title: Diabetes mellitus and sperm parameters.
abstract: Because of the paucity of studies and inconsistencies regarding the impact  of diabetes mellitus (DM) on semen quality, this disease is seldom looked for  in the infertile patient. Recently, this view has been challenged by findings  showing that DM induces subtle molecular changes that are important for sperm  quality and function. This brief review shows the main sperm parameters in  patients with DM and presents the mechanisms hypothesized to explain the  changes observed in these patients. The data available suggest that DM alters  conventional sperm parameters. In addition, DM causes histologic damage of the  epididymis, with a negative impact on sperm transit. Various mechanisms may  explain the sperm damage observed in patients with DM. These include endocrine  disorders, neuropathy, and increased oxidative stress. Many authors suggest  that DM decreases serum testosterone levels. This is associated with a  steroidogenetic defect in Leydig cells. In addition, diabetic neuropathy seems  to cause atonia of seminal vesicles, bladder, and urethra. Furthermore, DM is  associated with an increased oxidative stress, which damages sperm nuclear and  mitochondrial DNA. Finally, spermatogenesis derangement and germ cell  apoptosis in type 1 DM may relate to a local autoimmune damage, whereas  insulin resistance, obesity, and other related comorbidities may impair sperm  parameters and decrease testosterone serum levels in patients with type 2  DM.
authors.affiliation: Section of Endocrinology, Andrology, and Internal Medicine, Department of Internal Medicine and Systemic Diseases, Catania University, Policlinico G. Rodolico, S Sofia 78th St, Bldg 4, Rm 2C82, 95123 Catania, Italy. sandrolavignera@email.it
authors.forename: Sandro
authors.initials: S
authors.lastname: La Vignera
authors.forename: Rosita
authors.initials: R
authors.lastname: Condorelli
authors.forename: Enzo
authors.initials: E
authors.lastname: Vicari
authors.forename: Rosario
authors.initials: R
authors.lastname: D'Agata
authors.forename: Aldo E
authors.initials: AE
authors.lastname: Calogero
mesh_terms: D000818:Animals; D048909:Diabetes Complications / Q000209:etiology* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D005298:Fertility; D006801:Humans; D007248:Infertility, Male / Q000209:etiology* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D008297:Male; D013094:Spermatozoa / Q000378:metabolism / Q000473:pathology*