Diabetes is known to affect both men's and women's ability to conceive a baby. This is because diabetes is a condition that affects fertility and reproductive health in both genders by causing hormonal disruptions. These, in turn, can lead to delayed or failed implantation, which results in infertility. Moreover, diabetes is also associated with poor quality of sperm and DNA damage.

Diabetes and female infertility

Studies of the metabolic effects of type 1 and type 2 diabetes on the female reproductive system have shown that there is a relationship between diabetes and menstrual disturbances, such as delayed menarche, changes in the menstrual rhythm and potential consequences on fertility.

Here are the main ways diabetes affects a woman's fertility:

• Diabetic women are more susceptible to genitourinary infections that can lead to damage of their reproductive organs, especially their fallopian tubes.
    
• Diabetes typically causes tiredness, depression, and anxiety, which results in a decreased libido. Moreover, diabetic women may also experience less vaginal lubrication, which leads to pain and discomfort during sex.
    
• Pregnancy complications are common in women with diabetes, mostly because high blood glucose levels may lead to miscarriage or congenital defects in the fetus.
    
• Type 1 diabetes is associated with longer and heavier menstruation and anovulation, which is the absence of ovulation when it is normally expected.
    
• Type 2 diabetes often causes obesity, which is also associated with irregular menstrual cycles. Obesity may also cause polycystic ovarian syndrome (PCOS), which often results in irregular menstrual cycles and anovulation. Studies have shown that between 50 and 70% of women diagnosed with PCOS are also insulin resistant. 

Besides causing multiple issues when it comes to conceiving, abnormal glucose levels may also cause health concerns for both the mother and baby after conception. Type 1, type 2, and gestational diabetes all affect the health of the mother and baby, with the most common consequence of poor blood sugar control being the risk for miscarriage.

Moreover, uncontrolled gestational diabetes may lead to an increased risk for a C-section, an extra-large baby, preeclampsia, and hypoglycemia in the baby. Even though a couple of decades ago women with diabetes or uncontrolled blood sugar were told that being pregnant would not be safe, today it is possible to have a healthy child with medical support and by monitoring blood glucose levels within a safe range.

Diabetes and male infertility 

Diabetes also affects male fertility, typically via decreased libido and sexual dysfunction. One of the consequences of diabetes on the male reproductive system is the fact that it reduces the ability to maintain an erection, which leads to infertility. Moreover, the lack of glucose in certain areas of the brain may cause weakness, fatigue, and less sexual drive in men, which can also complicate plans of starting a family.

Diabetes is also associated with sperm DNA damage, which may impair the ability to conceive. Moreover, men who have been diagnosed with type II diabetes may also experience poor sperm concentration in semen and structural damage to the sperm and its DNA.

What are the main treatment options for infertility caused by diabetes?

Treating infertility with diabetes for both men and women involves enhanced control over blood sugars and reproductive hormones and functions. If you're experiencing fertility problems as a person who has been diagnosed with diabetes, you will typically work with an endocrinologist, who may suggest various treatment options such as oral medications and or insulin. Sometimes, your endocrinologist may also suggest associated treatment options such as weight loss surgery.

Infertility treatments may start with medications that treat sexual intercourse issues such as erectile dysfunction and premature ejaculation in men and stimulate ovulation or treat infections in women. Surgical management may be essential in cases of PCOS or uterine fibroids. In some cases, advanced reproductive technologies may be required to treat infertility in individuals diagnosed with diabetes. Sperm retrieval procedures for men and intrauterine insemination or in vitro fertilization for women are some examples of advanced reproductive technologies that may help people with diabetes conceive.

Pregnancy is possible with diabetes, but it requires good planning and sometimes treatment for both men and women. Pregnant women with diabetes are typically monitored not just by their gynecologist but also by an endocrinologist to make sure that their blood sugar levels are in a good range to maintain the pregnancy to full term.