Diabetes and fertility health go hand in hand. As a result, if you’re trying to conceive, it’s important to know how you can be affected.
Both women and men can be affected by this chronic health problem. You may find that you have more difficulty when you start on your journey to get pregnant. It’s worth knowing what to expect and what can happen once you begin the journey toward creating a family.
Diabetes and Fertility Health in Men
Men who are diabetic generally have higher levels of blood sugar, also known as glucose. Glucose is controlled by insulin, which is produced by the pancreas. Individuals who are diabetic produce very low amounts of insulin or none at all. As a result, blood sugar levels increase. The sugars then transfer into the bladder. Diabetes causes infertility in men in the following ways:
- Affects small blood vessels and lowers testosterone levels, which leads to erectile dysfunction.
- Lowers sex drive by lowering the levels of testosterone.
- Reduces the volume of the ejaculate or prevents ejaculation altogether as the nerves’ sensitivity that control it are decreased.
- Retrograde ejaculation, in which part or all semen of an ejaculation goes into the bladder instead of out the tip of the penis.
Studies have shown that diabetic men have lower levels of semen than their non-diabetic counterparts. Higher blood glucose levels also decrease the man’s chances to impregnate a woman.
According to a study performed in Ireland, there is a link between the disease and infertility in men. The study showed that metabolic disease adversely affects sperm cells by resulting in genetic alterations in the DNA and RNA. It was further concluded that these changes could lead to miscarriage, cancers and birth defects if conception occurs. The damage to the reproductive cells was also determined to be irreversible.
It was also found that high levels of blood sugar in men cause damage to the DNA found in sperm due to the accumulation of advanced glycation end products or AGEs. These are unmodified sugar molecules that are added to fats and proteins that are normally regulated by enzymes in the reproductive tract. However, AGEs can raise one’s risk of some health conditions. When men have high blood glucose levels, the accumulation of AGEs is excessive.
Unfortunately, AGEs can also interfere with the normal appearance and function of proteins. As a result, if DNA suffers damage due to too many AGEs, it can result in fertility problems.
Diabetes and Fertility Health in Women
Men are not alone when it comes to fertility risks due to diabetes. Women’s ability to conceive is reduced if they have diabetes. The following health conditions can occur in diabetic women:
- Endometrial Cancer: Also known as uterine cancer, this disease is more common in diabetic women, especially when they also suffer from polycystic ovary syndrome (PCOS). Infertility can occur if the cancer isn’t diagnosed and treated early enough.
- Microvascular and Cardiovascular Complications: Diabetic women are more likely to suffer from microvascular and cardiovascular complications, such as neuropathy, nephropathy and retinopathy. These complications can reduce fertility.
- Oligomenorrhea and Secondary Amenorrhea: Oligomenorrhea is a condition that results in irregular menstrual periods. Periods that come every 35 days or longer are considered irregular. Secondary amenorrhea is a condition characterized by the absence of periods for six months or more after previously-regular menstrual cycles. Women who are diabetic have a greater risk of developing each of these conditions.
- Polycystic Ovary Syndrome (PCOS): This is a common medical condition that results in the development of cysts in the ovaries. Although it carries no health risk, it can reduce fertility. Women with PCOS also have higher levels of testosterone and a higher risk of irregular periods (oligomenorrhea) or absent periods (secondary amenorrhea). Changes in lifestyle or, in some cases, prescribed medications can help the woman have a greater chance of conceiving. PCOS frequently occurs in diabetic women and in those who are obese. Increasing prescribed amounts of insulin on a daily basis can also increase one’s risk for the condition.
- Premature Menopause: Also known as premature ovarian failure, this condition occurs when women younger than 40 stop getting menstrual periods or have them only irregularly. Diabetic women are at greater risk of this medical condition.
More Risks for Mothers and Babies
It should be noted that women with diabetes are not automatically guaranteed to have fertility problems. If the condition is properly monitored and balanced, the odds of experiencing a normal, healthy pregnancy are better. However, women who are diabetic and want to conceive need to be diligent about speaking with their doctors and getting their condition properly under control to avoid complications.
There may still be risks to the mother and baby even if implantation of the embryo successfully occurs. Damage caused to the embryonic cells from high levels of glucose in the blood increases the risk of birth defects and the chances of needing a C-section. It also increases the mother’s risk of developing gestational diabetes.
While there are risks involved with high glucose levels and fertility, simply controlling your glucose levels will greatly reduce these risks while increasing the chances of a safe pregnancy. Keeping your glucose levels stable for several months before trying to conceive is always advisable. Doctors urge women to do the following as they plan ahead for pregnancy:
- Keep weight at a normal level, or reduce weight to reach that level. Obesity makes it harder to control glucose levels.
- GetA1C levels below 6.5 before getting pregnant. A1C is a blood test that measures the glucose levels in the blood over the past three months.
- Maintain good control of daily sugar levels for three to six months to help the body prepare for a pregnancy. The longer the period of time, the better.
Treatment Options for Men and Women
Both men and women with diabetes can get treatment to improve their fertility health. For men, the following options are available:
- Medication for erectile dysfunction
- Herbal supplements or selective estrogen-receptor modules to increase sex drive and levels of testosterone
- Alpha agonists or over-the-counter cold medications to improve the normal flow of ejaculation
- Consuming a healthy, balanced diet, reducing stress and exercising to promote better health
Women can get the following treatments:
- Consuming a healthy, balanced diet and exercising
- Nutritional supplements
- Artificial insemination or in-vitro fertilization
Diabetes doesn’t have to dictate your fertility health. If you get it under control, you can look forward to having the baby you’ve always wanted.