Larissa Telfer Dietitian
When it comes to fertility the focus tends to be on women’s health. However sperm is providing half of the DNA and genetic make up of an embryo, and is therefore a crucial part of making a healthy baby.
Type 1 and Type 2 diabetes have been shown to impact men’s fertility. Research looking into the quality of sperm in men with diabetes found that higher amounts of sperm with irregular DNA, this can impact embryo quality, lower implantation rates and in some cases childhood diseases.
Back to Basics
Let’s take a step back to the basics of male reproduction. The process of making sperm is called spermatogenesis. Men produce sperm in the testis where it is stored with seminal fluid until ejaculation.
The process takes around 3 months with testes producing approx. 100 million viable sperm daily. Spermatogenesis is sensitive to changes in the environment such as temperature, dietary deficiencies and oxidative stress, which can lead to DNA damage.
How does diabetes affect male fertility?
Sperm require glucose to provide them with the energy required to reach and implant an egg. Glucose crosses from the bloodstream into the testis, sperm are sensitive to high glucose levels that occur as a result of diabetes. Studies in mice with diabetes showed changes in the way glucose is transported into cells as a result of reduced insulin and high BGLs.
Men with diabetes have higher levels of inflammatory agents in the fluid around the sperm, which is linked to DNA changes in sperm. Optimising BGLs improves pregnancy outcomes by reducing inflammatory agents and therefore DNA damage.
Erectile dysfunction is a complication in men with diabetes long term and occurs as a result of long-term damage that occurs during long periods of high blood glucose levels (BGLs).
Is there a difference between Type 1 and Type 2 diabetes?
Type 1 diabetes is an autoimmune condition that results in the loss of insulin producing beta cells in the pancreas. Onset usually occurs earlier in life although can be diagnosed at any age. Research has shown that high BGLs in men with type 1 diabetes have reduced sperm volume and sperm motility.
Type 2 diabetes is caused by insulin resistance, usually as a result of lifestyle factors such as obesity, dietary habits and lifestyle. This is combined with reduction in insulin production resulting in high blood glucose levels. The chronic inflammation drives changes in sperm DNA and sperm vitality.
What can I do to optimise my chances of falling pregnant?
The first goal for men with any type of diabetes is to engage with your diabetes team to optimise your BGLs. This means checking in with your diabetes specialist and diabetes educator for a check up on your medications, your lifestyle and check you are up to date with the latest technology available for people with diabetes.
It is important to remember that the risk of these factors impacting fertility can be reduced with optimising BGL control.
How can a Dietitian assist men with diabetes and fertility?
A dietitian experienced in fertility and diabetes will be able to provide individualised nutrition plan to optimise your BGL control and nutrition to improve chances of a healthy pregnancy.
The research into the impact of healthy eating on sperm quality continues to build, with higher intakes of nutrients including selenium, zinc, omega-3s and CoQ10 showing benefits. Dietary patterns such as the Mediterranean diet and the DASH diet are also showing benefits for sperm quality.
If you know a man with diabetes please share this article as you just don’t know who might be trying to conceive.
Larissa is available for in person consultations in Geelong, telehealth consultations are available.
Wiebe, J. et. al. Fertility is reduced in women and men with type 1 diabetes: results from type 1 diabetes genetics consortium (T1DGC) Diabetologia, 2014, 57:2501-2504.
Condorelli, R. et. al. Diabetes Mellitus and infertility: different pathophysiology effects in type 1 and type 2 diabetes on sperm function. Froniters in Endocrinology, 2018, 9:1-9.
Salas-Huetos, A. et. al. Diet and sperm quality: Nutrients, foods and dietary patterns. Reproductive Biology, 2019.