Diabetes and Infertility

Why are so many young couples not able to conceive? What is preventing them from getting pregnant? Similarly, we can also question why so many youths are diagnosed with diabetes. Diabetes is a condition in which the level of sugar or glucose in the blood is higher than normal. Insulin is the hormone which helps the cells to absorb glucose for energy. The pancreas produces insulin. Diabetes occurs when the pancreas is not releasing any insulin or is releasing very small quantities of insulin, which is not sufficient to meet the body’s requirements. There are also medical conditions where insulin is produced by the pancreas, but the body does not use the insulin as it is supposed to.

Several decades ago, diabetes and infertility used to be conditions which only affected people after they had crossed 45 years. Today many young people are falling prey to diabetes. Unfortunately, their condition of diabetes is also affecting their fertility.

DIABETES AND INFERTILITY IN MALES

Diabetes among men is quite common in India as well as in other parts of the world. In some cases, a man with diabetes can father absolutely healthy children with no problems whatsoever. But on the other hand, diabetic males are susceptible to an array of conditions which could lead to infertility requiring medical assistance.

Many diabetic men, even those who are insulin-dependent, live perfectly healthy lives as long as they keep a check on their diet and weight. But some men with unhealthy lifestyles may face issues when it comes to fertility and having children.

Today infertility is a growing concern and diabetes could be one of the potential causes. Some of the effects of diabetes on male fertility are:

· ERECTILE DYSFUNCTION:

Many men with diabetes have a problem getting an erection or maintaining one. The main cause of this is nerve damage and lowered blood circulation.

· RETROGRADE EJACULATION:

This is a condition in which the semen retreats to the bladder instead of being expelled into the woman’s body during intercourse. Retrograde ejaculation is due to nerve damage, and though it does not cause any harm to a man, it prevents the sperm from entering the female body. Male suffering from retrograde ejaculation cannot make his female partner pregnant.

· DELAYED EJACULATION:

Delayed ejaculation is due to reduced nerve sensitivity and is caused by damage to the nerves in the penis.

· LOW TESTOSTERONE:

Testosterone is a hormone which plays a significant role in the production of sperm. Lowered production of testosterone means less sperm are being produced. The reduced quantity of sperm affects male fertility.

· REDUCED SPERM QUALITY:

Diabetes is said to affect the overall quality of the sperm, but fortunately does not impact sperm motility. This means that even with less sperm or poor sperm morphology, the sperm is still able to locate the female egg and fertilise it.

· REDUCED SEMEN:

Men who have diabetes are found to have less semen in their ejaculate as compared to men who are not diabetic.

· DNA:

The most dangerous side effect of male diabetes is DNA damage. When the DNA of the sperm is affected, it not only leads to a miscarriage but can also cause birth defects and may prevent a live birth.

DIABETES AND INFERTILITY IN FEMALES

Women with diabetes can get pregnant. So if you have diabetes and think that you won’t be able to conceive, that is not the case. Many women with diabetes are able to conceive successfully.

The fertility issues with diabetes present themselves in other forms. While the egg will fertilise and you will have an embryo, but due to the diabetes implantation does not take place. Many diabetic women suffer from multiple miscarriages in the earliest stages due to the embryo not being able to implant. The uterus of a diabetic woman is less receptive. The poor receptivity of the uterus prevents a woman from getting pregnant.

Besides implantation problems, the high blood sugar level interferes with the balance and levels of other hormones which are vital for the pregnancy process. It affects the levels of progesterone, oestrogen, and testosterone.

Women who have diabetes and are able to get pregnant naturally have to worry about other problems. The risk of birth defects is increased in mothers who have diabetes due to the high levels of glucose in the blood. The cells of the embryo get damaged with the excess glucose, and this harms the embryo leading to birth defects.

Women with diabetes usually face delivery complications and have to have a caesarean section. The surgery puts them at higher risk for infections. Due to their diabetes, healing of the incision is also slower.

Women with diabetes are at a higher risk of getting gestational diabetes. This is a type of diabetes that some women get, while they are pregnant. Their level of glucose in the blood is increased, and the insulin does not work very well. When gestational diabetes affects a woman, who does not have diabetes, she should not get worried, as gestational diabetes normally goes away on its own, after the delivery.

RISKS TO THE UNBORN BABY

When a woman has diabetes, and she wants to get pregnant, there are several concerns. Being able to get pregnant is the initial concern. The next concern is the effect it will have on the baby. What are the risks that the baby may suffer if the mother is diabetic? Some pregnancy risks are:

  • Macrosomia: This is a condition in which the baby grows larger than average. The big size of the baby affects a normal delivery, and the mother may have to have a Caesarean section.
  • Hypoglycaemia: is a condition characterised by low blood glucose. The high levels of insulin and a decreased glucose level can lead to hypoglycaemia during pregnancy.
  • Preeclampsia: Women with type 1 diabetes have a higher risk due to their condition of high blood pressure. Preeclampsia occurs around the 20th week of pregnancy. It can damage the liver and kidneys of the baby besides causing other problems such as blood clotting and fluid in the lungs.
  • Birth defects: If the blood sugar is not maintained in the safe range during pregnancy, it can cause birth defects in the baby. This can affect the normal development of the baby’s heart, spine, brain, kidneys, gastrointestinal tract etc. It can also lead to respiratory and heart problems in the baby.
  • Miscarriage: The risk of a miscarriage during the first 20 weeks is high when the mother has high blood sugar.

