Diabetes and infertility

Diabetes mellitus is a chronic disease that can pose a serious obstacle to pregnancy and cause problems during the reproductive period. Disruptions in carbohydrate metabolism negatively impact the reproductive function of both women and men, leading to various forms of infertility.

Female infertility in diabetes mellitus

Impact of diabetes in adolescence

Inadequate disease control during the prepubertal period can lead to the development of Mauriac syndrome, one of the manifestations of which is primary amenorrhea (absence of menstruation). In less severe cases, late menarche (first menstruation after 15 years) and late ovulatory menstrual cycles (after 17 years) are observed.

Reproductive age

In reproductive age, decompensation of diabetes mellitus can cause normogonadotropic anovulation. This manifests as secondary amenorrhea or opso amenorrhea (increased menstrual cycle to 35 days or more). Furthermore, female infertility in diabetes mellitus may be associated with autoimmune ovarian damage.

Hormonal and metabolic changes

Hormonal ovarian insufficiency in women with type 2 diabetes has a mechanism similar to that of polycystic ovary syndrome. The ovaries undergo cystic degeneration and excessive androgen production leads to acne, excessive hair loss, and greasy seborrhea. Metabolic and endocrine disorders increase the risk of obstetric complications such as preeclampsia, eclampsia, disseminated intravascular coagulation syndrome, severe gestosis, and early postpartum hemorrhage.

Infertility in diabetes mellitus in men

Main causes

In cases of carbohydrate metabolism disruption, male fertility is affected by hormonal changes and damage to peripheral nerves and blood vessels. The main causes of infertility are as follows:

1. deterioration of sperm quality. Diabetic men have an increased number of sperm with DNA fragmentation, making them unfit to fertilize an egg. Hypogonadism often develops, impairing sperm quality.
2. Retrograde ejaculation. Damage to peripheral nerves disrupts the functioning of the ejaculatory ducts and the bladder. This leads to decreased sphincter tone, pushing sperm into the bladder.
3. Vasculogenic erectile dysfunction. Microcirculation disorders caused by diabetes lead to obstruction of blood vessels by atherosclerotic plaques, worsening blood supply to the penis. Sexual intercourse becomes impossible.

Solutions and recommendations

Diabetes can cause infertility in both sexes, but appropriate management and a proper approach can significantly increase the chances of successful conception. It is important for individuals at risk of developing diabetes to monitor their health and maintain normal blood glucose levels.

Pregnancy planning

Couples where one or both partners are diabetic are advised to approach pregnancy planning with particular care. It is imperative to consult

• a gynecologist (for women);
• an andrologist (for men);
• a reproductive specialist gynecologist;
• an endocrinologist.

Use of assisted reproductive technologies

Aside from natural conception, modern therapies can be helpful in improving the effectiveness of IVF programs (in vitro fertilization), including IVF with sperm donation. These technologies help couples diagnosed with diabetes to overcome conception difficulties and successfully become parents.

Diabetes mellitus is a serious disease that affects not only general health but also reproductive function. Modern medicine offers many solutions for the diagnosis and treatment of infertility caused by diabetes. Timely diagnosis, disease monitoring, and the use of assisted reproductive technologies help many couples realize their dream of starting a family.