Diabetes And Infertility: When Blood Sugar Control Isn’t Enough
An excerpt from the book, Balancing Pregnancy With Pre-Existing Diabetes: Healthy Mom, Healthy Baby. Maybe your blood sugars have been great and you’ve been having ongoing sex with your partner. But if you’re still not pregnant after six to twelve months of trying, you’re considered infertile. Dealing with infertility and diabetes can feel like an energy-draining double whammy of health issues, but you’re not alone. There’s a definite group of women with diabetes who require even more maintenance and medical specialists to figure out why, once again, their bodies aren’t doing what seems to come naturally for everyone else. What’s Going On? Infertility is an inability to get pregnant. You are considered infertile after a year of actively trying to conceive (i.e., having unprotected sex around the time you ovulate) if you are younger than 35, and after six months if you’re 35 or older, or if you have a history of many miscarriages. The timeframe is key: It can take some fertile couples that long to conceive naturally, while older women are advised to seek help sooner since fertility declines rapidly with age. About 10 to 15 percent of all couples experience infertility. Of those, about 40 to 50 percent are caused by female infertility, while another 30 to 40 percent are caused by male infertility. The rest are either a combination of male and female factors, or are simply unexplained as one of life’s many mysteries. Several factors can lead to infertility, according to the national infertility association RESOLVE: age, weight, sexually transmitted diseases (STDs), Fallopian tube disease, endometriosis, exposure to a chemical known as Diethylstilbestrol (DES), smoking, and alcohol use. Diabetes and Infertility: Are They Related? While all the above are ge Continue reading >>
Diabetes Mellitus: The Infertility Triple Threat
Diabetes Mellitus: The Infertility Triple Threat Colors as possibility. Feathers in a kite shop, Beijing, China Based on the feedback received from doctors reading the blog, we are introducing a new feature: Case of the Month. This Case of the Month is an actual patient from The Turek Clinic . It is presented to recognize American Diabetes Association Alert Day . He is a 31-year old who has been trying to conceive with his 28-year old wife for 2 years. During this time, he has noticed a lower sex drive and has had trouble ejaculating . His medical history is negative except for a 6-year history of diabetes mellitus that is well controlled with insulin injections. Exacerbated, he states I really dont know whats happening to me! Upon further questioning, the sex drive issue started even before they were trying to conceive. Regarding ejaculation, the patient states that his erections are not very strong and, although he has the sensation of climax, nothing comes out of the penis with ejaculation. In fact, he is concerned that things might be backing up in his body with these symptoms. First identified as a disease of sweet urine in ancient times, diabetes mellitus a metabolic disease characterized by high blood sugar ( glucose ) levels. It is one of the most common medical diseases in the U.S., affecting 26 million adults and children or about 8% of the population . Among those affected, about 15 million are people of reproductive age. Normally, blood glucose levels are tightly controlled by insulin , a hormone produced by the pancreas. When the blood glucose rises, say after eating food, insulin is released to decrease the glucose level. In patients with diabetes, there is low or no production of insulin and therefore blood sugar levels are elevated. The sugars spill int Continue reading >>
Diabetes And Fertility: How Diabetes Can Affect Your Fertility
Diabetes and Fertility: How Diabetes Can Affect Your Fertility Home Uncategorized Diabetes and Fertility: How Diabetes Can Affect Your Fertility Diabetes and Fertility: How Diabetes Can Affect Your Fertility Youve have been trying with no luck to get pregnant and have not been able to a find a reason for your infertility. You may have tried a fertility cleanse , begun eating a fertility diet, and are taking all the right supplements and herbs, but are still having trouble conceiving. It may be time to have a simple blood test to determine if your glucose levels are too high. With the rates of Type II diabetes rising every year in the U.S., more and more infertility specialists are looking toward this health issue as a main cause of some otherwise unexplained infertility cases they see. According to the American Diabetes Association, there are more than 200,000 new cases of Type II diabetes diagnosed every year, with another 2.4% of the general childbearing population suffering from the disease but not knowing it. When it comes to diabetes and infertility the answer is clear: there is a connection, unless you factor in the metabolic syndrome and polycystic ovarian syndrome (PCOS).. No, in many cases (especially among women), diabetes alone does not necessarily keep them from getting pregnant, but it oftentimes keeps them from staying pregnant especially if their glucose control is poor and theyve had the disease for a long time. In many cases, say fertility doctors, a woman with higher than normal glucose levels can get pregnant month after month. Unfortunately her diabetes status prevents that embryo from implanting in the uterus, causing a miscarriage before she ever realizes she is pregnant. In this case, the diabetes isnt preventing conception, but is preventing an 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 >>
Diabetes And Male Fertility - Infertility, Retrograde Ejaculation, Sperm Quality
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. 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 possible to find sex positions that result in improved nerve stimulation. Assisted reproduction technology (ART), such as IVF, can help with treating infertility if conception via intercourse is problematic or impossible. Another problem that may result from neuropathy ( autonomic neuropathy ) is retrograde ejaculation. This occurs if nerves are unable to control the muscles of the bladder from closing at the point of ejaculation, which results in semen entering the bladder rather than exiting via the penis. Retrograde ejaculation does not cause health problems but can impair conceptio Continue reading >>
Q&a: How Could Diabetes Affect My Fertility?
