Endocrine Abstracts

Introduction: With the increasing need for reproductive planning among aging men, particularly those developing type 2 diabetes mellitus (T2DM), it is essential to study the effects of this condition on ejaculation quality.

Objective: To evaluate the quality of ejaculation in men diagnosed with T2DM.

Materials and Methods: This comparative cross-sectional study included 100 men with T2DM and 50 age-matched controls without T2DM, aged 35 to 45 years, at the Hospital Universitario de los Andes in Mérida, Venezuela, during 2022. Semen parameters were analyzed alongside levels of hemoglobin A1c and total testosterone. Differences between groups were considered statistically significant at P < 0.05.

Results: The prevalence of normozoospermia was significantly higher in men without T2DM compared to those with the condition. Men with T2DM exhibited a significantly higher prevalence of oligoasthenoteratozoospermia, bacteriospermia, and anti-sperm antibodies, with a notable trend towards increased leukospermia (P = 0.0031). Significant differences were observed between the two groups regarding the sperm count per milliliter of ejaculate, viable sperm percentage, motility (A+B), and normal sperm morphology, all favoring men without T2DM. Total testosterone levels were significantly lower in men with T2DM. Furthermore, when comparing hemoglobin A1c levels in men with T2DM based on their sperm morphology (normozoospermia versus pathozoospermia), those with normal spermatogenesis had significantly lower hemoglobin A1c levels (P = 0.002).

Conclusion: T2DM negatively impacts the quality of ejaculation, leading to a decline in quantitative indicators. Ejaculation quality is associated with bacteriospermia and inflammatory processes in the genital area. Additionally, carbohydrate metabolism derangement correlates with poorer ejaculation quality indicators.

Keywords: type 2 diabetes mellitus, ejaculation quality, sperm parameters, hemoglobin A1c, testosterone.