(pdf) Diabetes Mellitus And Infertility: Different Pathophysiological Effects In Type 1 And Type 2 On Sperm Function
Male infertility is increasing in recent decades, affecting 7% of males during their reproductive life. The standard semen analysis remains widely used, specifically sperm concentration, motility, viability, and normal sperm morphology. However, this analysis is limited in clinical usefulness without information of the functional capacity of the spermatozoa. Increased DNA fragmentation in spermatozoa is associated with over 80% of male infertility cases. Numerous pathologies associated with male infertility have a detrimental effect on spermatozoa chromatin condensation and DNA integrity through the spermatogenesis pathways, epididymal maturation, and post-ejaculations. Spermatozoa DNA damage is the consequence of modifications of the molecular structure of the DNA, causing structural changes in the DNA that prevents replication mechanisms from optimal functioning. The determination of DNA fragmentation or damage in spermatozoa has emerged as a stable parameter with lower variability and better predictability for infertility, pregnancy complications, and health outcomes of the offspring. Mechanisms of DNA modifications include chemical modification of bases such as 8-oxo-2-doxyguanosine (8-OHdG), single-strand breaks, double-strand breaks, base missing from the DNA backbone, modifications in purine, pyrimidine, and deoxyribose, introduction of a basic sites, and DNA cross-linking. Origins of DNA damage include endogenous causes, predominantly associated with ROS. Exogenous DNA damage is caused by radiation, genital heat stress, toxins, or mutagenic exposure. Pathology and risk factors associated with causing DNA fragmentation include varicocele, scrotal hyperthermia, genital tract infections and leukocytospermia, poor lifestyle habits, obesity and diabetes, environment Continue reading >>
Diabetes And Male Infertility: What Are The Concerns?
Diabetes is a worldwide epidemic with significant impacts on multiple aspects of men's health. 3.5 in every 1000 reproductive aged men (18-45 years old) in the United States are living with diabetes 1. While it is true that many Americans are aware of diabetes' impact on cardiovascular, renal, ophthalmologic, and neurologic health, many do not know that it can also negatively impact fertility. This occurs through a number of ways including: erectile dysfunction, ejaculatory dysfunction, hypogonadism and semen abnormalities. Diabetes is a well-known risk factor for developing erectile dysfunction. Diabetes affects the nerves and blood vessels throughout the body, including those that supply the penis. Damage to the nerves can cause decreased sensation and arousal, while the decreased blood flow to the penis can lead to difficulty achieving or maintaining erections firm enough for a satisfactory sexual encounter 2. Solutions for men suffering from erectile dysfunction are wide and varied, and the first line treatments are oral medications called PDE 5 inhibitors (Cialis, Levitra, Stendra, Viagra). These medications help relax the smooth muscle in the penis, thereby increasing the blood flow and allowing for erections. If oral medications fail, patients may be offered intracavernosal injections, intraurethral suppositories, vacuum erectile devices with constricting bands, and penile prosthesis surgery 3. Ejaculatory dysfunction is another problem encountered among men with diabetes. Normal ejaculation is essential to allow for deposition of semen into the female reproductive tract, where male sperm can then fertilize a female egg. Damage to the nerves from long standing diabetes can cause a failure of the mechanism that propels sperm forward. This can allow sperm to go bac Continue reading >>
Diabetes May Affect Men's Fertility
May 2, 2007 -- Men with type 1 diabetes may have more DNA damage in their sperm, possibly hampering fertility, a preliminary study shows. The study was small and doesn't prove that type 1 diabetes causes male infertility. But the findings deserve further research, write the researchers, who are based in Belfast, Northern Ireland. They included Ishola Agbaje, MD, of the Reproductive Medicine Research Group at Queen's University of Belfast. Agbaje and colleagues studied semen and blood samples from 27 men with type 1 diabetes. Those men weren't necessarily infertile; they were invited to participate in the study while getting routine diabetes checkups. For comparison, the researchers also studied semen and blood samples from 29 men without diabetes who were undergoing infertility tests. Both groups of men were in their early to mid-30s, on average. The men with diabetes had lower semen volume than the men without diabetes. But the diabetes patients' semen volume was still within the normal range set by the World Health Organization (WHO). Sperm count, shape, and motion (motility) were similar in both groups of men. But when the researchers analyzed the sperms' DNA, they found more DNA damage in the diabetes patients' sperm. Sperm damage may increase infertility, note the researchers. Many factors can cause DNA damage. It's not clear whether diabetes was responsible for the DNA damage seen in the study. The study didn't include any men without diabetes who weren't undergoing infertility tests. Such men might have even less DNA damage in their sperm than the study groups, the researchers note. Agbaje's team calls for further studies on DNA sperm damage -- and its possible fertility consequences -- in men with type 1 diabetes. The study appears online in the journal Human Re Continue reading >>
