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Type 1 Diabetes Infertility

Female Reproduction And Type 1 Diabetes: From Mechanisms To Clinical Findings

Female Reproduction And Type 1 Diabetes: From Mechanisms To Clinical Findings

The functional reproductive alterations seen in women with type 1 diabetes (T1D) have changed as therapy has improved. Historically, patients with T1D and insufficient metabolic control exhibited a high prevalence of amenorrhea, hypogonadism and infertility. This paper reviews the impact of diabetes on the reproductive axis of female T1D patients treated with modern insulin therapy, with special attention to the mechanisms by which diabetes disrupts hypothalamic–pituitary–ovarian function, as documented mainly by animal model studies. A comprehensive MEDLINE search of articles published from 1966 to 2012 was performed. Animal model studies on experimental diabetes and human studies on T1D were examined and cross-referenced with terms that referred to different aspects of the gonadotropic axis, gonadotrophins and gonadal steroids. Recent studies have shown that women with T1D still display delayed puberty and menarche, menstrual irregularities (especially oligomenorrhoea), mild hyperandrogenism, polycystic ovarian syndrome, fewer live born children and possibly earlier menopause. Animal models have helped us to decipher the underlying basis of these conditions and have highlighted the variable contributions of defective leptin, insulin and kisspeptin signalling to the mechanisms of perturbed reproduction in T1D. Despite improvements in insulin therapy, T1D patients still suffer many reproductive problems that warrant specific diagnoses and therapeutic management. Similar to other states of metabolic stress, T1D represents a challenge to the correct functioning of the reproductive axis. Disorders resulting in ovulatory disturbances are a relatively common cause of infertility. They occur most frequently in the context of WHO group 2 anovulation as reflected, for examp Continue reading >>

Does Having Type 1 Diabetes Affect Levels Of Fertility?

Does Having Type 1 Diabetes Affect Levels Of Fertility?

Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Does having type 1 diabetes affect levels of fertility? Hello, I'm just posting here because I am very curious about this question, I'm 19 years old and have had type 1 for about 8 years now, and this question has popped up into my mind a few times, but does having diabetes actually affect the chances of having children when your older. I don't plan on having children for a while that's why I'm curious, the longer I wait the less chance of having children? I would love to have children when I'm older that's why I've been thinking about this. if bs control is fine there is no such question Diabetic Krissy Type 1 Well-Known Member From what I have read you are more at risk of things (If your levels are not under control) However I don't think it affects your fertility at all. I don't think so. I conceived my son accidentally, so wasn't even trying - and my daughter after only a few months. I think if your levels are high you can miscarry more, or have problems later on in the pregnancy, but the actual sperm-meets-egg part isn't affected. Pretty lucky really seeing as diabetes seems to affect just about everything else in our bodies! From a male to a male.... Adam.... Diabetes can affect you ability to perform sexually especially if you do not have good control. (micro & macro vasular issues) It can also lead to lower testosterone levels so as a male, I am sure it can affect fertility. My advice to you is to keep good stable control and to try and keep your HBA1C between 6 and 8%. Something for you to think about is: as a diabetic male, we have a higher rate of passing on diabetes to the child - More so than a diabetic woman. When you do plan to have kid Continue reading >>

Fertility Issues In Women With Diabetes

Fertility Issues In Women With Diabetes

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 hypothalamicpituitaryovarian axis and the hormonal status, presence of autoimmune thyroid disease and antiovarian autoantibodies, and hyperandrogenism. Diabetes is a disease that affects millions of people and their families. The WHO estimates that more than 180 million people worldwide have diabetes. This number is likely to more than double by 2030.[ 1 ] Type 1 diabetes, which predominately affects youth, is rising alarmingly worldwide, at a rate of 3% per year. Some 70,000 children aged 14 and under develop Type 1 diabetes annually. Type 2 diabetes is also increasing in number among children and adolescents as obesity rates in this population continue to soar, in both developed and developing nations.[ 101 ] Diabetes affects women in many ways, and one of them will be the focus of the present review the association between diabetes mellitus and infertility ( Box 1 ). Table 1. Standardized fertility ratios among women hospitalized for Type 1 diabetes at 16 years of age, stratified by type of complications (19652004, Sweden). SFR for Type 1 diabet Continue reading >>

