This study was undertaken to evaluate conventional and some of the main bio-functional spermatozoa parameters, serum gonadal hormones and didymo-epididymal ultrasound features in patients with type 1 diabetes mellitus (DM1).
DM1 affects an increasing number of men of reproductive age. Diabetes may affect male reproduction by acting on the hypothalamic-pituitary-testicular axis, causing sexual dysfunction or disrupting male accessory gland function. However, data on spermatozoa parameters and other aspects of the reproductive function in these patients are scanty. Thirty-two patients with DM1 [27. 0 (25. 0-30. 0 years)] and 20 age-matched fertile healthy men [28. 0 (27. 25-30. 75 years)] were enrolled. Patients with diabetic neuropathy, other endocrine disorders or conditions known to alter spermatozoa parameters were excluded. Each subject underwent semen analysis, blood withdrawal for fasting and post-prandial glycaemia, hormonal analysis and didymo-epididymal ultrasound evaluation before and after ejaculation. Patients with DM1 had a lower percentage of spermatozoa with progressive motility [10. 0 (7. 0-12. 75) vs. 45. 0 (42. 0-47. 75) %; p < 0. 01] and a higher percentage of spermatozoa with abnormal mitochondrial function than controls [47. 0 (43. 0-55. 0) vs. 2. 0 (1. 0-5. 0) %; p < 0. 01]. Patients also had greater post-ejaculatory diameters of cephalic [11. 5 (10. 2-13. 6) vs. 6. 0 (4. 0-7. 0) mm; p < 0. 01] and caudal epididymis [5. 5 (4. 00-7. 55) vs. 3. 0 (2. 0-4. 0) mm; p < 0. 01] compared to controls, suggesting a lack of the physiological post-ejaculation epididymal shrinkage. Correlation analysis suggested that progressive motility was associated with fasting glucose (r = -0. 68; p < 0. 01). The other parameters did not show any significant difference. Patients with DM1 had a lower percentage of spermatozoa with progressive motility, impaired mitochondrial function and epididymal post-ejaculatory dysfunction. These findings may explain why patients with DM1 experience fertility disturbance. Larger multi-centric studies are necessary to confirm these results.
Andrology. 2015 Oct 07 [Epub ahead of print]
S La Vignera, R A Condorelli, M Di Mauro, D Lo Presti, L M Mongioì, G Russo, A E Calogero
Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy. , Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy. , Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy. , Unit of Pediatrics, Teaching Hospital "Policlinico - Vittorio Emanuele", University of Catania, Catania, Italy. , Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy. , Department of Urology, University of Catania, Catania, Italy. , Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.