Male Reproductive Function in Patients with Diabetes Mellitus

Introduction: Diabetes mellitus (DM) affects a growing number of men in reproductive age. Diabetes can impair male reproduction, though changes on the hypothalamus-pituitarytesticular axis, it may cause sexual dysfunction and defective function of the male accessory glands. However, clinical data regarding sperm parameters and other aspects of reproductive function in diabetic patients are limited.
Objective: To evaluate the characteristics and bio-functional differences of sperm in diabetic patients.
Materials and methods: observational, comparative cohort study of diabetic patients with a history of infertility or subfertility, collecting their main bio-functional sperm
parameters, hormone levels and metabolic characteristics.
Results: A sample of 90 patients with DM, with an age of 40 ± 10 years (mean ± SD) and range between 20 and 60 years old, the highest percentage of patients being around 30 years old, with a time of infertility of 4.7 ± 4.2 years, and an average diabetic disease time of 9.8 years. Patient’s type 1 represented
36% of total and 63% had type 2 DM. Up to 62 % of patients had suffered from DM for more than 10 years. A total of 199 non-diabetic patients with infertility aged 37.7 ± 7.39 years were obtained as control group. Age and BMI were higher in the group of DM compared to controls. Patients with DM had a
significantly lower percentage of sperm with progressive motility, pH, sperm concentration and total sperm count per ejaculate, as well as a lower proportion of spermatozoa with normal morphology than controls. A negative correlation was observed among the number of diabetic complications and semen volume (R=-0.277, p <0.05). Biochemical parameters, such as triglycerides, cholesterol and gonadotropins did not show any significant differences, while creatinine was higher and testosterone was lower in the group of DM compared to control group.
Conclusion: Infertile patients with DM show a significant impairment of the main sperm parameters we compared with non-diabetic infertile patients. These findings may explain why patients with DM have frequent fertility disorders.