Newly Diagnosed Diabetes Mellitus as an Etiology of Anejaculation and Primary Male Infertility: A Case Report and Review of the Literature

Diabetes Mellitus (DM) is becoming increasingly prevalent among young men. While DM is known to cause a myriad of health issues ranging from cardiovascular complications to vision loss, its impact on male reproductive health is often unrecognized. In this review, our primary objective is to summarize the literature linking DM and male infertility. We highlight a representative case of a young man who was seen in our clinic for infertility and was ultimately newly diagnosed with DM. Neurovascular changes in diabetic men can gradually lead to the development of sexual dysfunction. DM can also directly impact spermatogenesis through a variety of mechanisms, including the production of oxidative stress and disruption of hormonal pathways. Together, these processes may alter male fertility. When evaluating men with infertility, particularly those with ejaculatory concerns, clinicians must maintain a high index of suspicion for undiagnosed DM. In men with infertility and known DM, improvements in semen parameters are possible with behavioral modifications, weight loss, and improvement in glucose control. Finally, the imminent evaluation and management of a patient with DM and infertility relies on the standard principles of the male reproductive work-up, with emphasis on a few key components as detailed below.