Pregnancy And Kidney Disease
A new baby is a joy for any family. But pregnancy can put a lot of stress on your body. If you have kidney disease or kidney failure, it can put you and the health of your unborn child at risk. Are you thinking about pregnancy? If so, you should discuss it beforehand with your doctor or other healthcare provider. They know you, and they can help you make a decision that is based on your own personal health. There are many things to consider. You and your doctor should discuss them all very carefully. Some things that can affect a healthy pregnancy include: Your stage of kidney disease Your general health Your age Having high blood pressure, diabetes, or heart disease Having other serious health conditions Protein in your urine Here are a few brief answers to some common questions about kidney disease and pregnancy. Can a woman with "mild" kidney disease have a baby? That depends. There is good evidence to suggest that women with very mild kidney disease (stages 1-2), normal blood pressure, and little or no protein in the urine (called "proteinuria") can have a healthy pregnancy. What is proteinuria? It's a sign of kidney damage. Your body needs protein. But it should be in your blood, not your urine. Having protein in your urine usually means that your kidneys cannot filter your blood well and the protein is leaking out. In women with moderate to severe kidney disease (stages 3-5), the risk of complications is much greater. For some women, the risk to mother and child is high enough that they should consider avoiding pregnancy. If you are thinking of becoming pregnant, ask your doctor or other healthcare provider about your stage of kidney disease, your risk for complications, your degree of proteinuria, and any other health conditions you may have. Can a woman who is o Continue reading >>
Diabetes And Pregnancy
If you have diabetes or prediabetes and you want a child, can you do it? What will you be getting yourself into? If you’re considering children, here are some things you should know. Pregnancy in diabetes carries serious risks to mother and child. The American Diabetes Association (ADA) says that women with poor diabetes control are at greater risk for birth defects and also miscarriage. Your baby’s organs are completely formed by seven weeks after your last period. That time may be up before you realize you are pregnant. High glucose levels can damage those developing organs. So it’s important, says ADA, to get glucose levels under control before getting pregnant. Doctors recommend three to six months of very good control before trying to conceive. If you have high glucose levels, you may not get pregnant at all. You may conceive normally, but the fertilized egg won’t attach to the uterine lining. Not getting pregnant may be better than pregnancy with out of control diabetes. The ADA lists some common complications for babies of mothers with diabetes. • Three to four times greater risk of birth defects such as heart, brain, and spinal defects, oral clefts, kidney defects, and gastrointestinal problems. • Premature delivery • Miscarriage • Prolonged jaundice (yellowing of the skin) • Respiratory distress (difficulty breathing) The mother faces her own risks. Diabetic eye and kidney problems could get worse. She is at higher-than-normal risk of preeclampsia (high blood pressure, often with protein in the urine), which can be life-threatening. Delivery may be difficult or may require a C-section. Prediabetes pregnancy also risky If you have prediabetes, pregnancy could push you over the line into diabetes. This is called “gestational diabetes.” It ca Continue reading >>
Gestational Diabetes
Gestational diabetes definition and facts Risk factors for gestational diabetes include a history of gestational diabetes in a previous pregnancy, There are typically no noticeable signs or symptoms associated with gestational diabetes. Gestational diabetes can cause the fetus to be larger than normal. Delivery of the baby may be more complicated as a result. The baby is also at risk for developing low blood glucose (hypoglycemia) immediately after birth. Following a nutrition plan is the typical treatment for gestational diabetes. Maintaining a healthy weight and following a healthy eating plan may be able to help prevent or minimize the risks of gestational diabetes. Women with gestational diabetes have an increased risk of developing type 2 diabetes after the pregnancy What is gestational diabetes? Gestational diabetes is diabetes, or high blood sugar levels, that develops during pregnancy. It occurs in about 4% of all pregnancies. It is usually diagnosed in the later stages of pregnancy and often occurs in women who have no prior history of diabetes. What causes gestational diabetes? Gestational diabetes is thought to arise because the many changes, hormonal and otherwise, that occur in the body during pregnancy predispose some women to become resistant to insulin. Insulin is a hormone made by specialized cells in the pancreas that allows the body to effectively metabolize glucose for later usage as fuel (energy). When levels of insulin are low, or the body cannot effectively use insulin (i.e., insulin resistance), blood glucose levels rise. What are the screening guidelines for gestational diabetes? All pregnant women should be screened for gestational diabetes during their pregnancy. Most pregnant women are tested between the 24th and 28th weeks of pregnancy (see Continue reading >>
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Diabetes And Getting Pregnant