It's true, diabetes can affect fertility — in women and men. Here's why: In women, there's an association with diabetes and insulin-related causes of infertility like polycystic ovarian syndrome(PCOS) and obesity. The hyperinsulinemia associated with PCOS and obesity is thought to increase functional androgen levels in these women which in turn can cause follicular arrest (i.e. anovulation) and can adversely affect egg quality. Sometimes, just by correcting the hyperinsulinemia associated with these conditions pregnancy can be achieved. In men, diabetes can cause peripheral neuropathies (in other words, nerve damage) that can lead to retrograde ejaculation and erectile dysfunction. But these disorders can be treated — sometimes with medications or sometimes through assisted reproductive technologies. If you’re diabetic and comtemplating pregnancy, you should make sure that your blood sugar levels are well-controlled through diet, exercise, and/or medications, and seek early preconceptional counseling. Continue reading >>
Managing Diabetes For Health And Fertility
Managing Diabetes for Health and Fertility The biggest obstacle to managing diabetes or even prediabetes and insulin resistance is that we often dont know what we dont know. Presented for people with diabetes, prediabetes and for any women with blood sugar regulation issues, metabolic syndrome or PCOS who is trying to conceive in this series about effectively managing diabetes for long term health, longevity and quality of life we highlight the importance of:- Lifestyle changes you need to make to improve your insulin sensitivity Reasons why your sugar levels are skyrocketing despite the fact that youre eating free or low carbohydrate food Key food that will assist in slowing down the release of sugar from the food you eat, Truth about protein and dairy and how much you need to have to ensure optimum glucose control How meal timing can affect your weight, hunger hormones and insulin sensitivity and about timing your meals to optimize your blood glucose control When we talk about diabetes there are three types. Sometimes the lines between these can be a little blurred. The first type is Type I diabetes. This is the type I have and it occurs when the pancreas no longer produces any insulin. Its often diagnosed in childhood, but its not always the case. The exact reason that it occurs is not known, but genetic and viral factors seem to be implicated. Type I accounts for about 10% of cases of diabetes and it does require insulin as treatment. Type II diabetes is the biggest class and youre likely to hear most cases of diabetes being Type II, thats what most people do refer to. It represents about 85 to 90% of all cases. And it occurs when the pancreas is placed under demands to pump out excessive insulin. So this can wear out the pancreas and also make blood cells resistan Continue reading >>
How Does Diabetes Affect Female Fertility?
Yahoo!-ABC News Network | 2018 ABC News Internet Ventures. All rights reserved. How Does Diabetes Affect Female Fertility? SARVER HEART CENTER AT THE UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE Question: How does diabetes affect female fertility? Answer: There is somewhat of a relationship between diabetes and fertility. Young women with diabetes, either type 1 or type 2, tend, on average, to start their periods a little bit later in life than women without diabetes. Then, on the other end of the spectrum, women with diabetes tend to go through menopause slightly earlier, so this provides a slightly smaller window of fertility for women with diabetes. In addition, many women with type 2 diabetes have an underlying syndrome called 'polycystic ovarian syndrome.' We call it 'PCOS.' PCOS is associated with insulin resistance, which is a major player in type 2 diabetes, and so that's why there's a relationship between these two issues. Because of the effects of PCOS on the ovaries, women with type 2 diabetes and PCOS may find a harder time with conception than women without diabetes. So, that's really the relationship between diabetes and fertility. And, if a woman does want to get pregnant and has diabetes, it's critically important for her to be in good control of her blood glucose levels with an A1c below 7 percent before she goes off of contraceptive agents and starts trying to get pregnant. Continue reading >>
Fertility Issues In Women With Diabetes.
