By Dr. M Niharika, Consultant Fertility Specialist, Kamineni Fertility Centre
Diabetes mellitus is known to affect fertility and reproductive health in both men and women.
Diabetes mellitus has an effect on menstrual health and reproductive health in females. Uncontrolled diabetes mellitus is known to cause abnormal uterine bleeding due to hormonal imbalances. It is associated with increased risk of first trimester abortions and the abnormal sugar levels can also hamper implantation and lead to either low fertility rate or infertility.
Diabetes mellitus causes insulin resistance which disrupts the monthly folliculogenesis and ovulation leading to infertility. The oxidative stress created by the metabolic changes of diabetes can have an effect on the quality of oocytes. Diabetes is mostly associated with other metabolic disorders like Obesity, Hypertension and Coronary artery disease.
In females with Polycystic Ovarian syndrome insulin resistance and diabetes mellitus are commonly seen. Women suffering with diabetes mellitus should get treated promptly to maintain normal blood sugar levels which alleviates the hormonal changes caused by it and also improves fertility by normalizing ovulation.
Diabetes mellitus effects male sexual health and causes decreased libiodo, erectile dysfunction, and retrograde ejaculation due to the effect of diabetes on the autonomic nervous system. Diabetes mellitus induces subtle molecular changes that effect sperm parameters like decreased sperm count, decrease in sperm motility and also the morphology of sperms are damaged because of the oxidative stress caused by diabetes. Males with diabetes mellitus should be treated with medicines to control blood sugar levels which in turn will correct the metabolic imbalances.
Males with sexual health dysfunction can be treated by appropriate medication to overcome the dysfunction. Also to decrease the oxidative stress that causes abnormal semen parameters antioxidant therapy has been shown to improve semen abnormalities. Males with abnormal semen parameters are advised to use advanced fertility treatments like ICSI (Intra-Cytoplasmic Sperm Injection) for conception.
Women conceiving with diabetes mellitus need special care in the form of frequent monitoring of the child during pregnancy for the early detection of the complications associated with diabetes like missed abortions IUGR (Intra-uterine growth restrictions) and polyhydramnios.