Diabetes Mellitus and Infertility: Different Pathophysiological Effects in Type 1 and Type 2 on Sperm Function

Area of Science:

• Reproductive Medicine
• Endocrinology
• Urology

Background:

• Diabetes mellitus (DM) is linked to male sub-fertility, but specific pathogenic mechanisms differ between type 1 (DM1) and type 2 (DM2) diabetes.
• Understanding these differences is crucial for assessing DM as a male infertility risk factor.

Purpose of the Study:

• To investigate whether diabetes mellitus is a risk factor for male infertility.
• To compare the etiopathogenetic mechanisms of infertility in DM1 and DM2 patients concerning sperm function.

Main Methods:

• Enrolled 38 DM1 patients, 55 DM2 patients with idiopathic infertility, and 100 healthy fertile controls.
• Evaluated sperm function (conventional and biofunctional parameters), urogenital infection/inflammation markers (leukocyte counts, oxidative stress), andrological parameters (ultrasound, testosterone, LH, FSH) via microscopy and flow cytometry.

Main Results:

• Diabetic patients exhibited a higher infertility risk compared to controls (p < 0.05).
• DM2 patients showed inflammation and oxidative stress, leading to reduced sperm vitality and increased DNA fragmentation.
• DM1 patients presented with altered epididymal function, low ejaculate volume, and mitochondrial damage impacting sperm motility.

Conclusions:

• Diabetes mellitus is a significant cause of male infertility, with distinct pathophysiological pathways in DM1 and DM2.
• Preventive strategies for DM2 and regular seminal parameter monitoring for DM1 patients may help preserve fertility.