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Does Diabetes Affect Fertility?

Written on November 25, 2023 by Jordan Stachel, MS, RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.


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If you or someone you know has diabetes, you may be wondering, “Does diabetes affect fertility levels?” Read this article for everything you need to know.

What Is Diabetes?

Diabetes is a chronic disease that occurs when your pancreas does not produce enough insulin or when the body can’t use the insulin it makes to bring blood sugar levels back down to normal.[1] In Type 1 diabetes, the body doesn’t make insulin; therefore, individuals with Type 1 diabetes will need to take insulin multiple times per day. In Type 2 diabetes, the body is not using insulin properly, so individuals will have elevated blood sugar levels. While Type 1 diabetes is not preventable, Type 2 diabetes can be prevented.[1]

How Does Diabetes Affect Fertility?

There is research to indicate that having diabetes can affect fertility for both men and women. In one study conducted in women with Type 1 diabetes, it was found that they had reproductive abnormalities like a delayed menstrual cycle and more menstrual cycle irregularities.[2] Another study in women with Type 1 diabetes found similar findings of impaired fertility, as insulin insufficiency and fat loss in these populations tend to affect menstruation and overall fertility.[3]

In addition, some research indicates that women with Type 2 diabetes can have negative fertility outcomes. While this is an area for further research, the initial findings suggest that fertility is impacted by menstrual cycle irregularities and body mass index (BMI).[4] It is worth noting that the study population examined included women who were obese and had polycystic ovarian syndrome, both of which can also independently impact fertility efforts.[4]

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Diabetes is also thought to impact fertility levels due to the inflammation that takes place in the body. Because hyperglycemia, or elevated blood sugar levels, occurs with diabetes, the entire body can be affected by increased levels of blood sugar and inflammation. Having diabetes evokes an inflammatory response in the body that increases circulating cytokines, affecting all systems in the body.[5] Having higher levels of inflammation negatively affects fertility, as the uterus, cervix, and placenta can all be affected, making pregnancy more difficult.[6]

In men, diabetes also affects fertility. There is evidence to indicate that men have higher levels of reproductive dysfunction when also contending with Type 2 diabetes and obesity. This is because sperm quality and quantity are affected, changing the sperm count, morphology, motility, and progression.[7] Men with Type 2 diabetes also exhibit higher levels of inflammation, potentially negatively affecting male fertility.

How To Optimize Fertility Outcomes With Diabetes

If you have Type 1 diabetes, stabilizing your hemoglobin A1c is a good goal to work towards. This will help ensure that your blood sugar levels are in a more stable range.[8] Managing blood sugar levels with the help of a qualified healthcare provider is advised, especially throughout your pregnancy, once you do become pregnant.

If you have Type 2 diabetes, similarly, working to get your A1c to a good point is advised. Doing so through healthy diet and lifestyle modifications can help to improve your health and fertility efforts. If you are unsure of where to begin, try starting with some of these tips:

  • Begin some kind of movement: If you are more sedentary, start moving your body for 5-10 minutes at a time. Breaking up your day, especially following meals, with mini walks can be helpful for your health, blood sugar, and metabolism.
  • Add more anti-inflammatory foods: Adopting a more anti-inflammatory diet can help reduce inflammation in the body and get your blood sugar in a more desirable range.[9] Start by trying to add more colors on to your plate (i.e. leafy greens, orange squash, yellow zucchini, and red cherries). The more colors you have, the higher the antioxidant content of your meal.
  • Stress management: Stress isn’t good for anyone, especially when trying to manage diabetes and fertility efforts. Try engaging in more stress-reducing techniques like meditation and yoga. This can aid in combatting any inflammation that may be stress-related.
  • Keep an eye on your numbers: Aim to take your blood sugar more often to see where your numbers are. As always, you should consult a qualified healthcare provider for personalized recommendations and guidance.

Support Your Fertility Health With Everlywell

At Everlywell, we combine modernized, rigorous lab testing with easy-to-access at-home medicine. We provide a range of blood tests, including at-home HbA1c tests and at-home fertility tests that you can take from the comfort of your home (sample collection is done at home and you then mail the sample to a lab for testing). Your results will be analyzed in CLIA-certified labs and an experienced healthcare provider will deliver your results. Take control of your fertility health today with Everlywell.

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References

  1. WHO. Diabetes. www.who.int. https://www.who.int/news-room/fact-sheets/detail/diabetes. Published April 5, 2023.
  2. Jonasson JM, Brismar K, Sparen P, et al. Fertility in Women With Type 1 Diabetes: A population-based cohort study in Sweden. Diabetes Care. 2007;30(9):2271-2276. doi:https://doi.org/10.2337/dc06-2574
  3. Type 1 diabetes impairs female fertility even before it is diagnosed. Diabetes Research and Clinical Practice. 2018;143:151-158. doi:https://doi.org/10.1016/j.diabres.2018.07.010
  4. Mattsson K, Nilsson-Condori E, Elmerstig E, et al. Fertility outcomes in women with pre-existing type 2 diabetes—a prospective cohort study. Fertility and Sterility. 2021;116(2):505-513. doi:https://doi.org/10.1016/j.fertnstert.2021.02.009
  5. Calle MC, Fernandez ML. Inflammation and type 2 diabetes. Diabetes & Metabolism. 2012;38(3):183-191. doi:https://doi.org/10.1016/j.diabet.2011.11.006
  6. MD RHS. Does inflammation contribute to infertility? Harvard Health. https://www.health.harvard.edu/blog/does-inflammation-contribute-to-infertility-202302102888. Published February 10, 2023. Accessed November 20, 2023.
  7. Shima AbbasiHormozi, Azam Kouhkan, Abdolhossein Shahverdi, Amir Parikar, Azin Shirin, Vesali S. How much obesity and diabetes do impair male fertility? Reproductive Biology and Endocrinology. 2023;21(1). doi:https://doi.org/10.1186/s12958-022-01034-w
  8. The Complete Guide to Pregnancy Planning with Type 1 Diabetes. JDRF. https://www.jdrf.org/t1d-resources/living-with-t1d/pregnancy/pregnancy-planning/.
  9. CDC. Living Well With Diabetes. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/library/features/living-well-with-diabetes.html. Published October 17, 2018. Accessed November 20, 2023.
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