Diabetes, a chronic condition that affects a significant portion of the Singaporean population, has implications beyond its well-known complications. One area often overlooked is its impact on reproductive health and fertility.
Diabetes,a metabolic disorder characterised by the body’s inability to produce or effectively use insulin, is a growing concern in Singapore, with approximately 1 in 9 adults affected by this condition. While the impact of diabetes on vision, nerve, and kidney health is widely recognized, its influence on reproductive function is often underappreciated.
How Diabetes Affects Fertility for Men and Women
The connection between diabetes and fertility is multifaceted, affecting both men and women in distinct ways . For women, the condition is often linked to Polycystic Ovary Syndrome (PCOS), a common cause of infertility . PCOS is characterised by the formation of cysts around the ovaries, which can lead to irregular or absent menstrual periods, as well as a higher risk of developing type 2 diabetes over time.
Excess body weight or obesity, which are often associated with diabetes, can also complicate a woman’s fertility journey. Fluctuating blood sugar levels can further disrupt the delicate hormonal balance necessary for successful ovulation and embryo implantation, making natural conception more challenging.
Women with diabetes can conceive naturally, with some requiring in vitro fertilization (IVF) to achieve a successful pregnancy.
However, Dr. Yeong Cheng Toh , fertility specialist and medical director of IVF(SG), advises: “We usually like diabetes to be well controlled before embarking on an IVF cycle or embarking on a pregnancy to ensure that the patient is in good health before embarking on a potentially rigorous part of her motherhood journey.”
For women with diabetes, uncontrolled blood sugar levels can pose significant risks during IVF treatment . High blood sugar levels can disrupt the hormonal balance necessary for successful ovulation and a less receptive uterine lining for embryo implantation, all of which can decrease the chances of an IVF pregnancy.
“If the patient is on insulin and has a well-controlled diabetes, there is a better chance at pregnancy,” he adds.
For men living with diabetes, the impact on fertility can be equally significant. Diabetes can lead to a range of issues, including erectile dysfunction, ejaculatory problems, and semen abnormalities – all of which can compromise a couple’s ability to conceive.
In addition, men with diabetes are more likely to experience decreased sperm count, poor sperm motility, abnormal sperm shape, and a decrease in sperm DNA integrity – all of which can negatively impact fertility.
Dietary Strategies to Boost Fertility with Diabetes
Navigating the intersection of diabetes and fertility requires a multifaceted approach, focusing on lifestyle modifications and medical management. Dietary choices play a crucial role.
Sarah Sinaram, a registered dietitian, advised that to maintain steady blood sugar levels, prioritise low-glycemic-index (GI) foods like whole grains, brown or black rice, soba or bee hoon, chapati, legumes, soybeans, snow peas, chickpeas, and non-starchy vegetables. “
“Consumption of high-glycemic Index (GI) foods cause a sharp rise in post-meal blood glucose levels that decline rapidly, whereas consumption of low-GI foods results in a lower blood glucose level that declines gradually,” she explained.
GI ranks the number of carbohydrates in foods from zero to 100, indicating how quickly a food raises a person’s blood sugar. However, it does not tell you how high the blood sugar will rise after eating it.
“Here is where the glycemic load (GL) comes into play. It gives a more accurate picture of how food affects blood sugar by considering how it is prepared (for example, fried or baked), its fat and fiber content, and the quantity of carbohydrates consumed,” she added.
For instance, a serving of 100 grams of plain white rice is considered a high-GI and high-GL food when cooked. You can reduce the GL of rice by limiting the quantity consumed and adding dietary fiber and protein, such as stir-frying veggies, fish, or lean meat, to your meal.
Overcoming Infertility Related to Diabetes
For couples with diabetes who are trying to conceive, an early consultation with a fertility specialist is recommended for personalised care and monitoring of the couple’s progress. The doctor could recommend appropriate treatment options, including lifestyle adjustments, medication, or assisted reproductive technologies.
By understanding the relationship between diabetes and fertility, couples can then take proactive steps to optimise their chances of conception and start their journey to parenthood with confidence and support. With the right approach and medical expertise, the path to a healthy pregnancy is within reach, even for those navigating the challenges of diabetes.
