Male fertility and type 1 diabetes

Wednesday, 17 June 2020

There are a few factors to consider if you’re planning to become a Dad when you live with type 1 diabetes. For men with diabetes, there is an increased risk of developing sexual and reporductive health problems with makes a visit to your GDP an important first step.

Your GP can undertake an initial evaluation of factors that could affect your fertility. Considering how complex male fertility is, this could take some time.

There are many factors that can affect your fertility. Some can be changed, while others can’t. Some of the factors that you can change are discussed below.

Healthy weight

Being over your healthy weight range, particularly if your body mass index* (BMI) is greater than 30 kg/m2 is associated with fertility problems. It has been linked with changes in sperm quality and testosterone levels. Testosterone is needed for normal reproductive and sexual function. If levels are low in men this can cause symptoms such as irritability, poor concentration and low sex drive. A loss of 5-10% of body weight prior to conception may be advised.

Blood glucose levels

Higher than normal blood glucose levels (BGLs) over time can lead to low testosterone. It can also contribute to erectile dysfunction and poor sperm quality (6). Professional assistance from your diabetes care team, including your psychologist, is recommended to help get your BGLs in your target range.

Daily physical activity

Thirty minutes of moderate intensity activity daily is recommended for good health. While doing your chosen activity, keep in mind that increased testicular temperature can negatively affect sperm development. Wearing loose fitting shorts or pants may help this.

Being over your healthy weight can also contribute to higher than normal testicular temperatures due to the increased fat deposits in the abdomen and scrotum. Aim for 60 minutes of exercise a day if your goal is weight loss.

Dietary review

A dietitian can assess your diet to ensure you are meeting the Australian Dietary Guidelines for good health. A change in diet may be recommended where deficiencies are identified. For instance, to encourage normal sperm development it is believed that omega-3-fatty acids found in nuts and fish is needed. Other nutrients like folate, vitamin B12, selenium and zinc would also be assessed (2).

Avoid toxins

Some toxins in the environment that can reduce a man’s fertility include smoking, alcohol and potentially electromagnetic frequency radiation (EMF-R).

Smoking: tobacco smoke reduces fertility (1). Smoking should be avoided before trying for a baby. More and more research is showing how genes are affected by tobacco smoking that can have lasting consequences for the next generation (8). Talk to your GP or call Quitline on 13 78 48 for advice on giving up smoking.

Alcohol: can disrupt hormones in the body that then affect fertility (7). The new Australian alcohol guidelines to reduce the risk of harm are to drink no more than 10 standard drinks per week and no more than 4 standard drinks on any one day (learn what a standard drink is). Alternatively, you can offer fantastic support for the mum-to-be by not drinking at all along with her.

Radio frequency-electromagnetic radiation (RF-EMR):  exposure occurs when using smart phones and other wireless devices and is thought to decrease sperm viability, motility and number, however more research is required. Until more research gives definitive guidance, if you are having problems with fertility it would be wise to reduce RF-EMR exposure by keeping smart phones away from your scrotum and turning your WIFI off when not being used.

Mental health

Becoming a Dad for some can be an exciting prospect, while for others it is a future of unknowns. Understanding how you feel about becoming a father and managing your stress is important as psychological stress has been found to affect libido, erectile function and sperm health.

By planning to become a Dad you have time to change factors that can affect your fertility. Pre-conception clinics and your GP can assess your fertility and offer advice and support, all with the aim of having a healthy baby.

*calculate your BMI by dividing your weight in kilograms by your height in metres squared

BMI (kg/m2) = weight (kg)  divided by height (cm) x height (cm)

By Amanda Callaghan,

Registered Nurse and CDE

References:

1.Ying Li, Ph.D.,a Hui Lin, Ph.D.,b Yafei Li, Ph.D.,b and Jia Cao, Ph.D (2010), Association between socio-psycho-behavioral factors and male semen quality: systematic review and meta-analyses. https://doi.org/10.1016/j.fertnstert.2018.08.015

2. Feiby L. Nassan, Sc.D., M.B.B.C.H., M.Sc.,a,b Jorge E. Chavarro, M.D., Sc.D.,b,c,d and Cigdem Tanrikut, M.D (2018) Diet and men’s fertility: does diet affect sperm quality? https://doi.org/10.1016/j.fertnstert.2018.05.025

3. Mater Mothers Hospital Online Educational Material https://www.matermothers.org.au/antenatal-and-pregnancy-services/nutrition-and-dietetics/nine-months-of-nutrition

4. Mehmet Erol Yildirim a, *, Mehmet Kaynar b , Huseyin Badem c , Mucahıt Cavis a , Omer Faruk Karatas a , Ersın Cimentepe (2015), What is harmful for male fertility: Cell phone or the wireless internet?  http://dx.doi.org/10.1016/j.kjms.2015.06.006

5. Baan R, Gross Y, Lauby-Secretan B, El Ghissassi F, Bouvard V, Benbrahim-Tallaa L, et al. Carcinogenicity of radiofrequency electromagnetic fields. Lancet Oncol 2011;12:624e6

6. I.M. Agbaje1,4, D.A. Rogers1, C.M. McVicar1, N. McClure1,3, A.B. Atkinson2, C. Mallidis1 and S.E.M. Lewis.2007, Insulin dependent diabetes mellitus: implications for male reproductive function. Human Reproduction Vol.22, No.7 pp. 1871–1877, http://dx.doi:10.1093/humrep/dem077

7.  S. Aboulmaouahib Madkour I. Kaarouch  O. Sefrioui  B. Saadani  H. Copin  M. Benkhalifa  N. Louanjli  R. Cadi 92017) Impact of alcohol and cigarette smoking consumption in male fertility potential: Looks at lipid peroxidation, enzymatic antioxidant activities and sperm DNA damage.

8. Smoking induces differential miRNA expression in human spermatozoa A potential transgenerational epigenetic concern? (2012) Emma L. Marczylo,1,* Akwasi A. Amoako,2 Justin C. Konje,2 Timothy W. Gant1,†,‡ and Timothy H. Marczylo,2

9. Australian Government Department of Health: Alcohol standard drink https://www.health.gov.au/health-topics/alcohol/about-alcohol/standard-drinks-guide

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