Having a chronic condition such as diabetes (diabetes mellitus) takes careful monitoring of your health at the best of times, and this becomes even more crucial during pregnancy, a time when your body changes dramatically. Most women who have pre-existing diabetes who become pregnant have type 1 diabetes (once called insulin-dependent or juvenile diabetes), although some may have type 2 (once called non-insulin dependent or maturity-onset) diabetes. Another type of diabetes called gestational diabetes is a temporary type of diabetes that occurs in pregnant women who have never had diabetes before and it usually goes away after the baby is born. This article deals only with pre-existing diabetes — also known as 'pre-gestational diabetes'. If you have diabetes, there’s no reason that you can’t have a healthy and successful pregnancy and deliver a healthy baby. What it does mean is that you will probably have to work closely with your doctor and other healthcare professionals to ensure you manage your diabetes well during your pregnancy. I have diabetes and want to become pregnant: what should I do? Seeing your doctor for pre-pregnancy planning is an important step in ensuring the best outcome for you and your baby. You have a pre-existing condition, so you can plan ahead and discuss with your doctor what you need to do before you become pregnant, and what you can do to manage your diabetes during pregnancy. For example, if you have diabetes, you have a slightly higher risk than other women of your baby: having a birth defect; being born prematurely; weighing too much or too little; having jaundice; or having dangerously low blood sugar levels after birth. You yourself have an increased risk of having a miscarriage or of developing high blood pressure during the preg Continue reading >>
Azoospermia: What To Know About This Cause Of Male Infertility
Still not pregnant? For some couples, azoospermia, or a lack of sperm in the ejaculate, may stand in the way of conception. When it comes to planning a family, you might take the sperm end of the equation for granted. This makes good sense, of course, because the majority of men have enough strong swimmers to fertilize female eggs. But for some couples, azoospermia, or a lack of sperm in the ejaculate, may stand in the way of conception. "Most men with azoospermia have normal semen volumes but don't realize that there's no sperm in their fluid," says Marc Goldstein, M.D., chief surgeon in the department of male reproductive medicine at New York Presbyterian Hospital, Weill Cornell Medical Center in New York City. Infertility affects about 15 percent of the male population in the United States. Of this group, 10 to 15 percent suffer from azoospermia, which is approximately 1 to 2 percent, or over 1 million, post-pubertal men. "The rest of this group have either oligospermia [low sperm count or concentration], asthenospermia [slow swimmers], both conditions together [oligoasthenospermia] or crytoozoospermia [rare or very few sperm]," Dr. Goldstein explains. Fortunately, if you're trying to conceive, azoospermia isn't the end of the world. "There are many treatment options available for men with this condition to become biologic fathers, so it certainly doesn't mean there's no hope," notes Michael Eisenberg, M.D., director of male reproductive medicine and surgery and an assistant professor in the department of urology at Stanford University School of Medicine. Here's what you need to know about the causes, diagnosis, and treatment of azoospermia: The Types The two main types of azoospermia are defined as obstructive and nonobstructive. "If a man has the obstructive variet Continue reading >>
Diabetes Symptoms And Warning Signs In Women
Diabetes can happen at any age, though type 2 diabetes is more common in those over 45 years of age. Many of the risks for diabetes are the same between men and women, but there are some differences. The risk of developing diabetes is higher for people who: Are overweight or obese Are do not lead active lives Have high levels of fats called triglycerides, low levels of "good" cholesterol, or both Are a member of a high-risk race or ethnicity Have a history of high blood sugar Have a first-degree relative with diabetes Have conditions that are associated with the body not using insulin effectively (insulin resistance) Contents of this article: Women and diabetes One condition that is unique to women and linked to the body not using insulin effectively (insulin resistance) is polycystic ovarian syndrome. In this condition, the ovaries become enlarged and are unable to release eggs properly. Other unique risk factors include a history of gestational diabetes or having given birth to a baby weighing over 9 pounds. According to the National Institutes of Heath (NIH), close to one-third of women with diabetes do not know they have the disease. It is recommended that screening for adults of both genders be done in those over the age of 45 who are overweight or obese and who have one of the risk factors listed above. On the other hand, men are more likely to develop type 2 diabetes than women. The exact reasons why are unclear, however. One possible reason could be that men tend to carry their weight in the belly area more often than women, which can increase insulin resistance. Men are also more likely than women to develop heart disease as a result of their diabetes. The risks become relatively similar between the sexes once women reach menopause. Complications of diabetes fo Continue reading >>
