From the Guidelines
Metformin does not significantly affect semen quality or male fertility in most cases, and men taking metformin for diabetes or other conditions can generally father children without concerns about the medication impacting their sperm. The evidence from recent studies, such as 1 and 1, suggests that metformin is safe and effective for use in men with type 2 diabetes, and its benefits in improving insulin sensitivity and reducing glucose production in the liver can actually support reproductive function. Some research even suggests that metformin might improve certain semen parameters in men with metabolic disorders like insulin resistance or obesity.
The typical dosing of metformin (500-2000mg daily) has not been shown to reduce sperm count, motility, or morphology in healthy individuals. Men should continue their prescribed metformin regimen while trying to conceive, as poorly controlled diabetes can negatively impact fertility more than the medication itself. If concerned about fertility while taking metformin, men can discuss this with their healthcare provider, but stopping the medication without medical advice is not recommended.
Key points to consider:
- Metformin is generally safe for use in men with type 2 diabetes who are trying to conceive
- Metformin may actually improve certain semen parameters in men with metabolic disorders
- Poorly controlled diabetes can negatively impact fertility, so men should continue their prescribed metformin regimen while trying to conceive
- Men with concerns about fertility while taking metformin should discuss this with their healthcare provider before making any changes to their medication regimen.
From the Research
Metformin and Semen Quality
- Metformin is a commonly used medication for the treatment of type 2 diabetes mellitus (T2DM) and has been shown to have effects on the male reproductive system 2.
- Studies have investigated the impact of metformin on semen parameters, with some findings suggesting that metformin can inhibit human spermatozoa motility and signalling pathways mediated by protein kinase A and tyrosine phosphorylation 3.
- However, other studies have found that metformin therapy can improve semen parameters in hyperinsulinaemic males, including sperm morphology and chromatin packaging quality 4.
Mechanisms of Metformin's Effects on Semen
- The exact mechanisms of metformin's effects on semen quality are not fully understood, but it is thought that metformin may act on the male reproductive system by improving insulin sensitivity and decreasing plasma fasting insulin levels 2.
- Metformin may also have antioxidant properties, which could help to protect sperm from oxidative stress and damage 4.
- Additionally, metformin has been shown to improve steroidogenesis and spermatogenesis in men with metabolic disorders, which could contribute to its beneficial effects on semen quality 5.
Diabetes Mellitus and Semen Quality
- Diabetes mellitus (DM) has been shown to have negative effects on semen quality, including alterations in conventional sperm parameters and histologic damage to the epididymis 6.
- The mechanisms underlying the effects of DM on semen quality are thought to include endocrine disorders, neuropathy, and increased oxidative stress 6.
- Metformin may be beneficial for men with DM and infertility, as it has been shown to improve insulin sensitivity and reduce oxidative stress 2, 5.