Fertility In Women With Type 1 Diabetes

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 >>

Fertility And Diabetes

Fertility And Diabetes

1 in 7 couples experience difficulties conveiving within the first year of trying Infertility is defined as being unable to conceive following a year of regular unprotected sexual intercourse . The NHS states that amongst the population as a whole, around 1 in 7 couples experience difficulty conceiving within the first year. As diabetes can lead to additional problems that may affect fertility, the risk of infertility is therefore likely to be higher for couples in which one or more partner has diabetes. Infertility can usually be treated but bear in mind that treatment on the NHS may vary depending on the cause and by funding available in your area. If the cause of infertility can be identified, there is a better chance of being able to treat the problem. Infertility can affect both partners so it is best if you visit the doctor as a couple. As there are many conditions and factors that can affect fertility, your GP will ask you a number of questions to determine what the problem may be and whether specific tests should be run. A physical examination to check for abnormalities in the penis or testicles Chlamdiya is the most common sexually transmitted infection and can affect fertility. infertility may be categorised as primary infertility, if infertility occurs before a child is born, or as secondary infertility if trouble conceiving occurs after a previous pregnancy. Causes of infertility that can affect both men and women The following reasons can affect the chances of conceiving in both men and women: Certain medications may affect fertility. Chemotherapy can affect both male and female infertility as can taking the recreational drugs marijuana and cocaine . The most common causes of infertility in women are conditions that cause problems in releasing of an ovum ( Continue reading >>

Fertility In People With Childhood-onset Type 1 Diabetes.

Fertility In People With Childhood-onset Type 1 Diabetes.

Abstract AIMS/HYPOTHESIS: To assess the number of live births in a population-based, retrospective cohort of women and men with childhood-onset type 1 diabetes, and matched controls. METHODS: The reproductive histories of people in a Finnish cohort of 2,307 women and 2,819 men with type 1 diabetes and two matched controls (for each case) were obtained from National Population Register data. All persons with diabetes were diagnosed with the disease in 1965-1979 at the age of 17 or under. A proportional hazards model was used to model the association between the rate of live births as a function of the age of an individual and the observed covariates (sex and age at onset of diabetes). RESULTS: Both women and men with diabetes had a smaller number of live births than the controls; the HR of having a first child for diabetic women compared with controls was 0.66 (95% CI 0.62, 0.71) and for men was 0.77 (95% CI 0.72, 0.83). In women, a birth cohort effect was detected; in more recent birth cohorts, the difference between diabetic women and controls as regards having children was significantly smaller than in earlier cohorts. Later age at onset of diabetes was associated with a higher rate of having a first child among men (p = 0.04) and having a second live birth among women (p = 0.002). CONCLUSIONS/INTERPRETATION: Type 1 diabetes affects the number of live births in both women and men. The age at onset of diabetes is associated with the pattern of reproduction in both diabetic women and men. Continue reading >>

Diabetes And Male Fertility - Infertility, Retrograde Ejaculation, Sperm Quality

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 >>

Diabetes And Infertility: When Blood Sugar Control Isn’t Enough

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 >>

Infertility In Women

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 >>

Type 1 Diabetes And Your Fertility

Type 1 Diabetes And Your Fertility

Although I often struggle with maintaining consistent blood sugar levels, I do not suffer from diabetes. Because blood sugar is such an issue for me though, I often wonder what unforeseen effects diabetes can have on fertility and pregnancy. What I found was that pregnant women with type 1 diabetes are high-risk patients, and the most common problems they have are getting pregnant and staying pregnant. This is mainly tied to blood sugar levels. Type 1 diabetes doesn’t actually affect fertility in the usual way. Women who are experiencing fertility problems usually have a condition or disease that specifically makes them unable to have children, or makes having children problematic. Type 1 diabetes in itself is not tied to fertility troubles. It’s high blood glucose levels that make conceiving and staying pregnant difficult. Usually, women who are experiencing trouble with fertility because of high blood sugar levels are either unaware that they have type 1 diabetes, or they are not managing their diabetes very well. The most common fertility problem for women with type 1 diabetes and high blood sugar levels is miscarriage. If you maintain your diabetes with insulin injections and keep a consistent healthy diet, you should have no trouble conceiving and carrying a child to full term without incident. That’s not to say that your pregnancy won’t be considered high-risk however. For women with diabetes of any kind, it’s crucial that you find obstetrician who is proficient in handling high-risk pregnancies and has cared for other pregnant women with diabetes in the past. You also might want to find a dietician that can help you with meal planning through your pregnancy. Though you may have already had years of meal planning experience, finding a dietician is import Continue reading >>