Diabetes And Infertility: When Blood Sugar Control Isn’t Enough
An excerpt from the book, Balancing Pregnancy With Pre-Existing Diabetes: Healthy Mom, Healthy Baby. Maybe your blood sugars have been great and you’ve been having ongoing sex with your partner. But if you’re still not pregnant after six to twelve months of trying, you’re considered infertile. Dealing with infertility and diabetes can feel like an energy-draining double whammy of health issues, but you’re not alone. There’s a definite group of women with diabetes who require even more maintenance and medical specialists to figure out why, once again, their bodies aren’t doing what seems to come naturally for everyone else. What’s Going On? Infertility is an inability to get pregnant. You are considered infertile after a year of actively trying to conceive (i.e., having unprotected sex around the time you ovulate) if you are younger than 35, and after six months if you’re 35 or older, or if you have a history of many miscarriages. The timeframe is key: It can take some fertile couples that long to conceive naturally, while older women are advised to seek help sooner since fertility declines rapidly with age. About 10 to 15 percent of all couples experience infertility. Of those, about 40 to 50 percent are caused by female infertility, while another 30 to 40 percent are caused by male infertility. The rest are either a combination of male and female factors, or are simply unexplained as one of life’s many mysteries. Several factors can lead to infertility, according to the national infertility association RESOLVE: age, weight, sexually transmitted diseases (STDs), Fallopian tube disease, endometriosis, exposure to a chemical known as Diethylstilbestrol (DES), smoking, and alcohol use. Diabetes and Infertility: Are They Related? While all the above are ge Continue reading >>
Diabetes | Your Fertility
Diabetes only affects people who are overweight Diabetes can affect anyone, regardless of weight. Eating a healthy diet and regular exercise is important for everyone to help control blood sugar levels. When diabetes is not well-controlled, it can affect the chance of having a baby. In women, diabetes can result in irregular or absent menstrual cycles, while in men it can cause problems getting and maintaining erections and lower levels of testosterone (the male hormone). It can also increase the risk of miscarriage and stillbirth, caesarean section and the baby needing intensive care after birth. can help menstrual cycles become more regular reduces the risk of having a very large baby, and the baby requiring intensive care after birth reduces the risk of congenital disorder (a health problem that starts at birth) reduces the risk of stillbirth and neonatal death The good news is diabetes can be managed to control blood sugar levels. This involves regular monitoring of blood sugar levels, eating a healthy diet, regular physical activity, being in the healthy weight range, reducing stress and anxiety, and quitting smoking. Medication may also be needed. Your doctor can help you with the right information and accessing the support you need. Ideally, it is best to try for a baby when the diabetes is well-controlled and there are no other health problems. This will reduce diabetes-related risks during pregnancy. Visit your doctor (GP) or diabetes specialist as soon as you start thinking about having a baby; around 3 to 6 months before you start trying. It is recommended that women with type 1 or type 2 diabetes start taking high dose folic acid (2.5-5mg daily) at least one month before pregnancy and throughout the first trimester. If you do become pregnant, see your docto Continue reading >>
Fertility Issues In Women With Diabetes.
Abstract Diabetes mellitus Type 1 and Type 2 should be considered in the differential diagnosis of menstrual abnormalities and infertility. The reproductive period of diabetic women may be reduced due to delayed menarche and premature menopause. During the reproductive years, diabetes has been associated with menstrual abnormalities, such as oligomenorrhea and secondary amenorrhea. It was found that better glycemic control and prevention of diabetic complications improves these irregularities and increases fertility rates close to those that are seen in the general population. Women with persistent menstrual abnormalities despite adequate treatment need to be approached by broader evaluation, which will include the examination of the hypothalamic-pituitary-ovarian axis and the hormonal status, presence of autoimmune thyroid disease and antiovarian autoantibodies, and hyperandrogenism. Continue reading >>
Diabetes Mellitus And Infertility: Different Pathophysiological Effects In Type 1and Type 2 On Sperm Function.
