Male infertility and diabetes
Some medical conditions that predispose to the development of male infertility are more likely if the diabetes is not properly controlled.
While diabetes does not always bring consequences on fertility, there are some medical conditions related to male infertility, which are more common in patients with diabetes, especially those who do not have adequate control of their blood glucose levels or who has been suffering the disease for many years.
In this article, we'll see what these conditions are.
Conditions that predispose to suffer infertility in men
A number of problems can cause infertility in men. These include:
- Erectile dysfunction
- Delayed ejaculation
- Retrograde ejaculation
- Reduced sperm quality
- Hypogonadism (low testosterone)
Erectile dysfunction is a common problem associated with diabetes that causes difficulty achieving or maintaining an erection. It is caused by neuropathy (damage to the nervous system) and reduced blood flow as a result of typically poor control of diabetes or long-standing diabetes.
High levels of blood glucose, blood pressure and cholesterol are associated with an increased risk of erection problems. Keeping these conditions under control, reducing alcohol consumption and quitting smoking can help reduce the effects of erectile dysfunction. A number of different treatment options are also available.
Ejaculation problems also can occur when penis nerves are damaged. The lack of nerve sensitivity is a problem that can affect the ability of ejaculation. Delayed or poor ejaculation are all terms that describe a difficulty in achieving ejaculation.
Note that delayed ejaculation can also be caused or influenced by psychological problems, age and certain medications.
If poor ejaculation is caused by psychological problems, it can be treated with counseling or psychosexual therapy.
Ejaculation problems caused by nerve damage are more difficult to treat, but you may find sexual positions that result in a better stimulation of the nerve.
Assisted reproductive technologies (ART) such as in vitro fertilization, can help with the treatment of infertility if conception through sex is problematic or impossible.
Another problem that may be the result of neuropathy (autonomic neuropathy) is retrograde ejaculation. This occurs if the nerves are unable to control the bladder muscles from contracting at the time of ejaculation, resulting in the entry of semen into the bladder instead of its output through the penis.
Retrograde ejaculation does not cause health problems, but can endanger conception. If you are looking to conceive, sperm can be collected and used through assisted reproductive technology.
Reduced sperm quality
Research shows that diabetes can lead to reduced sperm quality, but diabetes, as such, does not appear to affect sperm motility (the ability of sperm to move toward the egg) or cause infertility as a result.
DNA damage in sperm that can lead to infertility is higher in diabetics
UK scientists have discovered that DNA damage in the sperm of diabetic men is higher than in the sperm of men who do not have diabetes. They suggest that this can cause infertility in men with diabetes.
The researchers, led by Dr. Ishola Agbaje, a researcher at the Research Group for Reproductive Medicine at Queen's University, Belfast, compared the quality of sperm of diabetic men with non-diabetic men by examining nuclear and mitochondrial DNA (mtDNA).
The participants were 27 diabetic men with an average age of 34 and 29 nondiabetic men, with an average age of 33.
The results showed that:
- Semen volume was lower in diabetic men compared with non-diabetic men (2.6 and 3.3 ml, respectively).
- However, the sperm concentration was not significantly different between the two groups.
- The total sperm output, form, structure and "mobility" (ability to move) were also largely the same in diabetics and non-diabetic men.
- The nuclear DNA in sperm cells of diabetic men was more fragmented than in nondiabetic men (52 percent versus 32 percent).
- There were more deletions in mitochondrial DNA of sperm cells of diabetic than in nondiabetic men men.
- Mitochondrial DNA deletions in sperm cells of diabetic men ranged from 3 to 6 with an average of 4, while for non-diabetic men ranged from 1 to 4 with an average of 3.
The study concluded that diabetes is associated with increased sperm nuclear and mtDNA damage that may impair reproductive ability of men.
Deletions and fragmentation of DNA results in the loss of genetic material, in the case of nuclear DNA, causes infertility as the sperm is not able to deliver its full complement of genetic codes to merge with the egg form create a viable embryo.
Mitochondrial DNA (mtDNA) is found in the mitochondria, tiny "power stations" inside cells.
In humans and many other organisms, mitochondria of sperm cells are destroyed when the nuclear DNA of the sperm is mixed with the nuclear DNA of eggs and only mitochondrial eggs are able to survive in the new individual.
A number of studies have suggested that high levels of mtDNA deletions in spermatozoa are associated with decreased fertility in men.