Diabetes mellitus is associated with a decrease in male reproductive potential and known to promote several sexual disorders, such as erectile dysfunction or retrograde ejaculation. Still, the “hidden effects” of this pathology on testicular physiology may lead to even more serious consequences for male fertility. Diabetes mellitus induces shifts in testicular metabolism, particularly in glucose metabolism, which is vital for the normal occurrence of spermatogenesis. So the maintenance of testicular glucose metabolism homeodynamics is of particular relevance; otherwise spermatogenesis may be arrested. For many years this issue was overlooked, but compelling evidence shows that spermatogenesis only occurs under a tight metabolic control. Thus, this subject is becoming a hot topic and will be on the spotlight in the next years. On the other hand, metabolic alterations induce pressure in biological systems whose responses are mediated by epigenetic modifications, particularly in sperm. These modifications are stable and can be passed to the subsequent generations, enhancing the transmission of phenotypes. Hence, the metabolic mechanisms responsible for the alterations in male reproductive health and subfertility/infertility in diabetic individuals deserve special attention.
This chapter will present cutting-edge information on the effects of diabetes mellitus in the testicular physiology and metabolism. It will be also discussed how this metabolic disease contributes to stable epigenetic changes that may alter not only male gametes’ function but also contribute to a potential transgenerational amplification of the current diabetes-related deleterious effects. Finally we will address the concept that testicular metabolism can be a potential pharmacologic target to counteract subfertility/infertility promoted by diabetes mellitus.
Total Pages: 114-194 (81)
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