Abstract Diabetes mellitus Type 1 and Type 2 should be considered in the differential diagnosis of menstrual abnormalities and infertility. The reproductive period of diabetic women may be reduced due to delayed menarche and premature menopause. During the reproductive years, diabetes has been associated with menstrual abnormalities, such as oligomenorrhea and secondary amenorrhea. It was found that better glycemic control and prevention of diabetic complications improves these irregularities and increases fertility rates close to those that are seen in the general population. Women with persistent menstrual abnormalities despite adequate treatment need to be approached by broader evaluation, which will include the examination of the hypothalamic-pituitary-ovarian axis and the hormonal status, presence of autoimmune thyroid disease and antiovarian autoantibodies, and hyperandrogenism. Continue reading >>
Infertility In Women
Tweet Diabetes is associated with lower rates of fertility. There are a number of reasons which can play a part including, obesity, being underweight, having diabetic complications, having PCOS and having an autoimmune disease. With this said, many women with diabetes are able to conceive, particularly if diabetes is well controlled and a healthy body weight is maintained. Conditions The following conditions are associated with reduced fertility rates: Polycystic ovary syndrome (PCOS) Oligomenorrhea (irregular periods) Secondary amenorrhea (absent periods) Premature menopause (premature ovarian failure) Endometrial cancer (uterine cancer) Microvascular and cardiovascular complications Polycystic ovary syndrome (PCOS) PCOS is a common condition in which a large number of cysts develop on the ovaries. Whilst this feature does not in itself pose a health risk, it can reduce fertility. Women with PCOS have higher than normal levels of testosterone (hyperandrogenism). PCOS can affect fertility by leading to irregular periods (oligomenorrhea) or absent periods (secondary amenorrhea). The condition can be treated through making lifestyle changes, while medications such as clomifene and metformin can help with improving the chances of conception. PCOS is particularly associated with obesity and type 2 diabetes. People with type 1 diabetes that are taking high amounts of insulin daily may also be at risk of or suffer from PCOS. Oligomenorrhea and secondary amenorrhea Oligomenorrhea is the term for irregular periods that arrive at intervals of 35 days or more between each period. Secondary amenorrhea is said to occur if you have previously had a normal menstrual cycle but have stopped getting a periods for 6 months or longer. Both type 1 diabetes and type 2 diabetes are associate Continue reading >>
Diabetes May Affect Men's Fertility
May 2, 2007 -- Men with type 1 diabetes may have more DNA damage in their sperm, possibly hampering fertility, a preliminary study shows. The study was small and doesn't prove that type 1 diabetes causes male infertility. But the findings deserve further research, write the researchers, who are based in Belfast, Northern Ireland. They included Ishola Agbaje, MD, of the Reproductive Medicine Research Group at Queen's University of Belfast. Agbaje and colleagues studied semen and blood samples from 27 men with type 1 diabetes. Those men weren't necessarily infertile; they were invited to participate in the study while getting routine diabetes checkups. For comparison, the researchers also studied semen and blood samples from 29 men without diabetes who were undergoing infertility tests. Both groups of men were in their early to mid-30s, on average. The men with diabetes had lower semen volume than the men without diabetes. But the diabetes patients' semen volume was still within the normal range set by the World Health Organization (WHO). Sperm count, shape, and motion (motility) were similar in both groups of men. But when the researchers analyzed the sperms' DNA, they found more DNA damage in the diabetes patients' sperm. Sperm damage may increase infertility, note the researchers. Many factors can cause DNA damage. It's not clear whether diabetes was responsible for the DNA damage seen in the study. The study didn't include any men without diabetes who weren't undergoing infertility tests. Such men might have even less DNA damage in their sperm than the study groups, the researchers note. Agbaje's team calls for further studies on DNA sperm damage -- and its possible fertility consequences -- in men with type 1 diabetes. The study appears online in the journal Human Re Continue reading >>
Fertility In Women With Type 1 Diabetes
