Evidence mapPaperPMID 42498725Full record

ArticleScientific reports2026

The link between diabetes and male infertility: mechanisms and implications.

Hesham Haffez, Mohamed Mosaad, Ahmed Y Rezk, Ahmed Sayed, Zeinab A Hassan

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Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

5 authors.

Hesham HaffezBiochemistry and Molecular Biology Department, Faculty of Pharmacy, Capital University (Formerly Helwan University), Cairo, 11795, Egypt. hesham.haffez@pharm.capu.edu.eg.
Mohamed MosaadBenha Fertility and ICSI Centre, Qalyubia, 13511, Egypt.
Ahmed Y RezkObstetrics & Gynecology Department, Faculty of Medicine, Benha University, Qalyubia, 13511, Egypt.
Ahmed SayedGenomics Research Program, Children's Cancer Hospital 57357, 11562, Cairo, Egypt.
Zeinab A HassanBiochemistry and Molecular Biology Department, Faculty of Pharmacy, Capital University (Formerly Helwan University), Cairo, 11795, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Diabetes mellitus (DM) is a growing global health crisis affecting male reproductive function, yet the enhanced combined effects of diabetes with pre-existing fertility abnormalities remain poorly understood. This study aims to investigate the individual and combined effects of diabetes and abnormal semen parameters on male reproductive function and the underlying apoptotic mechanisms. Thirty-nine men were enrolled and stratified into two phases: a validation cohort (nondiabetic vs. diabetic; fertile vs. abnormally infertile) and a four-group mechanistic study (normal nondiabetic (n = 10), abnormal nondiabetic (n = 11), normal diabetic (n = 10), and abnormal diabetic (n = 8)). We assessed HbA1c, FSH, LH, testosterone, semen parameters, sperm apoptosis (Annexin V/PI flow cytometry), DNA fragmentation (diphenylamine), and expression of apoptotic markers (caspase-3, cytochrome c, Bax, and Bcl-2) at gene and protein levels. Diabetic patients had significantly higher HbA1c (9.6 ± 2.31% vs. 5.49 ± 0.42%, p < 0.001), elevated FSH and LH, and reduced testosterone. Abnormal infertile patients showed impaired motility and morphology. The abnormal diabetic group had the most severe dysfunction: lowest rapid progressive motility (11.3 ± 3.10%, p < 0.001 vs. control) and highest early apoptosis (58.9 ± 8.79%, p < 0.0001). Protein analysis showed a pro-apoptotic shift with an elevated Bax/Bcl-2 ratio (3.64), increased cytochrome-c, and caspase-3 activation exclusively in this group (p < 0.0001). Diabetes and abnormal semen parameters exert enhanced combined detrimental effects on male fertility via enhanced activation of the intrinsic mitochondrial apoptotic pathway. Diabetic men with pre-existing fertility abnormalities exhibit the most severe phenotype and require prioritized clinical intervention.

Indexed as

Diabetes MellitusInfertility, MaleAdultApoptosisCaspase 3DNA FragmentationFollicle Stimulating HormoneGlycated HemoglobinHumansLuteinizing HormoneMaleSemen AnalysisSpermatozoaSperm MotilityTestosteroneCaspase 3Follicle Stimulating HormoneGlycated HemoglobinLuteinizing HormoneTestosteroneApoptosisDiabetes mellitusHormonesMale infertilitySemen

Identifiers

PMID42498725
PMCPMC13400617

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.