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In addition, under hyperglycemic conditions, disrupted glucose metabolism pathways generate a large number of metabolic byproducts (such as dihydroxyacetone, lactate, etc.), which, through oxidative stress, further damage the cells and genes involved in spermatogenesis [220,221,222]

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from weeks 2 to 4, rats in all the T2DM groups had lower body weight than those in the normal group, among which the body weight of rats in the T2DM + RYGB group increased slowly post-operation, slightly higher than that in T2DM and T2DM + sham