How Does Type 2 Diabetes Affect Fertility?

Type 2 diabetes is a chronic condition that can impact major body systems and organs. It can also affect both male and female fertility. If you’re trying to conceive, you should be aware of factors that can impact infertility.

Learn more about the links between diabetes and fertility, complications that can make it harder to get pregnant, and how managing diabetes can help.

Type 2 Diabetes and Female Fertility

Research suggests women with type 2 diabetes have about a 25% lower chance of childbirth compared with women who don't have diabetes. Many women with type 2 diabetes also have obesity and polycystic ovarian syndrome, contributing to female reproductive dysfunction. 

Polycystic Ovarian Syndrome (PCOS)

There's an association between diabetes and PCOS and between PCOS and ovulation.

PCOS is a condition in which there's a hormone imbalance. It's unclear what causes it, but it involves high insulin levels and androgens. PCOS causes cysts to develop in the ovaries, which can affect fertility in several ways:

• Eggs may not fully develop
• Eggs may not be released during ovulation
• Periods can become irregular or missed

PCOS affects about 6–10% of women of reproductive age and is one of the most common reasons for female infertility. More than half of those with PCOS develop diabetes or prediabetes before 40.

Obesity

Carrying extra weight can cause your body to make more estrogen. Extra estrogen can act like a hormonal contraceptive to prevent you from ovulating. Excess weight can increase the time it takes to conceive and the risk of infertility.

Endometrial Cancer

Diabetes may increase the risk of endometrial cancer, also known as uterine cancer. And obesity is a risk factor for type 2 diabetes and endometrial cancer.

The most common treatment is a hysterectomy, or removal of the uterus, resulting in immediate infertility. It's also possible to undergo in vitro fertilization (IVF) to freeze your eggs or create embryos that can be transferred into a gestational carrier. In some cases, fertility-preserving treatment may be possible in younger women with early-stage uterine cancer.

Diabetes and Male Fertility

Diabetes can lead to male infertility by interfering with erection, ejaculation, and sperm.

Erectile Dysfunction

Erectile dysfunction (ED) is more common in men with diabetes than in men without diabetes. This may have to do with damage to nerves and blood vessels due to high blood sugar or high blood pressure. Other factors that may contribute to ED are:

• Certain medicines used to treat high blood pressure, depression, or allergies
• Treatment for prostate cancer or enlarged prostate
• Surgery that affects the pelvic area or spinal cord
• Tobacco and alcohol use
• Sleep disorders

Ejaculatory Dysfunction

Delayed ejaculation is a condition in which it takes a long time to reach an orgasm and ejaculate. Some men with delayed ejaculation don't ejaculate at all. Anorgasmia is when you have trouble reaching an orgasm.

In retrograde ejaculation, the semen moves backward into the bladder instead of being ejaculated out of the penis. Semen that enters the bladder leaves the body when you urinate.

Decreased or Damaged Sperm

Both diabetes and obesity are associated with:

• Reduced semen volume
• Reduced sperm count, concentration, and motility
• Decreased testosterone, which can affect sex drive, erection, ejaculation, and sperm

Other Possible Fertility Complications

Reduced Libido for Men and Women

Both high and low blood sugar levels can change how you feel physically and emotionally. Low libido, or low sexual desire, is more common in people with diabetes than without. It tends to happen when diabetes is not well controlled.

Increased Risk of Genitourinary Infection

Genitourinary infections are those that affect the genital organs and urinary tract. People with type 2 diabetes have some predisposition to developing these infections.

Genitourinary infection can affect male fertility by causing inflammation-related obstruction of the reproductive tract and direct or indirect damage to the quality and functioning of sperm.

In women, untreated urinary tract infections (UTIs) can spread to other organs. Conditions such as chlamydia and gonorrhea can lead to pelvic inflammatory disease (PID), damaging the fallopian tubes and uterus and causing infertility.

Treatment

Treatment involves managing type 2 diabetes, complications, and coexisting health issues.

Managing Diabetes

Managing diabetes helps prevent issues that can lead to sexual and fertility problems. This involves careful monitoring of:

• Blood glucose
• Blood pressure
• Cholesterol levels

Type 2 diabetes management should also include:

• Regular exercise
• Keeping to the recommended weight range
• Following diet recommendations
• Taking medicines as prescribed

Fertility Assistance

When you decide you want to conceive, start by speaking with your healthcare provider. Ask what you should know about getting pregnant with type 2 diabetes. Together, you can decide if there's anything else you can do to manage diabetes and related conditions.

Infertility is the inability to conceive after one year of unprotected sex. However, if you're older than 35 or have health issues that can affect fertility, there's no need to wait. Ask your provider for a referral to a fertility specialist.

Female and male infertility treatments may include:

• Medicines
• Surgery
• Intrauterine insemination
• In vitro fertilization (IVF)

Each type comes with its potential benefits and risks. Your treatment options depend on the specific reasons for your infertility, your overall health, and your personal preferences.

Summary

Type 2 diabetes is a chronic disease affecting major body systems and organs. When not well controlled, it can lead to fertility problems. Diabetes also increases the risk of some other conditions. These include endometrial cancer, ED, and low sperm count, which can impact fertility. Co-existing conditions, such as PCOS and obesity, can make it harder to conceive. Treatment starts with good management of diabetes to control blood sugar, blood pressure, and cholesterol.

A Word From Verywell 

Type 2 diabetes affects your life in many ways, including fertility. If you're considering getting pregnant, you might want to see a healthcare provider for support and to make sure your diabetes is under control at the outset. If you've been trying but haven't conceived, don't hesitate to seek help. A fertility specialist can determine the cause and recommend the next steps.