SUCCESS STORY ON INFERTILITY DUE TO DIABETES

I was diagnosed with type 1 diabetes at the age of 17. When I was 28, we began trying for a baby. I got pregnant several times but miscarried within a few weeks. After 4 miscarriages we decided to take a break for a year and then try again. By the time I was 30 and was not able to get pregnant during the first three months of trying. We went to Medicover for fertility help as I learnt that pregnancy with diabetes was very risky. The treatment we received at Medicover Fertility was excellent. We had a Prenatal Genetic Diagnosis test done to make sure that our baby does not get diabetes. The doctors stood by me and attended to all the complications ensuring that my baby would not get affected. Today we are proud parents of a healthy baby. – Savita

PRECAUTIONARY MEASURES TO BE TAKEN FOR PREGNANCY

Controlling the levels of insulin and blood sugar in the body is essential for women who want to get pregnant. Women who have Type I Diabetes do not produce any insulin at all and hence need to take insulin injections. This type of diabetes is not very conducive to pregnancy and can cause both the mother and baby harm.

Women with Type II Diabetes still produce some insulin in their pancreas. This type of diabetes is very common and also known as lifestyle diabetes as it is caused due to an unhealthy lifestyle. Maintaining healthy body weight and proper dietary habits can help to regulate insulin levels in the body. Women with Type II Diabetes can have a safer pregnancy with a regulated lifestyle.

Before getting pregnant, doctors advise women with diabetes–

  • Regulate their weight: Controlling blood sugar levels when you are not overweight is a lot easier if you want to get pregnant. Obese people are more prone to infertility.
  • Control HbA1C levels: It is advisable to get your HbA1C levels to at least 6.5 if you want to get pregnant.
  • Limit sugar intake: When you are planning to have a baby, to prepare your body for the upcoming pregnancy, you need to ensure that you limit your sugar intake for at least 3 to 6 months prior. The longer, the better.

Ensuring that you are in good health for your pregnancy is vital. Taking steps to keep your sugar levels in check and maintaining an overall good lifestyle is beneficial.

HOW CAN MEDICOVER FERTILITY HELP YOU TO DEAL WITH INFERTILITY DUE TO DIABETES?

Medicover Fertility is a fertility clinic that specialises in helping couples with their fertility issues. Due to diabetes, many men and women suffer from infertility problems. In most instances, they are either not able to conceive or not able to hold the pregnancy. With latest technology fertility treatment options, Medicover Fertility is able to address these medical problems and help couples where either one or both are suffering from diabetes to have a healthy baby.

Medicover has a large team of in-house specialised doctors who are highly qualified and widely experienced. The Medicover panel of doctors works in conjunction to diagnose specific problems pertaining to particular patients and create a case history which can be used to help them treat the specific problems which are preventing the couple from getting pregnant.

Related Questions:

Q) CAN YOU GET PREGNANT IF YOU HAVE DIABETES?

A) You can get pregnant, but there are health risks for both you and your baby. Constant monitoring by a doctor is advisable.

Q) CAN DIABETES CAUSE INFERTILITY IN MEN?

A) Diabetes does not cause infertility in men but can lead to a condition which may affect male fertility like erectile dysfunction, lowered sperm count, low testosterone and ejaculation problems.

Q) CAN DIABETES AFFECT YOUR SPERM COUNT?

A) Diabetes affects testosterone levels, which can reduce sperm count.

Q) CAN A MAN WITH DIABETES MAKE A WOMAN PREGNANT?

A) A man with diabetes can impregnate a woman. However, he may need some supportive treatment from the doctor.

Q) CAN DIABETES CAUSE INFERTILITY IN WOMEN?

A) Women with diabetes can get pregnant naturally but are at higher risk for miscarriages. In some cases, women are not able to get pregnant due to the uterus not supporting embryo implantation, leading to a miscarriage in the initial stages. If blood sugars are uncontrolled, various complications could arise, such as birth defects.

References

1. https://www.diabetes.co.uk/pregnancy-complications/infertility-in-men.html
2. 
https://www.ncbi.nlm.nih.gov/pubmed/19863473
3. 
https://www.diabetes.co.uk/pregnancy-complications/infertility-in-women.html
4. 
https://www.ncbi.nlm.nih.gov/pubmed/14614196ww.ncbi.nlm.nih.gov/pubmed/14614196