Type 1 Diabetes Linked To Lower Fertility
Significantly fewer children are born to couples when one partner has type 1 diabetes…. The authors, led by Andreas Holstein, MD, from the First Department of Medicine, Lippe-Detmold Hospital, Detmold, Germany, note that there are only limited data regarding the fertility of people with type 1 diabetes, and that this is especially true for men. “Therefore, the aim of this study was to assess the number and sex of children in individuals with Type 1 diabetes and to determine the impact of parental diabetes on the age at onset of Type 1 diabetes,” they write. The researchers studied 697 individuals with type 1 diabetes (364 women, 333 men) who were part of a background regional German population of 350,000 people. The investigators assessed the number of children born to families, the sex of the children, and whether the family had a prior history of diabetes. They then compared those findings with 2009 government statistics for the overall region. The investigators tallied births that took place throughout the entire lifespan, including those that occurred after the onset of diabetes. They report that the overall fertility rate for women in the background population was 1.36 children during the reference year (2009). In the cohort of women with type 1 diabetes, however, the fertility rate fell to 0.88. In men with type 1 diabetes, the fertility rate was 0.65, the authors said. More men with type 1 diabetes were childless compared with their female counterparts (51.1% vs 35.7%; P < .0001). The ratio of male to female offspring was nearly equal, the researchers say. Women with diabetes gave birth to 200 girls and 199 boys (P = 1.00), whereas men with diabetes fathered 171 girls and 160 boys (P = .63). In the subgroup of children born to parents after their type 1 dia Continue reading >>
Dads: How Your Age Can Affect Your Fertility And Your Baby's Health
What are the implications for dads-to-be if they delay starting a family? Read on to find out. Can a man's age affect his fertility? Yes, it can. Men have a biological clock of sorts. Men in their 70s, 80s or even 90s can, and do, father children. However, a man this age is more likely to take years rather than months to get his wife pregnant. Generally speaking, the older a man is, the longer it will take for him to get his wife pregnant. One UK study found that the chance of conception taking more than a year is: about eight per cent when the man is under 25 about 15 per cent when the man is over 35 The age gap between the husband and wife can make a difference, too. If a woman's husband is at least five years older than her, she has less chance of conceiving within a year than if her husband is the same age. That's the case whatever the woman's age. How do men and women's biological clocks differ? There is a clear difference between men and women. A woman's oestrogen level plummet once she reaches a certain age and this change is irreversible. The changes in hormone levels men experience aren't as sudden or noticeable, but happen gradually. The other major difference is that all women eventually reach menopause and stop releasing eggs. However, a man can usually produce sperms throughout his lifetime. How are men's and women's biological clocks similar? As women grow older, they produce less oestrogen. This means there's a higher risk of having a baby with chromosomal problems. See our article on getting pregnant in your 30s and your 40s. Similarly, as men get older they have a decline in testosterone, and therefore a decline in fertility. This also creates a greater risk of fathering children with chromosomal problems. So just because a man can make sperms, it doesn Continue reading >>
Things That Can Harm A Man’s Fertility
While the journey to pregnancy can be straightforward for some, others face roadblocks along the way. For the nearly 15 percent of American couples who do not conceive within the first year of trying (i.e., unprotected sex about two to three times a week), their journey has an official label: Infertility. Many factors can contribute to fertility troubles, and the health of both partners plays an important role. In fact, male infertility accounts for about half of the couples who are unable to conceive. The primary causes of male infertility include low sperm production, abnormal sperm function, or blockages that prevent the delivery of sperm. But while these issues are sometimes the result of underlying health problems, they can also be caused by certain lifestyle factors. One recent study even suggests that the type of job a man has can significantly impact his chances of conceiving with a partner. What did the study find? After examining 456 men around the age of 32 who were in committed relationships and had stopped using contraception, researchers found that 13 percent of the men with physically demanding jobs had low sperm counts. In contrast, only 6 percent of men who did not perform such strenuous work had lower semen concentrations. The researchers were able to demonstrate that the physical demands of the job were what mattered: Other work factors like late-night shifts, heat, noise, or prolonged sitting were not associated with semen quality. Physical work on the job wasn’t the only factor the researchers linked to sperm quality. Men diagnosed with high blood pressure faced issues as well, presenting lower percentages of normally shaped sperm. It isn’t known whether the elevated blood pressure itself or the treatments used to combat it are behind the associ Continue reading >>