1. Front Endocrinol (Lausanne). 2018 May 25;9:268. doi: 10.3389/fendo.2018.00268.eCollection 2018. Diabetes Mellitus and Infertility: Different Pathophysiological Effects in Type 1and Type 2 on Sperm Function. Condorelli RA(1), La Vignera S(1), Mongio LM(1), Alamo A(1), Calogero AE(1). (1)Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy. Although the prevalence of sub-infertility in diabetic patients in childbearingage is known, the mechanisms by which diabetes mellitus (DM) causes maleinfertility are not completely explained. This detrimental effect is achievedwith a variety of mechanisms that include pre-testicular, testicular, andpost-testicular pathogenetic moments and can be different in type 1 diabetesmellitus (DM1) and type 2 diabetes mellitus (DM2) patients because of type ofdiabetes, duration of disease, and glycemic metabolic compensation. Aim of thisstudy was to evaluate whether diabetic disease can be considered a risk factorfor infertility considering the etiopathogenetic differences between DM1 and DM2 on sperm function. We enrolled 38 DM1 patients and 55 DM2 patients withidiopathic infertility history >12 months, and 100 healthy fertile subjects. The following outcomes were evaluated in optical microscopy and flow cytometry: spermfunction (by conventional and biofunctional sperm parameters) and signs ofurogenital infection/inflammation (by sperm leukocyte concentrations and indices of oxidative stress). Moreover, an andrological evaluation (by didymo-epididymal ultrasound evaluation, serum total testosterone, LH, and FSH measurements) wasperformed in DM1 and DM2 patients compared to controls. Diabetic patients showed a higher risk of becoming infertile and the pathophysiological mechanisms ofdamage were different in Continue reading >>
Diabetes Mellitus: A New Cause Of Male Infertility
Rosita Angela Condorelli, Sandro La Vignera, Rossella Cannarella, Laura Maria Mongioì & Aldo Eugenio Calogero Introduction: Diabetes mellitus (DM) may cause male infertility acting with pre-testicular, testicular and post-testicular mechanism. Aim: To evaluate the presence of male infertility and the mechanisms of sperm damage in diabetic patients in childbearing age. Patients and methods: Thirty-four patients with DM1, 55 with DM2 and 100 healthy fertile men (controls) were enrolled. Diabetic patients were further divided into three groups based on their glycometabolic status and illness duration. Conventional and biofunctional sperm parameters were evaluated by standard semen analysis and flow cytometry. This latter included sperm DNA fragmentation, vitality, early and late apoptosis, chromatin condensation, mitochondrial membrane potential (MMP), leukocyte subpopulations, lipid peroxidation (PL) and sperm mitochondrial superoxide. In addition, all patients and controls underwent testicular ultrasound sca and serum LH and testosterone measurements. Results: Diabetic patients had lower sperm concentration, progressive motility and morphology vs controls (P<0.05). The ejaculate volume is significantly lower in patients with DM1 vs controls (P<0.05). Leukocyte concentrations were higher in patients with DM2 (P<0.05), showing a statistically significant reduction in the percentage of T helper cells and an increase of the suppressor T lymphocytes compared to controls (P<0.05). The analysis of the biofunctional sperm parameters showed worsening MMP in diabetic patients (P<0.05). Patients with DM2 showed a significant decrease in the degree of sperm vitality and increased spermatozoa in late apoptosis vs Controls and of the DNA fragmentation compared to the other two groups Continue reading >>
Diabetes Mellitus And Infertility
Abstract It has long been thought that diabetes mellitus may impair female fertility (Macnaughton 1976). However, objective data are lacking (Sobel et al. 1986). Nonetheless it is likely that the introduction of insulin therapy has improved fertility by decreasing the incidence of amenorrhoea in diabetic women (Gilbert and Dunlop 1949). Certainly prior to the introduction of insulin in 1923, amenorrhoea was common among women with uncontrolled diabetes and accounted for the very low fertility rates observed at that time (Skipper 1933). Preview Unable to display preview. Download preview PDF. Continue reading >>
High Blood Sugar And Male Infertility
