The reproductive axis prolongs from the brain to the ovaries. The transmission of various biological signals gets affected by various hormones. Insulin acts as a gonadotropin, meaning, it helps the biological hormones in their functioning. Hence, people with diabetes can suffer from infertility issues as diabetic people have low levels of insulin.
Diabetes is well known to lay down a negative impact on pregnancy and efficacious deliveries. However, women are not the only ones anxious about the effects of diabetes on their reproductive health. Men, too, share the same concern.
With type 1 diabetes, the level of insulin is immensely reduced, leading to poor functioning of the reproductive axis. Whereas, type 2 diabetes results from insulin resistance (Insulin level is high but cannot work) as seen in PCOS patients.
In recent years, with the change in lifestyle and dietary patterns, it has been noted that many individuals with reproductive health concerns are also infested with diabetes.
Hence, if diabetes is not controlled, it can seriously affect the likelihood of conceiving a baby.
Genitourinary infections: Infection and damage in reproductive organs like fallopian tubes are more common in women with diabetes.
Pregnancy complications: With high sugar levels, women can experience miscarriage or congenital defects in the foetus. This, in turn, can cause a big-baby syndrome or macrosomia.
Anovulation: It refers to the absence of ovulation in post menarche or premenopausal woman. Type-1 diabetes can result in anorexia-like hypothalamic anovulation, which in turn, can be a factor in disruption in hypothalamic pulsatile secretion of the gonadotrophin-releasing hormone.
PCOs, diabetes, and obesity: Type 2 diabetes mostly occurs in postmenopausal women. However, with modern diet and lifestyle, obesity is on a record high, increasing the incidence of type-2 diabetes during even reproductive years.
Obesity is associated with PolyCystic Ovarian Syndrome (PCOS), which is a metabolic ailment and is described by cysts on the ovaries, uneven menstrual cycles, and an excess of androgens. Obesity is a recognized cause of failure after fertility treatment.
Sperm DNA damage: Type-2 diabetes can result in low sperm concentration in motility. Structural damage is also a possibility, especially mitochondrial and nuclear damage in the sperm’s DNA, which in turn, can weaken the reproductive capability of men.
Decrease in libido: Less glucose in specific areas of the brain can lead to fatigue, weakness, and less sexual drive.
Sexual dysfunction: Diabetes can lead to erectile dysfunction (ED), affecting fertility in men negatively. Again ED may be the earliest sign of diabetes.
Infection: Phimosis and Balanitis (Infections in Penis) can happen due to diabetes and can lead to more serious infections.
Low testosterone levels or Hypogonadism: Various studies have indicated that 1 in 4 men with type-2 diabetes suffers from Hypogonadism. This can further become a major cause of erectile dysfunction, low sperm count and reduced sex drive.
Retrograde ejaculation: It arises if nerves are incapable to control the muscles of the bladder from closing at ejaculation, which leads to semen entering the bladder instead of exiting through the penis. It does not cause health concerns but can harm conception.
Here are a few tips which you can undertake to avoid any concern in your fertility journey.
Consult a reproductive medicine specialist& a diabetologist when you are planning to have a baby.They will guide your pregnancy journey.
Blood sugar levels must be in control, at least 3 months prior attempting pregnancy.
Lifestyle Changes – Follow proper diet and regular exercise.
Consistent drug therapy and thorough education can help to prevent many complications listed above.
If you turn pregnant, meet your doctor for a review of your diabetes. Your doctor can help you keep your blood sugar levels in control. A few ways by which this is possible are:
Preparing a balanced diet plan, Doing physical activity regularly, Reducing stress or anxiety, Quit smoking, Reviewing your blood sugar levels regularly, Follow the medications as advised by doctor
Conceiving a healthy baby while you are diabetic is possible. The key is to understand and reduce the risks, work on your weight, follow a healthy diet plan and implement the guidelines of your reproductive healthcare team.