A population-based cohort study in Sweden Abstract OBJECTIVE—The purpose of this study was to assess fertility in women with type 1 diabetes and the risk of congenital malformations in their offspring. RESEARCH DESIGN AND METHODS—This was a register-based cohort study in Sweden. All 5,978 women hospitalized for type 1 diabetes at age ≤16 years identified in the Swedish Inpatient Register during 1965–2004 were followed until the end of 2004 through linkage to nationwide registers. A standardized fertility ratio (SFR), the ratio of observed to expected number of live births, with 95% CIs, was used to express the relative fertility rate. The proportion of newborns with congenital malformations was compared with that of the general population. RESULTS—We observed 4,013 live births (SFR 0.80 [95% CI 0.77–0.82]). The SFRs for those who had retinopathy, nephropathy, neuropathy, or cardiovascular complications were 0.63, 0.54, 0.50, and 0.34, respectively. Stratified analyses by year of first hospitalization showed that the reduced fertility was confined to women first hospitalized before 1985, but the presence of complications was associated with subfertility in all calendar-year strata. The proportions of newborns with congenital malformations decreased from 11.7% during 1973–1984 to 6.9% during 1995–2004 but were consistently higher than the corresponding figures for the general population. CONCLUSIONS—Women with type 1 diabetes have reduced fertility, but it appears that normalization has occurred among women with uncomplicated disease and an onset in the past 20 years. Our results suggest that the stricter metabolic control exercised in the past 20 years may have helped prevent subfertility. However, although the risk of congenital malformations has decre Continue reading >>
- Improved pregnancy outcomes in women with type 1 and type 2 diabetes but substantial clinic-to-clinic variations: a prospective nationwide study
- Postprandial Blood Glucose Is a Stronger Predictor of Cardiovascular Events Than Fasting Blood Glucose in Type 2 Diabetes Mellitus, Particularly in Women: Lessons from the San Luigi Gonzaga Diabetes Study
- Type 2 Diabetes in Women: Young, Slim, and Diabetic
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 >>
Will Diabetes Make Me Infertile?
According to the American Diabetes Association, more than 20 million Americans are diagnosed with diabetes, and more than eight million are undiagnosed but assumed to have the condition. Diabetes is a serious health concern which requires careful attention and monitoring of diet, exercise and lifestyle habits. When diabetics take care of themselves, they can lead normal, healthy lives with relatively minimal daily impact from their condition. However, one unexpected concern that doesn’t usually come up in diabetes discussions with men is their fertility and the effect diabetes can have on trying to conceive. How does diabetes affect fertility? In men, diabetes is known to cause certain medical issues that make conception difficult or not possible without treatment. These conditions include erectile dysfunction, retrograde ejaculation, retarded (delayed) ejaculation, low sperm quality, and low testosterone, also known as hypogonadism. What are these male infertility conditions? Erectile dysfunction – Men who struggle with erectile dysfunction are unable to get or maintain an erection. Erectile dysfunction is caused by nerve damage and issues with proper blood circulation. It is most common in long-term diabetics and those with untreated diabetes. Retrograde ejaculation – This is when semen enters your bladder instead of exiting the body. This is not a serious health concern, but it will make it difficult to conceive without assisted reproductive technology. Retarded ejaculation – This is when a man struggles to ejaculate due to penile nerve damage, certain medications, stress or psychological issues, or diabetes. Assisted reproductive services are needed in order to address infertility caused by nerve damage. Low sperm quality – Sperm quality and sperm motility Continue reading >>
Infertility In A Young Woman With Type 2 Diabetes
Go to: Case history A 33-year-old teacher (BMI 28 kg/m2) saw her general practitioner (GP) due to primary infertility. She was previously fit and healthy apart from a history of hirsutism which had been treated by laser therapy in her 20s. As part of her initial diagnostic work-up, she was identified to have Type 2 diabetes and polycystic ovaries on a transvaginal ultrasound scan. Her recent HbA1c was 7.7% (DCCT) (IFCC 60.7 mmol/mol). She was referred to a structured education programme and a dietician. She was also started on metformin and the dose was gradually increased to 2 g/day. Her total cholesterol was 6.2 mmol/l and her blood pressure was 144/86 mmHg. Her case was brought to the Ealing multidisciplinary group meeting for further discussion. Go to: Ways to think about the problem What is the likely cause of her infertility? In the UK, approximately one in seven heterosexual couples experience problems conceiving and investigations reveal a cause in 75% of these. The most frequent causes of subfertility are outlined in Table 1. Male causes of subfertility are mainly detected by semen analysis and testing for sexually transmitted infections (STI). In women, the routine investigations would include a transvaginal ultrasound scan, folliclestimulating hormone (FSH) and Luteinising hormone (LH) levels, day 21 progesterone level, STI checks and, if necessary, more invasive procedures such as an hysterosalpingogram or laparoscopy. Fertility problems affecting both the man and the woman are detected in 40% of couples with conception problems.1 This young woman has infertility associated with Type 2 diabetes, high BMI and polycystic ovaries. The most likely diagnosis would be polycystic ovarian syndrome (PCOS), causing oligo-ovulation and metabolic disturbance. What is th Continue reading >>