This article is republished from A ndrology Australia . In healthy people, the pancreas (a small gland in the body) releases the hormone insulin to control blood sugar levels after eating a meal. When blood sugar levels are not properly controlled and become too high this is called hyperglycaemia. High blood sugar levels are linked to an unhealthy lifestyle, particularly being overweight, having a poor diet and a lack of exercise. Our genetics also play a major role. When hyperglycaemia reaches a certain level and persists, the condition becomes type 2 diabetes. Type 2 diabetes happens when the pancreas can no longer produce enough insulin to control blood sugar levels, or the body becomes resistant to insulin so it stops working. Diabetes can cause many serious health conditions if not properly managed. Pre-diabetes is a condition where the body cant properly process sugars. In pre-diabetes blood sugar levels are higher than normal but not high enough to be called type 2 diabetes and is sometimes called impaired glucose tolerance. Pre-diabetes, which can occur without any symptoms, increases the risk of developing type 2 diabetes and heart disease. Lifestyle factors and/or having a family history of diabetes are usually the cause of pre-diabetes. How does diabetes affect male sexual and reproductive health? Diabetes can damage blood vessels and nerves, and increase risk of infection, especially when not well controlled. As a result, diabetes is associated with a range of sexual problems including erectile dysfunction, decreased sex drive (libido), ejaculation problems and inflammation of the foreskin (balanitis). The rate of pre-diabetes and diabetes is increasing among young people so any harmful effect on fertility is a huge health concern. It is already known that Continue reading >>
Infertility In Women
Tweet Diabetes is associated with lower rates of fertility. There are a number of reasons which can play a part including, obesity, being underweight, having diabetic complications, having PCOS and having an autoimmune disease. With this said, many women with diabetes are able to conceive, particularly if diabetes is well controlled and a healthy body weight is maintained. Conditions The following conditions are associated with reduced fertility rates: Polycystic ovary syndrome (PCOS) Oligomenorrhea (irregular periods) Secondary amenorrhea (absent periods) Premature menopause (premature ovarian failure) Endometrial cancer (uterine cancer) Microvascular and cardiovascular complications Polycystic ovary syndrome (PCOS) PCOS is a common condition in which a large number of cysts develop on the ovaries. Whilst this feature does not in itself pose a health risk, it can reduce fertility. Women with PCOS have higher than normal levels of testosterone (hyperandrogenism). PCOS can affect fertility by leading to irregular periods (oligomenorrhea) or absent periods (secondary amenorrhea). The condition can be treated through making lifestyle changes, while medications such as clomifene and metformin can help with improving the chances of conception. PCOS is particularly associated with obesity and type 2 diabetes. People with type 1 diabetes that are taking high amounts of insulin daily may also be at risk of or suffer from PCOS. Oligomenorrhea and secondary amenorrhea Oligomenorrhea is the term for irregular periods that arrive at intervals of 35 days or more between each period. Secondary amenorrhea is said to occur if you have previously had a normal menstrual cycle but have stopped getting a periods for 6 months or longer. Both type 1 diabetes and type 2 diabetes are associate Continue reading >>
Infertility In Women
Tweet Diabetes is associated with lower rates of fertility. There are a number of reasons which can play a part including, obesity, being underweight, having diabetic complications, having PCOS and having an autoimmune disease. With this said, many women with diabetes are able to conceive, particularly if diabetes is well controlled and a healthy body weight is maintained. Conditions The following conditions are associated with reduced fertility rates: Polycystic ovary syndrome (PCOS) Oligomenorrhea (irregular periods) Secondary amenorrhea (absent periods) Premature menopause (premature ovarian failure) Endometrial cancer (uterine cancer) Microvascular and cardiovascular complications Polycystic ovary syndrome (PCOS) PCOS is a common condition in which a large number of cysts develop on the ovaries. Whilst this feature does not in itself pose a health risk, it can reduce fertility. Women with PCOS have higher than normal levels of testosterone (hyperandrogenism). PCOS can affect fertility by leading to irregular periods (oligomenorrhea) or absent periods (secondary amenorrhea). The condition can be treated through making lifestyle changes, while medications such as clomifene and metformin can help with improving the chances of conception. PCOS is particularly associated with obesity and type 2 diabetes. People with type 1 diabetes that are taking high amounts of insulin daily may also be at risk of or suffer from PCOS. Oligomenorrhea and secondary amenorrhea Oligomenorrhea is the term for irregular periods that arrive at intervals of 35 days or more between each period. Secondary amenorrhea is said to occur if you have previously had a normal menstrual cycle but have stopped getting a periods for 6 months or longer. Both type 1 diabetes and type 2 diabetes are associate Continue reading >>
