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Background  It is well established that diminished reproductive health is one of the notable long-term outcomes of type 2 diabetes mellitus (T2DM), especially among males. Due to the global increasing rate of T2DM and infertility, we aimed to investigate the impact of  Lactobacillus plantarum (L. plantarum) , inulin, and their combinatory supplementation on fertility markers as well as testicular kisspeptin and androgen receptor (AR)’s expression in diabetic male rats.    Methods  Thirty-five Male Wistar rats with Streptozotocin-induced T2DM were supplemented with  L. plantarum , inulin, or their combination for 8 weeks. At the end-point, the animals were sacrificed and serum, testicular, and seminal parameters were studied.    Results  Administration of  L. plantarum  and inulin in diabetic male rats improved sperm motility and viability (P < 0.001, both) as well as testicular tissue development via increasing leydig cell number, testicular spermatid count, and diameter of seminiferous tubules (P < 0.001, all). Testicular expression of Kisspeptin was elevated by inulin supplementation (P = 0.01).  L. plantarum  administration increased testicular AR expression (P = 0.01). The expression of Kisspeptin showed a remarkable correlation with fertility markers (P < 0.001).    Conclusion  Supplementation with either  L. plantarum , inulin, or their combination can prevent infertility caused by T2DM in male rats via improving testicular kisspeptin and AR expression, leydig cell count, and effectively increasing epididymal sperm motility and viability.

The potential therapeutic effects of Lactobacillus plantarum and inulin on serum and testicular reproductive markers in diabetic male rats