The inability of a couple to have offspring after one year becomes a health problem once it is defined as infertility.In the general population, infertility occurs between ten and 15 percent of couples of reproductive age, and in the case of people with diabetes mellitus, this percent is much greater due to causes associated with this chronic disease.
Dr. Manuel Gómez Alzugaray, head of the National Institute of Endocrinology, explains that diabetes mellitus produces changes and affects almost all the organs and systems of the person who suffers from it, among which the reproductive system is not exempt, both of theMan like that of the woman, who has investigated this theme more.
«Among the most frequent causes of male infertility are Oligoastenozoospermia idiopathic, hypogonadotropic and hypergonadotropic hypogonadism, testicular lesions due to radiation, heat, trauma and sexually transmitted infections, among others.
«The alterations of the reproductive system in the person with diabetes can be a consequence of direct damage caused by metabolic endocrine changes, secondary to neuropathic or vascular complications that appear in these patients.
"Transformations in the metabolism caused by diabetes mellitus can lead to the decrease in libido and sperm production, as well as its deterioration."
Gómez Alzugaray explains that the disease does not always lead to negative consequences for male fertility, but there are some conditions that favor the appearance of problems, especially in those men who do not carry adequate control of the disease or in those who suffer from many years.
«Diabetics have significantly reduced their ability to repair the sperm DNA, so, once affected, it cannot be restored.In addition, although the sperm of diabetic men seem normal morphologically, they have damage to their genetic material.
"Studies on the state and cellular content of the sperm stating that, even if they have mobility, if their genetic material has damages, it is most likely that they do not fertilize the ovule, and if they do it is likely that there are implantation failures or spontaneous abortions"
The specialist insists on the fact that if diabetes is not controlled, some medical conditions that predispose the development of infertility, such as erectile dysfunction, delayed ejaculation, due to damage to the sensitivity of the nerve of the penis, the penis sensitivity,Retrograde ejaculation, the reduction of sperm quality due to the fragmentation of DNA, as well as hypogonadism, as one in four men with type II diabetes mellitus presents low levels of testosterone.
Pondera Gómez Alzugaray who, taking into account all the changes described, diabetes can be another cause that alters male fertility.
The optional states that “50 percent of the causes of infertility implies man as a unique or shared cause with the woman.Therefore, with the growing increase in the number of people with diabetes in the male population, it is a factor that must be taken into account if there are reproductive problems ».
It is advisable to perform a sperm DNA fragmentation test before starting any assisted reproduction treatment, adds the doctor, who specifies that in the case of women with un controlled diabetes, they can have ovulation problems or be more prone to infectionsCérvico-vaginal.
«Usually, the treatment of diabetes is sufficient to restore fertility.People with diabetes under good medical control, with goodBody weight and normal levels of glucose and blood cholesterol, usually have better quality semen and ejaculate normally, ”concludes the doctor.