your sperm motility remains unaffected. You should understand here that even if you have less sperm or poor semen morphology, your sperm can still be able to find an egg and combine with it causing fertilization.
  • Reduced production of Semen: It is found that Diabetes results in less semen production.
  • Sperm DNA damage: This is the most dangerous impact of Diabetes on your fertility. Sperm DNA is damaged due to high blood sugar levels, which results in miscarriage, birth defects and may even prevent the live birth of the baby.
Read more:Endometriosis and its effect on Infertility
 

Risks to The Unborn Baby When Mother Is Diabetic

To become pregnant with Diabetes is a great achievement. There are few concerns associated with your pregnancy, like the first being, your ability to get pregnant and the next is, what effect it may have on the baby.

Few issues that a baby may face if her mother is Diabetic are,

  • Macrosomia: When your baby grows larger than normal in size, known as Macrosomia, it would be difficult for you to deliver vaginally and you may require a cesarean section delivery.
  • Hypoglycemia: It is a condition in which you have low blood glucose levels. With a higher insulin level and a reduced glucose level, you may suffer from hypoglycemia while carrying the baby.
  • Pre-eclampsia: This condition is common during pregnancy if you have Type 1Diabetes. Pre-eclampsia is the result of your uncontrolled high blood pressure that usually occurs in the 20th week of pregnancy. The adverse effects of Pre-eclampsia in your baby are damage to liver and kidneys, the formation of blood clots and fluid build-up in the lungs.
  • Birth defects: If your blood sugar is not kept under control during your pregnancy, it will cause birth defects in the baby. Uncontrolled blood glucose in your pregnancy will lead to abnormal development of the baby's spine, heart, brain, kidneys, and digestive tract.
  • Miscarriage: During the first 20 weeks of pregnancy, you may have an increased risk of miscarriage, if you have Diabetes.

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references

List of ReferencesHide

1 .

Goyal Rajeev, Jialal Ishwarlal.“Diabetes Mellitus Type 2”.pubmed.ncbi.nlm.nih.gov.Review.PMID:30020625.

2 .

Diabetesjournals.org.“Diagnosis and Classification of Diabetes Mellitus”.American Diabetes Association Diabetes Care 2010 Jan;33(Supplement 1): S62-S69.

3 .

Youth Fertility.org.au.“Diabetes”.Yourfertitliy.org.au, 04 September 2020

4 .

Livshits Anna, Seidman S Daniel.“Fertility Issues in Women with Diabetes”.pubmed.ncbi.nlm.nih.gov.Womens Health (Lond).2009 Nov;5(6):701-7.PMID:19863473.

5 .

Diabetes.Co.UK.“Infertility in Women”.Diabetes.Co.UK. Jan 15, 2019.

6 .

Glenn R J David, McClure Neil, et al.“The hidden impact of Diabetes on male sexual dysfunction and fertility”.pubmed.ncbi.nlm.nih.gov.Hum Fertil (Camb).2003 Nov;6(4):174-9.PMID:14614196.

7 .

Diabetes.co.uk.“Infertility in Men”.Diabetes.co.uk.Jan 15, 2019.

Last updated on: : 28 Sep 2020

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