We studied the semen quality and plasma testosterone levels (T) in 32 adolescent patients with insulin-dependent diabetes mellitus and in an aged-matched control group. Semen volume, motility and morphology were significantly lower in diabetics whereas seminal fructose and glucose were significantly higher. Even though the sperm count was lower in these adolescent diabetics, the difference was not significant when compared to the control group. No difference was observed in plasma testosterone levels. Patients were divided into two groups according to the presence of retinopathy and neuropathy, and degree of metabolic control. Spermiogram parameters, seminal fructose and glucose were lower in diabetics with neuropathy. No difference was observed in spermiogram parameters between diabetic patients with or without retinopathy, but seminal fructose, and glucose were lower in the former. All spermiogram parameters, as well as seminal fructose were lower in diabetics with poor metabolic control but seminal glucose was higher. No correlation was detected between clinical parameters (age at onset and duration of diabetes mellitus and time since first ejaculation), semen parameters, plasma T, glycemia and glycosuria. In conclusion, a deterioration of the quality of human semen occurs in adolescent diabetic patients. Neuropathy and poor metabolic control seem to be important factors of this deterioration. The presence of retinopathy does not correlate with T and semen quality.

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We studied 19 male patients with primary hyperlipoproteinaemia, a control group of 28 healthy men and 44 infertile males before any treatment was undertaken. Spermiogram, seminal biochemical studies, measurements of plasma hormone levels and lipid determinations were carried out. Most hyperlipoproteinaemic patients showed abnormalities in the spermiograms and the mean values were lower than in the controls except for semen volume. Seminal biochemical determinations were normal in the majority and the hormone profile showed some abnormal values, mainly for E2. Lipid abnormalities were more common in azoospermic infertile men and mean lipid levels were higher. Correlation studies suggest that high levels of C and/or Tg are associated with poor semen quality and higher FSH levels. The results of our studies suggest that high lipid levels exert adverse direct effects at the testicular level.