Expert-reviewed by Ashwini S.Kanade, Registered Dietician and Certified Diabetes Educator with 17 years of experience.
WHO defines infertility as “a failure to conceive despite two years of cohabitation and exposure to pregnancy.”
According to Dr. Pallavi Prasad, Fertility Consultant at Nova IVI Fertility, Bengaluru, “About 1 in every 10-12 couples require specialist investigation or infertility treatment in order to conceive. There are many young couples who face problems in child-bearing because one of the partners is suffering from diabetes.”
In the current scenario, incidences of diabetes are becoming more common in India, with a potential epidemic of more than 62 million diabetic individuals currently been diagnosed. 
This means that the cases of infertility are also bound to increase. Diabetes can have various effects on the fertility potential of men and women.
Diabetic women and reduced fertility rate
In a study conducted in 2016, it was found that almost 8% of married women in India suffer from infertility, out of which a majority were suffering from secondary infertility (5.8%). 
“In women, diabetes can be associated with the hormonal imbalance disorder called polycystic ovarian syndrome (PCOS). PCOS further leads to an increase in body weight, which triggers other complications. Overweight or obese women find it extremely difficult to conceive naturally and even infertility treatments such as IUI or IVF may not be successful.
Apart from this, because of a delay in the first occurrence of menstruation and early menopause in diabetic women, the reproduction might suffer. This is because diabetes is linked heavily with menstrual irregularities, for example, oligomenorrhea (infrequent menstrual periods) and secondary amenorrhea (when a woman has stopped menstruating for three or more months in the absence of pregnancy).” adds Dr Prasad.
Women with diabetes can also face challenges in conceiving naturally. More so when it comes to diabetic women who also have PCOS and hyperthyroidism, there are more difficulties during the tenure of their pregnancy. 
If you are unable to conceive naturally and are suffering from diabetes, you must go for these tests immediately:
- Swab tests to check for chlamydia
- Blood tests to get your hormone levels in control, and
- Ultrasound scans
Diabetic men and reduced fertility rate
Several scientists have time and again discovered that DNA damage in the sperms of diabetic men is higher than in the sperms of men who do not have diabetes. Whether it is lower sperm count, lower semen volume or sperm DNA damage, adult men with diabetes tend to face infertility issues. 
Infertility affects almost 15% of couples worldwide, concluding to almost 48.5 million couples. In fact, according to this study,  20-30% of infertility cases are because of males alone, contributing to almost 50% of overall cases.
“Diabetes leads to erectile dysfunction by having a direct impact on the health of small blood vessels and lowering testosterone levels. Diabetic men suffer from reduced libido, which leads to lower sex drive and reduced testosterone levels. Lastly, diabetes also tends to lower the amount of ejaculate volume, which directly affects the small nerves, lowering testosterone levels,” reveals. Dr. Prasad.
So, can diabetics conceive at all?
Yes, all hope isn’t lost. “Couples with diabetes are able to conceive, particularly if diabetes is well controlled and a healthy body weight is maintained. In extreme cases, infertility treatment can help couples conceive, provided blood glucose levels are under control,” signs off Dr. Prasad.
- Joshi SR, Parikh RM. India–diabetes capital of the world: now heading towards hypertension. J Assoc Physicians India. 2007 May;55:323-4.. https://www.ncbi.nlm.nih.gov/pubmed/17844690/
- Sanjit Sarkar* and Pallavi Gupta. Socio-Demographic Correlates of Women’s Infertility and Treatment Seeking Behavior in India. J Reprod Infertil. 2016 Apr-Jun; 17(2): 123–132.. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4842234/
- Romana Szaboova and Senan Devendracorresponding author. Infertility in a young woman with Type 2 diabetes. London J Prim Care (Abingdon). 2015; 7(3): 55–57. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4494467/
- Guo-Lian Ding, Ye Liu,1,2, Miao-E Liu,1,2 Jie-Xue Pan, Meng-Xi Guo, Jian-Zhong Sheng. The effects of diabetes on male fertility and epigenetic regulation during spermatogenesis. Asian J Androl. 2015 Nov-Dec; 17(6): 948–953. Published online 2015 Mar 24. doi: 10.4103/1008-682X.150844. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4814953/
- Ashok Agarwal,corresponding author Aditi Mulgund, Alaa Hamada, and Michelle Renee Chyatte. A unique view on male infertility around the globe. Reprod Biol Endocrinol. 2015; 13: 37. Published online 2015 Apr 26. doi: 10.1186/s12958-015-0032-1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4424520/