Diabetes Impact on Reproductive Health
Glucose is the body’s main energy source. Insulin, a glucose-absorbing hormone produced by the pancreas, normally regulates glucose demand and blood glucose levels. When glucose intake is properly controlled, the body’s glucose levels stay within a healthy range. Otherwise, the individual may exhibit signs or symptoms of diabetes or impaired glucose tolerance.
Diabetes is a disease that occurs when the pancreas either does not produce enough insulin (Type I diabetes) or does not function correctly (Type II diabetes) (Type 2 diabetes). According to the WHO, diabetes affects more than 180 million people globally. Type 1 diabetes is growing at an alarming rate of 3% each year worldwide.
Diabetes and female infertility:
Systematic studies of the metabolic effects of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) on the hypothalamus–pituitary–ovary (HPO) axis have revealed a link between these diseases and menstrual disturbances such as delayed menarche (puberty), alterations in the menstrual rhythm (including primary and secondary amenorrhoea), and potential fertility implications (successful full-term gestation and childbirth).
What is the impact of diabetes on fertility?
Diabetes makes diabetic women more vulnerable to infection and damage to reproductive organs, especially the fallopian tubes, as a result of genitourinary infections.
High blood glucose levels during pregnancy may result in a miscarriage or congenital defects in the foetus. High blood glucose levels and heavy feeding of the developing foetus induce macrosomia (big baby syndrome).
Reduced libido: Most diabetic women have decreased sexual desire as a result of tiredness, despair, and anxiety. Due to a lack of vaginal lubrication, women may feel pain and discomfort during intercourse.
What effect does type 1 diabetes have on female fertility?
Menstrual cycle disruptions and menarche: Type 1 diabetes is associated with a longer menstrual cycle (>31 days), longer menstruation (>6 days), heavier menstruation, and menstrual problems beginning at a young age (29 years). In children with type 1 diabetes, menarche is delayed.
Anovulation is described as the absence of ovulation when it should occur (in a post-menarche, premenopausal woman). Anovulation may be caused by a variety of factors such as severe mental illness, hormonal abnormalities, pituitary or ovarian malfunction, and diabetes. Diabetes in women with a low BMI causes irregular periods, which leads to cell deprivation (intracellular starvation). This may impede hypothalamic pulsatile secretion of gonadotropin-releasing hormone (GnRH), resulting in decreased gonadotropin secretion. This results in a decrease in luteinizing hormone (LH) and prolactin levels, both of which are essential in reproduction.
Anti-sperm antibodies: Diabetes-related antibodies have the potential to damage sperm and eggs.
What effect does type 2 diabetes have on female fertility?
PCOS, diabetes, and obesity: Type 2 diabetes is more prevalent in postmenopausal women, but obesity is on the increase as a result of contemporary eating and lifestyle practises, increasing the risk of Type 2 diabetes throughout the reproductive years.
Obesity has been linked to Polycystic Ovarian Syndrome and irregular menstrual periods (PCOS). This metabolic disease is characterised by an excess of androgens (male hormones), cysts on the ovaries, and irregular menstrual cycles/lack of ovulation. Insulin resistance affects 50-70 percent of PCOS women.
Adiponectin is a fat-burning hormone that improves insulin sensitivity. In women with PCOS, lower levels of adiponectin induce insulin resistance and fat breakdown. As a consequence, PCOS coexists with diabetes and obesity, presenting a three-pronged threat to reproductive health and fertility.
Losing weight via a healthy diet and exercise regimen is the most effective approach for addressing insulin resistance, increasing fertility, and preventing Type 2 diabetes and its consequences.
Diabetes and male infertility: How can diabetes affect male fertility?
Diabetes affects men’s ability to sustain an erection, which leads to infertility.
Reduced libido: In males, a shortage of glucose (the brain’s main source of energy) in certain regions of the brain may cause fatigue, weakness, and a reduction in sexual desire.
What effect does type 1 diabetes have on male fertility?
Diabetes is associated with increased nuclear, mitochondrial, and DNA damage in sperm, which may impair men’s reproductive ability.
What impact does type 2 diabetes have on male fertility?
Sperm purity: Low sperm concentration and motility have been related to type 2 diabetes. Structure damage to the sperm and its DNA has also been found in type 2 diabetics.
Diabetes and infertility treatment: Treating infertility with diabetes necessitates improved blood sugar control (glycemic control), reproductive hormones, and functions in both men and women. Infertility is often diagnosed and treated by jointly reviewing the couple’s medical and family history.
Medication and Advanced Reproductive Technologies (ART) are used to treat infertility and effectively conceive a child.
Medical supervision is required when using medications to promote ovulation in women, cure infections, and treat sexual intercourse problems such as erectile dysfunction and premature ejaculation in males to treat infertility. Hormone supplements may or may not be utilised in conjunction with the therapy.
Surgical therapy: In many instances of PCOS, uterine fibroids, and severe injuries, surgical treatment is needed.
Future reproductive technology:
Male sperm retrieval procedures (such as microTESE) and intracytoplasmic sperm injection.
Women have the option of intrauterine insemination, assisted laser hatching, and in vitro fertilisation.
Diabetes and pregnancy are both feasible; all it needs is some thinking and planning. A team of endocrinologists, gynaecologists, and andrologists monitors your blood sugar levels to guarantee that you can conceive and bring your pregnancy to term. Understanding and minimising the risks associated, eating properly, striving toward your ideal weight, and adhering to your healthcare team’s recommendations are the keys to success. If there are no option to conceive pregnancy, you can consult with the best IVF doctor in Delhi at World IVF Centre.