Diabetes And Pregnancy
Diabetes and your unborn baby Diabetes is a condition in which the amount of sugar (glucose) in the blood is too high. Glucose comes from the digestion of starchy foods, such as bread and rice. Insulin, a hormone produced by your pancreas, helps your body to use glucose for energy. Three types of diabetes can affect you when you're pregnant: type 2 diabetes – long-term conditions that women may have before they get pregnant (pre-existing diabetes) gestational diabetes – develops only in pregnancy and goes away after the baby is born The information on this page is for women who have pre-existing diabetes in pregnancy. Most women with diabetes have a healthy baby, but diabetes does give you a higher risk of some complications. If you already have diabetes If you already have type 1 or type 2 diabetes, you may be at a higher risk of: having a large baby – which increases the risk of a difficult birth, having your labour induced, or a caesarean section People with type 1 diabetes may develop problems with their eyes (diabetic retinopathy) and their kidneys (diabetic nephropathy), or existing problems may get worse. If you have type 1 or type 2 diabetes, your baby may be at risk of: not developing normally and having congenital abnormalities, particularly heart and nervous system abnormalities being stillborn or dying soon after birth having health problems shortly after birth, such as heart and breathing problems, and needing hospital care developing obesity or diabetes later in life Reducing the risks if you have pre-existing diabetes The best way to reduce the risk to your own and your baby's health is to ensure your diabetes is controlled before you become pregnant. Ask your GP or diabetes specialist (diabetologist) for advice. You should be referred to a diabetic Continue reading >>
Male Fertility Problems
What are fertility problems? Infertility can be defined as the failure to achieve pregnancy after regular unprotected sex (without the use of any contraception) for at least a year. 'Primary' infertility means failure to achieve a first pregnancy, 'secondary' infertility means failure to achieve a subsequent pregnancy. Primary infertility is an extremely common problem, affecting more than one in seven (15 per cent) couples attempting their first pregnancy. Among those experiencing difficulty with conception, a male fertility problem is considered important in around 40 per cent of couples. In 15 per cent of couples it will be solely a male fertility problem and in around 25 per cent, there will be a problem in both partners. Why do men get fertility problems? There are several causes of fertility problems in men. They include: obstructive problems (blockages in sperm-carrying tubes) testicular injury and disease sperm disorders genetic disorders hormonal problems general medical disorders that reduce fertility drugs that reduce fertility environmental toxins and radiation. Obstructive problems A blockage in a sperm-carrying tubes has many potential causes. The most common are outlined below. Groin surgery (including hernia repair and fixation of undescended testicles). Trauma to the scrotum sack covering the testicles (even fairly minor sporting injuries). Infection (particularly chlamydia, gonorrhoea and tuberculosis). Previous vasectomy (a form of contraception that involves tying the sperm-carrying tubes). Some men have congenital (present at birth) absence of the vas deferens on one or both sides. The vas deferens is the tube that conducts the sperms from the testis into the semen (most of which comes from the seminal vesicle glands behind the prostate). About 10 p Continue reading >>
Infertility In Men
Tweet Whilst diabetes needn’t present fertility problems, there are some conditions related to male infertility which are more likely, particularly in diabetes that has either not been well controlled or has been present for many years. We look at what these conditions are as well as the treatment options that are available. Conditions A number of issues can cause infertility in men. These include: Erectile dysfunction Retarded ejaculation (delayed ejaculation) Retrograde ejaculation Reduced sperm quality Hypogonadism (low testosterone) Erectile dysfunction (ED) Erectile dysfunction is a common problem associated with diabetes that causes difficulty with getting or maintaining an erection. It is caused by neuropathy (nerve damage) and reduced blood circulation typically as a result of less well controlled diabetes or long standing diabetes. High levels of blood glucose, blood pressure and cholesterol are all associated with an increased risk of erectile difficulties. Getting these under control, as well as cutting down on alcohol and quitting smoking can help to reduce the effects of ED. A number of different treatment options are also available. Retarded ejaculation Ejaculation problems can also result if nerves in the penis become damaged. Lack of nerve sensitivity is one problem which can affect the ability to ejaculation. Retarded, delayed and impaired ejaculation are all terms which describe a difficulty in achieving ejaculation. Note that retarded ejaculation can also be caused or influenced by psychological problems, age and by certain medications. If impaired ejaculation is brought on psychological problems then treatment, such as through counselling or psychosexual therapy. Ejaculation problems caused by nerve damage tend not to be treatable but it may be pos Continue reading >>