Diabetes Mellitus And Infertility: Different Pathophysiological Effects In Type 1 And Type 2 On Sperm Function
Diabetes Mellitus and Infertility: Different Pathophysiological Effects in Type 1 and Type 2 on Sperm Function Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy Edited by: Marc Yeste, University of Girona, Spain Reviewed by: Reecha Sharma, Saint Josephs University, United States; Ellis Fok, The Chinese University of Hong Kong, Hong Kong *Correspondence: Rosita A. Condorelli, [email protected] , [email protected] Specialty section: This article was submitted to Reproduction, a section of the journal Frontiers in Endocrinology Received 2018 Feb 1; Accepted 2018 May 8. Copyright 2018 Condorelli, La Vignera, Mongio, Alamo and Calogero. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. This article has been cited by other articles in PMC. Although the prevalence of sub-infertility in diabetic patients in childbearing age is known, the mechanisms by which diabetes mellitus (DM) causes male infertility are not completely explained. This detrimental effect is achieved with a variety of mechanisms that include pre-testicular, testicular, and post-testicular pathogenetic moments and can be different in type 1 diabetes mellitus (DM1) and type 2 diabetes mellitus (DM2) patients because of type of diabetes, duration of disease, and glycemic metabolic compensation. Aim of this study was to evaluate whether diabetic disease can be considered Continue reading >>
Diabetes Mellitus/male Infertility.
Abstract Diabetes mellitus (DM), associated with very subtle disorders, affects, either directly or indirectly, various functions of the reproductive system. Adequate, regular, and timely therapy may prevent or delay these disorders. The T synthesis disorder is caused by molecular changes at the level of Leydig cells and may lead to other disorders in all target organs and tissues. The close correlation between Leydig and Sertoli cells function, i.e., between spermatogenesis and second sex glands function, results in certain anomalies in diabetic patients' spermiograms. Parallel lesions associated with DM, through CNS (hypothalamus-hypophysis), and endocrine profile are indirectly intensified or induced by these disorders, which reflect dysfunction of homeostatic balance in carbohydrate metabolism. Sexual dysfunction in all its forms (reduced erection, impotence, and other libido dissociations) is an accompanying phenomenon of the diabetic disease. However, manifestations of these disorders are related to the regulation of carbohydrate metabolism and to the duration of disease. The duration of disease is not necessarily correlated with sexual dysfunction. Even carbohydrate metabolism remains within normal range in addition to other lesions, diabetes leads gradually but progressively to premature aging of body cells. Continue reading >>
Fertility Issues In Women With Diabetes
Diabetes mellitus Type 1 and Type 2 should be considered in the differential diagnosis of menstrual abnormalities and infertility. The reproductive period of diabetic women may be reduced due to delayed menarche and premature menopause. During the reproductive years, diabetes has been associated with menstrual abnormalities, such as oligomenorrhea and secondary amenorrhea. It was found that better glycemic control and prevention of diabetic complications improves these irregularities and increases fertility rates close to those that are seen in the general population. Women with persistent menstrual abnormalities despite adequate treatment need to be approached by broader evaluation, which will include the examination of the hypothalamicpituitaryovarian axis and the hormonal status, presence of autoimmune thyroid disease and antiovarian autoantibodies, and hyperandrogenism. Diabetes is a disease that affects millions of people and their families. The WHO estimates that more than 180 million people worldwide have diabetes. This number is likely to more than double by 2030.[ 1 ] Type 1 diabetes, which predominately affects youth, is rising alarmingly worldwide, at a rate of 3% per year. Some 70,000 children aged 14 and under develop Type 1 diabetes annually. Type 2 diabetes is also increasing in number among children and adolescents as obesity rates in this population continue to soar, in both developed and developing nations.[ 101 ] Diabetes affects women in many ways, and one of them will be the focus of the present review the association between diabetes mellitus and infertility ( Box 1 ). Table 1. Standardized fertility ratios among women hospitalized for Type 1 diabetes at 16 years of age, stratified by type of complications (19652004, Sweden). SFR for Type 1 diabet Continue reading >>
