Diabetes and Fertility

In the past three decades, the number of people in the UK diagnosed with diabetes has increased from 1.4 million to 3.9 million. Diabetes.co.uk estimates there are likely to be close to a further one million living with undiagnosed diabetes, bringing the total estimate to over 4.8 million. This represents 6% of the population or one in every 16 people. Type 2 diabetes accounts for around 90% of cases, with Type 1 representing only 10%. Does diabetes affect fertility? Yes, both Type 1 and Type 2 diabetes can affect male fertility and female fertility.

In this article, we examine the issues around diabetes and fertility, including:

• What are the signs of diabetes?
• How do Type 1 diabetes and Type 2 diabetes affect fertility?
• If you have diabetes, how can you improve your chances of conception and healthy pregnancy?

What are the signs of diabetes?

The early warning signs of Type 1 diabetes can be quite sudden and severe, while for Type 2 diabetes, they come on slowly and may be mild. Both are associated with hunger, thirst, tiredness and a need to urinate frequently.

• Feeling hungrier than normal
• Feeling tired
• Feeling very thirsty
• Feeling dehydrated
• A dry mouth
• Itchy skin

Hunger is a symptom of both types of diabetes because your body cannot convert the food you eat into glucose to provide you with energy. Without glucose, you may feel hungrier and more tired than normal.

Thirst is also a symptom of both types of diabetes because your kidneys need to make more urine to get rid of the excess glucose. You can become dehydrated, constantly thirsty, and as a result, need to go to the toilet more frequently.

Despite drinking lots of fluids, you can become dehydrated. A dry mouth and itchy skin are also common symptoms.

Unintended weight loss, nausea and vomiting characterise Type 1 diabetes, while yeast infections, pain or numbness in the feet or legs and an inability to heal minor injuries as quickly as normal characterise Type 2 diabetes.

How does diabetes affect fertility?

If diabetes is not well managed, it can have a negative impact on fertility for both men and women. There is a widespread assumption that diabetes, especially Type 2, is always associated with obesity and that obesity causes fertility problems. While it is true that Type 2 diabetes is often accompanied by obesity, the cause of any diabetes-related infertility is not so simple. The leading cause of impaired fertility is the hormonal disruption the disease causes. This hormonal disruption can damage DNA and has been associated with an increased risk of congenital abnormalities and impaired egg, sperm and embryo quality.

Diabetes and fertility for women

For women, diabetes can make it difficult to conceive because of absent or irregular menstrual cycles. There is also a higher risk of miscarriage, which can often occur before the woman is aware of being pregnant due to genetic irregularities. Although many women with diabetes do not experience any problems with conceiving, high blood sugar levels during pregnancy can harm the development of the foetus. There remains an elevated risk of miscarriage, stillbirth, and a baby needing post-natal intensive care.

The impact of diabetes on fertility for men

In the UK, diabetes is more common in men than women, with men accounting for 56% of diabetic adults, compared with 44% women. For men, the condition can cause erection problems, retrograde or retarded ejaculation, lowered testosterone and reduced libido. It can also cause a reduction in sperm volume and quality, represented by a corresponding increase in malformed or abnormal sperm.

What should you do if you want to conceive?

Diabetes.co.uk advises that you should consult your GP initially if you or your partner has diabetes and you intend to conceive. It is advisable to attend your appointment as a couple, as a couple’s fertility is commonly reduced if one partner has diabetes.

If you start to plan at least three to six months before trying to conceive, there is a good chance that you can get the condition under control and reduce your chances of a diabetes-related complication during your pregnancy.

General lifestyle and health-related measures that you should take before trying for a baby include:

• Making a healthy eating plan but avoiding fad or crash diets. If you are already pregnant, please note it’s not a good idea to diet or drastically alter your normal food consumption.
• Getting at least some exercise daily.
• Achieving, as far as possible, a weight within the healthy range.
• Reducing, as much as you can, stress and anxiety.
• Stopping smoking.
• Taking folic acid every day. Women with diabetes are often advised to take a slightly higher dose, so it’s best to ask your doctor because this dose is unavailable over the counter.

The main goal if you have diabetes and plan to conceive is to get your blood sugar levels as close to the ideal range as possible before you start to try. You may need medical assistance, if only for measuring and monitoring, but home testing and monitoring kits are also available. Your target should be for your blood sugar to be at a fasting level of 99 mg/dL or less. However, since everybody is different, taking medical advice about your optimum level is a good idea.

Learning more about fertility treatment

When the condition is well-controlled, diabetes should not be an obstacle to starting or extending your family. Diabetes can, however, make it more difficult and be one of many possible causes of infertility. If you’ve been trying to conceive for a year without success, it may be time to consider seeking professional advice and treatment. If you would like to learn more about IVI, you can view our IVI clinics in the UK, browse our website for more information, or get in touch directly through our online contact form.