Having A Baby After Age 35
PDF Format Having a Baby After Age 35 Why is there a concern about having a child later in life? Becoming pregnant after age 35 years can present a challenge. Also, having a child later in life has certain risks. These risks may affect a woman’s health as well as her baby’s health. How does age affect fertility? Fertility in women starts to decrease at age 32 years and becomes more rapid after age 37 years. Women become less fertile as they age because they begin life with a fixed number of eggs in their ovaries. This number decreases as they grow older. Eggs also are not as easily fertilized in older women as they are in younger women. Problems that can affect fertility, such as endometriosis and uterine fibroids, become more common with increasing age as well. What specific health concerns are there for later childbearing? Older women are more likely to have preexisting health problems than younger women. For example, high blood pressure is a condition that is more common in older women (see FAQ034 Preeclampsia and High Blood Pressure During Pregnancy). If you are older than 35 years, you also are more likely to develop high blood pressure and related disorders for the first time during pregnancy. The risk of developing diabetes mellitus or gestational diabetes increases with age as well (see FAQ177 Gestational Diabetes). How can high blood pressure affect pregnancy? High blood pressure poses risks that include problems with the placenta and the growth of the fetus. How can diabetes affect pregnancy? If you have diabetes, you are at greater risk of having a child with birth defects. The risks of high blood pressure, miscarriage, and macrosomia, a condition in which the fetus grows too large, are increased as well. Do older women have an increased risk of having a Continue reading >>
Infertility & Pre-diabetes – What's The Relationship?
Because of that, we will be dedicating Mondays in November to this topic and how it relates to infertility and fertility treatment. Reproductive Medicine Associates of Connecticut (RMACT) has had its focus on this topic for quite a while. Carolyn Gundell, MS, one of RMACT’s Fertility Nutritionists talked about diabetes and its connection to fertility three years ago in 2012 on PathtoFertility. In case you haven’t had a chance to read her thoughtful piece, here it is again. Best thing about Carolyn’s piece? How hopeful it is. And how she explains things in a way that is manageable and accessible to a non-clinical person reading it. Pre-diabetes and diabetes are conditions that do need to be examined if you are trying to conceive. Isn’t it a relief to know that there are programs in place, led by qualified, knowledgeable and passionate professionals that can turn a situation around so that it’s safe and effective to try to become and stay pregnant? Think of this as a preview for November. You will hear more from Carolyn Gundell, MS, Dr. Spencer Richlin, (RMACT’s Surgical Director and lead physician for the Diabetes Program), Melissa Kelleher, LCSW (one of RMACT’s Fertility Counselors) and more. Do you have questions about why this is an important subject? Or how it could affect you? Please let us know. We’re happy to find the right person to answer your questions. When it comes to pre-diabetes and diabetes, we have made sure that we have the right professionals to help with these serious, but manageable problems. ~Lisa Rosenthal November is Diabetes Awareness Month. As I think about this, I recall many patients who I have counseled through ourNutrition Program for pre-diabetic and diabetic conditions. I remember their disappointment as we discussed that th Continue reading >>
Dads-to-be: How Your Age Can Affect Your Fertility And Your Baby's Health
It’s easy to think that your age doesn’t matter when it comes to having a child. After all, celebrities such as Robert De Niro and Rupert Murdoch have fathered healthy babies well into their twilight years. However, the truth about male fertility and age may surprise you. Does my age affect my fertility? In short, yes. Although most men are able to have children well into their 50s and beyond, it becomes gradually more difficult after the age of 40. There are many reasons for this, including: Sperm quality tends to decrease with age. You may still produce a similar number of sperm in your 50s as you did in your 30s. However, their shape (morphology) and movement (motility) are both likely to deteriorate as you get older. As a result, it will be more difficult for them to fertilise an egg. From about the age of 40, your testosterone levels are likely to decrease. This may reduce your libido, or make it more difficult for you to have regular sex. Illnesses that decrease fertility are more common among older men. Certain medications for later-life medical problems can also interfere with fertility. Older men tend to have older partners. Female fertility starts to decline after the age of 30, dropping more sharply after the age of 35. The older your partner, the more difficult it may be to conceive. These factors don’t necessarily mean that you won’t be able to father a child in later life. But they do mean that it’s likely to be more difficult. Will it take longer to conceive as I get older? Yes, the older you are, the longer it’s likely to take for you and your partner to conceive. This applies no matter how old she is. Other factors will play a part too, but in general, the chance of conception taking more than a year is: about eight per cent if you’re unde Continue reading >>
