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Diabetes and Infertility: How Does Diabetes Cause Infertility?

Why are increasing numbers of young adults unable to conceive? What is preventing them from getting pregnant? Similarly, we can also question why so many youths are diagnosed with diabetes. Diabetes is a condition in which the sugar or glucose level in the blood is higher than usual. The pancreas produces a hormone called insulin. When the pancreas is not releasing any insulin or is releasing insufficient quantities of this hormone, which does not meet the body's requirements, then diabetes occurs. Diabetes and infertility used to be conditions that only affected people after they had crossed 45 years. Today, many young people are falling prey to these conditions. Unfortunately, their state of diabetes is also affecting their fertility.


There are two types of diabetes. In the first, the body produces inadequate amounts of insulin, and in the second, body cells cannot use insulin properly. Both result in elevated blood sugar levels.  Diabetes can cause damages of the body, including the heart, kidneys and eyes; and other systems and processes such as the nervous system, digestion, and metabolism. Both men and women can also suffer complications related to reproductive health.

Can diabetes cause infertility in men? Can diabetes cause infertility in women?

How Does Diabetes Cause Infertility in Men?

In some cases, a man with diabetes can father healthy children without any problems at all. But on the other hand, diabetic males are susceptible to a range of conditions that may lead to infertility.


Most men with diabetes, even those who are insulin-dependent, live perfectly healthy lives as long as they keep a check on their diet and weight. But some men with unhealthy lifestyles may face issues when it comes to fertility and having children.


Research shows that diabetes can affect fertility, especially in males. Some of the problems it can cause are:


  • Low Testosterone
  • DNA Damage
  • Reduced Semen
  • Reduced Sperm Quality
  • Delayed Ejaculation
  • Erectile Dysfunction
  • Retrograde Ejaculation

How Does Diabetes Cause Infertility in Women?

Women with diabetes can get pregnant. So if you have diabetes and think that you won't be able to conceive, that is not the case. Many women with diabetes can conceive successfully.

 

People with diabetes often have severe infertility. The embryo will fertilize and implant in the uterus, but it doesn't get past that stage. This is because due to diabetes, the uterus becomes less receptive to the embryo, which is why some women can't get pregnant.

 

Besides problems with the implantation process, the high blood sugar level interferes with the balance and stories of other hormones such as progesterone, oestrogen, and testosterone.

 

Women who have diabetes and can get pregnant naturally face potential risks because of higher glucose levels in the blood. The excess levels of glucose damage the cells of the embryo and can become damaged.


Moreover, there is a list number of reasons which can affect fertility such as being underweight, having diabetic complications or having PCOS and having an autoimmune disease. The following medical conditions can lead to reduces fertility rates:


Polycystic ovary syndrome (PCOS): PCOS (Polycystic ovary syndrome) is a hormonal condition caused by an excess of male hormones and a deficiency of female hormones. A lack of ovulation characterizes it because of the imbalance in male and female hormones. A woman who has polycystic ovaries does not ovulate or does not ovulate regularly. They also have an excess production of androgen, which is the male hormone. This prevents them from becoming pregnant. The production of androgen can disrupt the average balance of hormones. The abnormal production of androgen in women is called PCOS. PCOS can cause problems with infertility, and it's primarily seen in women who are obese and those with diabetes type II. Women with diabetes type I who take high doses of insulin are likely to get PCOS.


Premature Ovarian Failure: Primary ovarian insufficiency, sometimes called premature ovarian failure (POF), is a reproductive disease affecting mostly women, in which the ovaries stop producing eggs before the age of 40. When ovaries stop working, they don’t ovulate and produce average amounts of the hormone estrogen, putting them at risk of severe conditions such as osteoporosis, heart disease or infertility. Some studies have also indicated that diabetes type II may cause premature ovarian failure.



Irregular periods: For some women, their periods are like clockwork. For others, their periods come early or late. For example, the length of a menstrual cycle can range from 21 days to 35 days, the average length of the cycle is 28 days. Menstruation lasts for several days, usually 4 to 7. Both type 1 diabetes and type 2 diabetes are associated with the risks of having late and absent periods (oligomenorrhea and secondary amenorrhea).

Pregnancy Risks

There are many concerns when a woman has diabetes and wants to get pregnant. The pregnancy risks include:


Miscarriage: It's important to know that the risk of miscarrying is high during the first 20 weeks when the mother has high blood sugar levels. There is list of possible pregnancy risks:


Congenital disabilities: If a pregnant woman allows her blood sugar to go too high or too low, it can cause congenital disabilities in the baby. This can affect the normal development of the baby's heart, spine, brain, kidneys, gastrointestinal tract etc. 


Hypoglycaemia: Diabetes can happen during pregnancy because of the high insulin levels and a decreased glucose level, leading to hypoglycemia.


Macrosomia: This is a condition in which the baby grows more significant than average. The enormous size of the baby makes the mother's uterus grow, which may lead to the child getting stuck during delivery and may require a C-section.



Preeclampsia: Women with type 1 diabetes have a higher risk due to their condition of high blood pressure. Preeclampsia occurs around the 20th week of pregnancy. It can damage the liver and kidneys of the baby besides causing other problems such as blood clotting.

Planning Pregnancy with Diabetes

For women who want to get pregnant, controlling insulin and blood sugar levels in the body is essential. If you have Type I Diabetes, you do not produce any insulin and hence need to take insulin injections. This type of diabetes is often difficult to control and can cause both the mother and baby harm.

 

Some women with Type II Diabetes still produce some insulin in their pancreas, and the condition is also known as lifestyle diabetes because it is caused due to an unhealthy lifestyle. But maintaining healthy body weight and proper dietary habits can help to have a safer pregnancy.

 

If a woman has diabetes and wants to get pregnant, the doctor will advise her:

 

  • Limit sugar: For people who are planning to get pregnant, it's recommended to limit your sugar consumption for a period of three to six months before the pregnancy.
  • Control HbA1C levels: It's advisible if you want to get pregnant to get your HbA1C levels to at least 6.5.
  • Regulate weight: If you're not overweight, managing your blood sugar levels is more manageable and allows you to avoid infertility.


Remember that good health is vital for your pregnancy. Keeping your blood sugar levels in check and improving your health will improve your quality of life.


References:

  1. https://www.newhealthadvisor.org/diabetes-and-infertility.html
  2. https://www.tandfonline.com/doi/abs/10.3109/01485019008987617
  3. https://pubmed.ncbi.nlm.nih.gov/29887834/
Polina Pylypenko • July 20, 2021
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