Having A Healthy Pregnancy With Type 1 Diabetes

Having A Healthy Pregnancy With Type 1 Diabetes

Kerri Sparling was 7 years old when she was diagnosed with type 1 diabetes. She grew up believing that she'd never be able to have children of her own. But by the time she became an adult, significant technological advances in managing the illness gave her hope. With two decades of blood sugar control under her belt, Sparling eventually looked around for models of a healthy pregnancy with type 1 diabetes. Aside from Julia Robert’s character in the movie Steel Magnolia, she didn’t find much. Roberts’ character had type 1 diabetes and successfully carried a child to term, only to die soon after from diabetes complications. “It wasn’t a positive image,” Sparling said. Undaunted by the Hollywood dramatization, Sparling did her own research and, in preparation for pregnancy and with the help of her endocrinologist, worked for more than a year to get her A1C — a standard test to find out average blood sugar levels over several months — below seven. Sparling, now 34, has a 3-year-old daughter and confirms that while type 1 diabetes and pregnancy might be a challenging mix, a healthy pregnancy and a healthy baby are both possible. That said, pregnancy demanded a lot more insulin than she was used to taking, and she had to spend the last month of her pregnancy in the hospital with pre-eclampsia (high blood pressure in pregnancy) before her 6-pound, 13-ounce baby girl was delivered by Caesarean section. “Pregnancy has a definitive end,” Sparling said. “I felt I could make it through to the end of that. But diabetes goes on and on.” Like Sparling, other diabetic women can get pregnant. But without proper monitoring and extra precautions, the chronic illness puts both the mother and the baby at risk for various complications. Here are some of the important m Continue reading >>

Type 1 Diabetes Linked To Lower Fertility

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 May Affect Men's Fertility

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 >>

Infertility With Type 1 Diabetes

Infertility With Type 1 Diabetes

You may have seen some older posts about what your a1c should be while trying to conceive, diabetes & pregnancy, and others about the chances of my children actually developing t1d too. Well, those were posted around the time that my husband and I started trying for a baby… and then it never happened. I never thought it would take so long for us to see positive test result. How come it always seems so easy for everyone who isn’t trying? In November, my fertility endocrinologist discovered I had a septate uterus, where the shape of the uterus looks more like a heart, rather than the normal triangular shape. Luckily, a septate uterus can be treated with a minor procedure called a hysteroscopy. The top piece of the heart needed to be removed during a hysteroscopy so my monthly cycles would regulate, I would ovulate, we could conceive easier, and the chances of miscarriage would be minimized. I’ve always been on birth control so that my cycles would be normal, and I didn’t realize there was anything wrong with my body. “[The hysteroscopy surgery] involves inserting surgical instruments through the cervix and removing the septum without having to make an abdominal incision,” says Beth W. Rackow, M.D., an assistant professor of OB-GYN at Yale University School of Medicine in New Haven, Conn. After the surgery, I was prescribed with many different hormones to regulate my cycles and help me heal faster. Those prescriptions, such as progesterone, have not only messed with my hormones and emotions, but also with my control of my blood sugars! I feel like I’ve been an emotional wreck and my poor husband is there to pick up the pieces. The hormones have made my blood sugars impossible to control, with so many highs and lows. I’ve learned to eat slightly lower carbs Continue reading >>

Reproductive Function In Male Patients With Type 1 Diabetes Mellitus.

Reproductive Function In Male Patients With Type 1 Diabetes Mellitus.

Abstract This study was undertaken to evaluate conventional and some of the main bio-functional spermatozoa parameters, serum gonadal hormones and didymo-epididymal ultrasound features in patients with type 1 diabetes mellitus (DM1). DM1 affects an increasing number of men of reproductive age. Diabetes may affect male reproduction by acting on the hypothalamic-pituitary-testicular axis, causing sexual dysfunction or disrupting male accessory gland function. However, data on spermatozoa parameters and other aspects of the reproductive function in these patients are scanty. Thirty-two patients with DM1 [27.0 (25.0-30.0 years)] and 20 age-matched fertile healthy men [28.0 (27.25-30.75 years)] were enrolled. Patients with diabetic neuropathy, other endocrine disorders or conditions known to alter spermatozoa parameters were excluded. Each subject underwent semen analysis, blood withdrawal for fasting and post-prandial glycaemia, hormonal analysis and didymo-epididymal ultrasound evaluation before and after ejaculation. Patients with DM1 had a lower percentage of spermatozoa with progressive motility [10.0 (7.0-12.75) vs. 45.0 (42.0-47.75) %; p < 0.01] and a higher percentage of spermatozoa with abnormal mitochondrial function than controls [47.0 (43.0-55.0) vs. 2.0 (1.0-5.0) %; p < 0.01]. Patients also had greater post-ejaculatory diameters of cephalic [11.5 (10.2-13.6) vs. 6.0 (4.0-7.0) mm; p < 0.01] and caudal epididymis [5.5 (4.00-7.55) vs. 3.0 (2.0-4.0) mm; p < 0.01] compared to controls, suggesting a lack of the physiological post-ejaculation epididymal shrinkage. Correlation analysis suggested that progressive motility was associated with fasting glucose (r = -0.68; p < 0.01). The other parameters did not show any significant difference. Patients with DM1 had a lower Continue reading >>

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