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2 . 2022

Semen quality in men with type 2 diabetes mellitus


Considering the need for some men to implement reproductive plans in elderly age, in which type 2 diabetes mellitus (T2DM) often develops, it is important to study its effect on semen quality.

Aim – ​evaluation of ejaculate quality in men with T2DM.

Material and methods. 100 men with T2DM and 50 men without diabetes, who made up the comparison group, were included in a continuous one-stage comparative study. The spermogram parameters, the glycated hemoglobin level and total testosterone were evaluated. The differences between the groups were considered statistically significant at p<0.05.

Results. The prevalence of normozoospermia in men without diabetes was statistically significantly higher than that in men with T2DM. The features of the group of men with T2DM were statistically significantly higher prevalence of oligoasthenoteratozoospermia, bacteriospermia and the carriage of antisperm antibodies, with a statistical tendency to increase the prevalence of leukospermia. Statistically significant differences were revealed in the groups of men with and without T2DM in the number of spermatozoa in 1 ml of ejaculate, the content of live spermatozoa, the mobility of A+B and the content of normal forms of spermatozoa. These indicators were better in men without diabetes. The levels of total testosterone in the group of men with T2DM were statistically significantly lower than those observed in men without diabetes. When comparing the glycated hemoglobin levels in men with T2DM with the presence of normozoospermia or pathozoospermia, the levels of this indicator were statistically significantly lower in men with normal indicators of spermatogenesis.

Conclusion. T2DM negatively affects the quality of the ejaculate, leading to deterioration in its quantitative indicators, and is associated with bacteriospermia and inflammatory processes in the genital area. Decompensation of carbohydrate metabolism is associated with worse indicators of semen quality.

Keywords:males; semen analysis (sperm count test); diabetes mellitus

Funding. The research was carried out with support of the Voronezh State Medical University named after N.N. Burdenko of the Ministry of Healthcare of the Russian Federation, from extrabudgetary funds.

Conflict of interest. The authors declare no conflict of interest.

Contribution. Collection and processing of scientific material, writing the text – ​Esaulenko D.I.; development of the research concept, statistical processing of the results obtained – ​Rozhivanov R.V.; text editing – ​Shishkina V.V.

For citation: Esaulenko D.I., Rozhivanov R.V., Shishkina V.V. Semen quality in men with type 2 diabetes mellitus. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2022; 11 (2): 14–20. DOI: (in Russian)


1. Standards of specialized diabetes care. Edited by Dedov I.I., Shestakova M.V., Mayorov A. Yu. 10th Edition. Moscow, 2021. DOI: (in Russian)

2. Sexual dysfunction in men with diabetes mellitus. Edited by Kogan M.I. Moscow, 2005: 224 p. (in Russian)

3. Mel’nichenko G.A., Shestakova M.V., Rozhivanov R.V. The clinical and epidemiological characteristics of hypogonadism in men with type 2 diabetes mellitus. Sakharniy diabet [Diabetes Mellitus]. 2019; 22 (6): 536–41. DOI: (in Russian)

4. Choy J.T., Eisenberg M.L. Male infertility as a window to health. Fertil Steril. 2018; 110 (5): 810–4. DOI:; PMID: 30316415.

5. WHO laboratory manual for the examination and processing of human semen. 5th ed. WHO, 2010.

6. Bhasin S., Gagliano-Jucá T., Huang G., Basaria S. Age-related changes in the male reproductive system. In: Feingold K.R., Anawalt B., Boyce A., Chrousos G., de Herder W.W., Dhatariya K., et al. (eds). Endotext [Internet]. South Dartmouth (MA):, 2000. PMID: 25905229.

7. Ray S., Pramanik S. Reproductive dysfunctions in males with type 2 diabetes mellitus: an updated review. EMJ Diabetes. 2020; 8 (1): 79–89.

8. Ding G.L., Liu Y., Liu M.E., Pan J.X., Guo M.X., Sheng J.Z., et al. The effects of diabetes on male fertility and epigenetic regulation during spermatogenesis. Asian J Androl. 2015; 17 (6): 948–53. DOI:; PMID: 25814158; PMCID: PMC 4814953.

