Effects of diabetes mellitus on sperm quality and fertility outcomes: Clinical evidence

Abstract

Background: Diabetes mellitus is a global epidemic characterized by high morbidity and mortality. Diabetes mellitus can lead to acute and chronic systemic complications.Among them, a negative effect of diabetes mellitus on sperm quality and male/couple fertility has been suggested. However, available studies in diabetes mellitus men evaluated relatively small cohorts with discordant results.Objectives: To evaluate the clinical evidences of the effects of diabetes mellitus on sperm quality and fertility outcomes.Methods: An extensive Medline search was performed identifying studies in the English language.Results: The prevalence of diabetes mellitus in infertile men ranges from 0.7% to 1.4%, while the prevalence of infertility in diabetes mellitus men, evaluated in a few studies, ranges from 35% to 51%. Male diabetes mellitus seems to play a negative effect on couple fecundity, while being childless or subfertile men might increase the risk of diabetes mellitus. Available cross-sectional studies investigating semen parameters and male sexual hormones in men with diabetes mellitus are heterogeneous, assessed relatively small cohorts, show often discordant results and frequently are not directly comparable to derive robust conclusions. Two meta-analyses support a negative effect of diabetes mellitus on sperm normal morphology and no effect on sperm total count, with contradictory results regarding other semen parameters. Considering only studies on type 1 diabetes mellitus men, meta-analyses support a negative effect of diabetes mellitus on sperm motility and no effect on sperm total count, with contradictory results regarding other semen parameters. The rate of children observed among type 1 diabetes mellitus men was lower than controls, especially in subjects with a longer diabetes mellitus duration. Couples with a diabetes mellitus male partner undergoing assisted reproduction techniques showed lower pregnancy rates than controls. No study evaluated the impact of diabetes mellitus treatment on semen quality and male fertility. Conclusions: Overall, available data show that diabetes mellitus might impair male reproductive health and couple fertility. However, further larger and full of details studies are needed.

Not only a matter of glucose: The andrological consequences of diabetes mellitus

“…In contrast with the evidence on the hormonal and sexual adverse effects of DM, that on the impact of this highly prevalent chronic disease on fertility is much less consistent. Lotti et al extensively reviewed the clinical studies, which report the relationship among DM, sperm quality, and fertility outcomes, 21 pointing out not only the adverse effect of DM on fertility but also the increased risk of diabetes among childless men.…”

“…Lotti et al. extensively reviewed the clinical studies, which report the relationship among DM, sperm quality, and fertility outcomes, 21 pointing out not only the adverse effect of DM on fertility but also the increased risk of diabetes among childless men.…”

Causal relationship between genetically predicted type 2 diabetes mellitus and male infertility

“…However, some studies have reported that the prevalence of infertility in males with DM ranges from approximately 35%-51%. DM in males appears to exert a discernible adverse impact on the fertility of couples, wherein the status of being childless or subfertile in males may be associated with an elevated risk of developing DM ( 9 ). Recent studies have brought to light a substantial correlation between DM and sexual dysfunctions ( 3 , 10 ), specifically, erectile ( 3 , 11 ) and ejaculatory dysfunctions ( 12 ) as well as hypogonadism ( 11 ).…”

“…Recent studies have brought to light a substantial correlation between DM and sexual dysfunctions ( 3 , 10 ), specifically, erectile ( 3 , 11 ) and ejaculatory dysfunctions ( 12 ) as well as hypogonadism ( 11 ). Available data underscores the evident roles that DM plays in impairing male reproductive organs, thereby influencing overall couple fertility ( 9 , 13 ). Therefore, it is well known that the low fertility rate of DM patients in humans.…”

Therapeutic Potential of 4-Hexylresorcinol in Preserving Testicular Function in Streptozotocin-Induced Diabetic Rats

“…Type 1 DM has been found to contribute to significant alterations in male gonadal physiology in both experimental models and clinical cases [2]. According to meta-analyses conducted on studies focusing exclusively on men with type 1 DM, there is evidence supporting a detrimental effect of diabetes on sperm motility [5]. Type 1 DM individuals exhibit a significantly higher prevalence of immaturity-and apoptosis-related defects in spermatozoa compared to the control group, suggesting an association with impaired spermatogenesis that could potentially impact male fertility [6].…”