Fertility In Men Not Affected

Q. My husband and I would like to start a family. He has been an insulin-dependent diabetic since the age of 14.

I’m not a diabetic. He currently takes insulin injections daily. Does diabetes affect a man’s ability to produce healthy sperm? What are the chances of our child becoming diabetic? - J.H., Stockton, Calif.

A. Fortunately, regardless of whether or not your husband is a diabetic-insulin-dependent or noninsulin dependent - there’s no affect on his ability to produce healthy and normal sperm.

So, fertility in a man is not affected by diabetes. But that’s not to say that he can’t develop impotence as a complication of diabetes.

Diabetes can lead to damage of the nerves that control erection. When these nerves are damaged, small blood vessels don’t relax to allow filling of the spongy erectile tissue of the penis with blood to create an erection. If he’s impotent, Viagra and other treatment options can help.

Whereas a man with diabetes can be fully fertile, a woman who’s diabetic may have difficulty. Achieving pregnancy and a healthy delivery in a diabetic female can be a challenge.

First of all, if diabetic control is poor, the woman’s menstrual cycles may be irregular or absent entirely if nutritional health is poor.

Polycystic ovarian syndrome, a disorder affecting about 6 percent of women of reproductive age, is a disorder of male-hormone over-production and excess insulin production, and can be a cause for reduced fertility. These women, while not necessarily diabetic, do respond to drugs such as Glucophage and Avandia, which are drugs used to treat diabetes.

A women who’s diabetic before pregnancy or who develops diabetes during pregnancy is at greater risk for baby and mom complications.

It’s really difficult to predict the likelihood that your child will become diabetic.

Obviously, if one or both parents is diabetic - either the child/juvenile-onset insulin-dependent type or the adult-onset type - there’s an increased risk of having a child that will one day develop diabetes.

But I really can’t give you the odds because genes alone aren’t enough. For instance, if one identical twin has child/juvenile-onset diabetes, the chances that the other twin will get the disease is 50 percent at most. But when one twin develops adult-onset type diabetes, the chances that the other twin will get adult-onset diabetes is at most 75 percent.

In addition to inherited risk factors, there are still unknown triggers for child/juvenile type diabetes. Some researchers believe things like cold climates, viruses, and diet play a role somehow.

Adult-onset diabetes has a stronger genetic risk, due largely to the increased risk of it in obese folks with a high fat/calorie diet and little exercise. If one parent is obese, the risk of obesity in a child is said to be 50 percent. But if both parents are obese, the risk of obesity in a child rises to 85 percent. And if the parent(s) is/are obese and diabetic, the risk of the child eventually becoming an adult-onset diabetic tends to parallel the risk of developing obesity.