9. Barkabi-Zanjani S., Ghorbanzadeh V., Aslani M., Ghalibafsabbaghi A., Chodari L. Diabetes mellitus and the impairment of male reproductive function: possible signaling pathways. Diabetes Metab Syndr. 2020; 14 (5): 1307–14. DOI:; PMID: 32755827.

10. Condorelli R.A., La Vignera S., Mongioì L.M., Alamo A., Calogero A.E. Diabetes mellitus and infertility: different pathophysiological effects in type 1 and type 2 on sperm function. Front Endocrinol. 2018; 9: e00268. DOI:

11. Tian An, Yue-Fen Wang, Jia-Xian Liu, Yan-Yun Pan, Yu-Fei Liu, Zhong-Chen He, et al. Comparative analysis of proteomes between diabetic and normal human sperm: Insights into the effects of diabetes on male reproduction based on the regulation of mitochondria-related proteins. Mol Reprod Dev. 2018; 85 (1): 7–16. DOI:

12. Gandhi J., Dagur G., Warren K., Smith N.L., Sheynkin Y.R., Zumbo A., et al. The role of diabetes mellitus in sexual and reproductive health: an overview of pathogenesis, evaluation, and management. Curr Diabetes Rev. 2017; 13 (6): 573–81. DOI:; PMID: 27875946.

13. Maresch C.C., Stute D.C., Alves M.G., Oliveira P.F., de Kretser D.M., Linn T. Diabetes-induced hyperglycemia impairs male reproductive function: a systematic review. Hum Reprod Update. 2018; 24 (1): 86–105. DOI:

14. Maric C., Forsblom C., Thorn L., Waden J., Groop P.H.; FinnDiane Study G. Association between testosterone, estradiol and sex hormone binding globulin levels in men with type 1 diabetes with nephropathy. Steroids. 2010; 75: 772–8.

15. Temidayo S.O., Stefan S.P. Diabetes mellitus and male infertility. Asian Pacific J Reprod. 2017; 7 (1): 6–14.

16. Agarwal P.K., Singh P., Chowdhury S., et al. A study to evaluate the prevalence of hypogonadism in Indian males with type-2 diabetes mellitus. Indian J Endocr Metab. 2017; 21: 64–70. DOI:

17. Beatrice A., Dutta D., Kumar M., et al. Testosterone levels and type 2 diabetes in men: current knowledge and clinical implications. Diabetes Metab Syndr Obes Targets Ther. 2014; 7: 481–6. DOI:

18. Cheung K.K.T., Luk A.O.Y., So W.Y., et al. Testosterone level in men with type 2 diabetes mellitus and related metabolic effects: a review of current evidence. J Diabetes Invest. 2015; 6 (2): 112–23. DOI:

19. Gaunay G., Nagler H.M., Stember D.S. Reproductive sequelae of diabetes in male patients. Endocrinol Metab Clin North Am. 2013; 42 (4): 899–914. DOI:; PMID: 24286955.

20. Kurbatov D.G., Dubsky S.A., Rozhivanov R.V., Lepetukhin A.E. Urological and andrological diseases in diabetes mellitus. In: Diabetes mellitus. Acute and chronic complications. Edited by Dedov I.I., Shestakovа M.V. Moscow: MIA, 2011: 432–45. (in Russian)

21. Bozhedomov V.A., Laurent O.B., Sukhikh G.T. Etiology and pathogenesis of male autoimmune infertility. Andrologiya i genital’naya khirurgiya [Andrology and Genital Surgery]. 2001; (1): 72–7. (in Russian)

22. Bozhedomov V.A., Laurent O.B., Sukhikh G.T. Etiology and pathogenesis of male autoimmune infertility. Andrologiya i genital’naya khirurgiya [Andrology and Genital Surgery]. 2001; (2): 78–87. (in Russian)

Ametov Alexander S.
Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Head of Subdepartment of Endocrinology, Head of the UNESCO Network Chair on the subject «Bioethics of diabetes as a global problem» of the Russian Medical Academy of Continuous Professional Education (Moscow)
Medicine today

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