This article is designed to discuss data on diabetic complications negatively affecting male fertility, such as retrograde ejaculation and secondary hypogonadismthat frequently occur in patients with diabetes mellitus. It has been shown that 5 - 10% of the DM1 patients present with retrogradeejaculation associated with long-term decompensation of carbohydrate metabolism. Over 40% of the patients with DM2 have decreased total andfree testosterone levels regardless of compensation of carbohydrate metabolism. These complications are managed using neurotropic therapy (retrogradeejaculation) and stimulatory hormonal therapy (secondary hypogonadism).

We examined 22 infertile patients with oligospermia to evaluate efficiency of hormonal therapy. All the patients were treated with clomiphene citrate or chorionic gonadotropin for 3 months and showed significant elevation of testosterone levels. Clomiphene therapy caused a statistically significant rise in the number of spermatozoa per 1 ml ejaculate and percentage of their morphologically intact forms coupled to insignificant improvement of sperm motility (A + B). Sexual partners of two patients reported being pregnant. Treatment with chorionic gonadotropin resulted in a significant rise in the number of spermatozoa per 1 ml ejaculate and insignificant increase in percentage of their morphologically normal forms. No improvement of (A + B) spermatozoon motility was documented. The partner of one patient developed pregnancy. Patients of either group with azoospermia failed to exhibit spermatozoa in the ejaculate after the treatment. It is concluded that the two therapeutic modalities are efficacious in terms of increasing the total number of spermatozoa. Their additional advantage is normalization of the total testosterone level. Moreover, therapy with clomiphene citrate brought about a rise in the number of morphologically adequate cells. However, neither modality produced beneficial effect in patients with azoospermia.