Diabetes isn’t just about sugar: How it can quietly affect your fertility

In India, diabetes is rising quickly, but one of its lesser-known effects is on fertility. High blood sugar and insulin resistance can quietly affect both men and women, making it harder for couples to conceive. Often, people do not realise that diabetes could be one of the hidden causes behind their fertility struggles.

According to experts, diabetes—especially type 2 diabetes (T2DM)—can interfere with several processes necessary for conception. In women, it can disturb ovulation, hormone balance, and even egg quality. These problems often appear alongside polycystic ovary syndrome (PCOS), a condition that is closely linked to insulin resistance. Both PCOS and diabetes can make it harder for women to get pregnant, creating a cycle where one condition worsens the other.

Women with PCOS have a higher risk of developing diabetes later in life, and women with diabetes may show symptoms of PCOS, such as irregular periods or excessive hair growth. This overlap leads to irregular ovulation and poor-quality eggs, which reduce the chances of conception.

Medical studies show that about one in five infertile women suffer from insulin resistance. In those women, the pregnancy success rate after ovulation treatment is much lower compared to women without insulin resistance.

Doctors explain that high blood sugar harms fertility in many ways. Chronic hyperglycaemia (too much sugar in the blood) can increase oxidative stress and inflammation in the body. These reactions can disturb hormones, cause irregular periods, and damage egg quality. The uterus may also become less receptive, making it harder for an embryo to implant.

In simple terms, diabetes and insulin resistance affect a woman’s body long before she even notices symptoms. This silent damage can delay pregnancy and sometimes make natural conception very difficult.

When diabetes affects men’s fertility and sperm health

Men, too, face fertility challenges because of diabetes. Studies show that diabetes affects sperm count, movement, and quality. Men with high blood sugar often have lower sperm volume and reduced motility (movement), making it harder for sperm to reach and fertilise the egg.

Research also reveals that diabetes can cause DNA damage in sperm, which affects embryo development. Additionally, high blood sugar can lead to nerve damage, resulting in retrograde ejaculation (when semen flows backward into the bladder instead of exiting through the penis).

Vascular problems caused by diabetes may also reduce blood flow to the reproductive organs, while oxidative stress can harm sperm production. Erectile dysfunction, another common complication of diabetes, further decreases the chances of conception.

These issues often go unnoticed because many men are unaware that their fertility is being affected by their blood sugar levels. They may blame age or stress, when in reality, controlling diabetes could significantly improve reproductive health.

Why the connection is often ignored

One major reason this link is overlooked is lack of awareness. When couples face difficulty conceiving, they usually focus on reproductive organs and hormones. However, doctors say it is equally important to assess metabolic health. Diabetes and insulin resistance often stay hidden until they begin to interfere with fertility treatments or cause other health problems.

In many fertility clinics, metabolic screening is not always a standard part of evaluation. As a result, couples may spend months—or even years—on expensive treatments without addressing the real issue behind their infertility.

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What couples can do to protect their fertility

The good news is that diabetes-related infertility can often be prevented or improved through early diagnosis and proper care. Doctors recommend that both partners undergo blood sugar and insulin-resistance testing when fertility problems arise. This helps identify underlying issues early and allows timely treatment.

Maintaining glycaemic control (stable blood sugar levels) is crucial for women with diabetes. Controlled diabetes helps preserve ovarian function and reduces hormonal imbalances. For men, keeping blood sugar in check improves sperm quality and overall reproductive health.

Lifestyle changes can also make a huge difference. A balanced diet, regular exercise, enough sleep, and maintaining a healthy weight can improve insulin sensitivity. These habits not only reduce diabetes risk but also support better fertility outcomes.

It’s also important to understand that infertility is not only a structural or hormonal problem. When repeated fertility treatments fail, couples should consider checking for metabolic factors like diabetes or insulin resistance.

The Indian reality: A rising challenge

In India, where both diabetes and infertility rates are increasing, the connection between the two deserves more attention. Studies show that nearly 20% of infertile women in India suffer from insulin resistance. As diabetes becomes more common, it may be silently worsening fertility problems for many couples.

While diabetes is often seen as a disease of the heart, kidneys, or eyes, its effects on fertility are equally serious. It quietly disrupts the body’s hormonal and reproductive balance, reducing the chances of conception.

Raising awareness and including metabolic testing in fertility checkups can help couples identify the cause earlier. For many, addressing diabetes may unlock the path to successful conception. Recognising the role of blood sugar in reproductive health could prevent years of frustration and heartache for couples dreaming of becoming parents.