diabetes It is a chronic health condition that affects millions of people around the world, and its complications go far beyond well-known problems like heart disease and kidney failure. A lesser known but serious consequence is its potential impact on male fertility. Research has shown that diabetes can contribute to infertility in men, affecting their ability to conceive with a partner. We contacted Dr Smeet Patel, gynecologist and endometriosis specialist, Mayflower Women’s Hospital, Ahmedabad, who explains the link between diabetes and male infertility, highlights how this condition can affect reproductive health and What can men do to reduce these effects?

Infertility is generally defined as a couple’s inability to conceive after one year of regular, unprotected intercourse, says Dr. Smeet. While infertility is often considered a female problem, it affects men and women almost equally. Studies show that about 10 to 20 percent of couples worldwide struggle with infertility, with about 10 percent of men having problems related to sperm production or health.

Male infertility can result from a variety of factors, including problems with sperm count, motility (movement), or morphology (shape). It has been found that diabetes, both type 1 and type 2, has a significant impact on these factors, which directly impacts a man’s reproductive abilities.

How does diabetes affect male fertility?

1. Sperm Quality and DNA Fragmentation

One of the primary ways diabetes affects male fertility is by damaging sperm quality. Dr. Smeet explains that men suffering from diabetes have a higher percentage of sperm with nuclear and mitochondrial DNA fragmentation. Studies have shown that the sperm of men with diabetes are more likely to have structural abnormalities that make it difficult to fertilize an egg. This damage is largely oxidative, meaning high blood sugar levels Causes oxidative stress which damages the DNA in sperm.

Sperm DNA damage is strongly linked to poor embryo quality, low implantation rates, and potentially the onset of certain childhood diseases. Additionally, sperm with compromised DNA can lead to miscarriage or failure of assisted reproductive technologies such as IVF.

Glucose metabolism plays an important role in spermatogenesis – the process by which sperm are produced in the testicles. Diabetes interferes with this process, affecting sperm production, motility and overall health. Dr. Smeet says that proper glucose levels are essential not only for the production of sperm but also to maintain their motility, which is essential for successful fertilization.

It has been observed that both type 1 and type 2 diabetes disrupt these processes, leading to reduced sperm count and less healthy sperm. In addition, men with diabetes often face problems with seminal plasma composition, which can impair the ability of sperm to function properly and reach the egg.

3. Hormonal imbalance and obesity

Another important factor linking diabetes and infertility is hormonal imbalance, which is often aggravated by obesity. Dr. Smeet explains that many men suffering from diabetes also suffer from obesity, which can lead to a condition called hypogonadotropic hypogonadism. This is a hormonal imbalance where the body does not produce enough testosterone, which is a hormone necessary for sperm production. Obesity in men can lead to low total testosterone and free testosterone levels, which further reduces fertility.

Additionally, conditions such as metabolic syndrome and sleep apnea – which are often associated with both obesity and diabetes – further complicate this problem by contributing to hormonal imbalances that negatively impact reproductive health.

Emerging research suggests that diabetes may have long-term effects on male fertility through epigenetic changes. “These are changes in gene expression that do not involve changes in the DNA sequence but that can be passed on to offspring. “Diabetes can cause epigenetic modifications during spermatogenesis, and these changes can potentially affect future generations,” he said.

For example, studies have shown that diabetes may increase the risk of metabolic disorders in offspring. Diabetic fathers may unknowingly pass on an increased risk of diabetes and related health conditions through these epigenetic changes. This highlights the importance of managing diabetes not only for one’s health but also for the health of future generations,” he further said.

Despite the complications caused by diabetes, there are some steps men can take to reduce its impact on fertility. Dr. Smeet says weight loss and lifestyle changes are among the most recommended actions. For men who are overweight or obese, losing weight can improve hormonal balance, reduce insulin resistance and increase overall sperm quality.

It is also essential to manage blood sugar levels through proper diet, regular exercise and medications. Keeping blood sugar levels within a healthy range can significantly reduce oxidative stress on sperm and improve the chances of conception. In cases where diabetes has caused severe damage to sperm, assisted reproductive technologies (ART) such as IVF or ICSI (intracytoplasmic sperm injection) may be necessary.

“Men suffering from diabetes can improve their fertility. For people struggling with infertility, it is essential to seek medical advice to explore all possible treatments and make informed decisions about their reproductive health,” he said.

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