Diabetes and InfertilityDr Asha S Vijay
With the rates of Type II diabetes rising every year, more and more infertility specialists are looking toward this health issue as the 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. In many cases, High glucose levels are reported to increase a woman’s chances of miscarriage by 30-60% according to statistics released by the American Diabetes Association.
Even when implantation does occur, there are other risks to consider, including:
> An increased risk of birth defects due to damage caused to embryonic cells from high levels of glucose in the blood
> A larger baby resulting in a c-section, which increases a mother’s chances of infection
> An increased risk of gestational diabetes in the mother, which can cause other health concerns for both mother and baby
When Glucose Levels Are Too High
In addition to keeping an embryo from implanting, glucose levels that are too high can also affect hormone levels throughout the body including the all-important estrogen, progesterone and testosterone levels needed for a pregnancy to occur. That is why glucose control is so vital to your fertility.
Types of Diabetes
Type I Diabetes
Most people know how dangerous Type I diabetes can be. In most cases this type of diabetes destroys the insulin-producing cells in the body, making it necessary to supplement insulin through daily injections. When it comes to diabetes and pregnancy, this is the most dangerous type of diabetes to have for both mother and child.
Type II Diabetes
Type II diabetes, or an inability of the body to produce enough insulin to keep up with glucose levels in the bloodstream, is the most common type of diabetes now experienced in the U.S., and can often be controlled with dietary changes and an increase in exercise. (search Dr Gabriel Cousins who has cured diabetes through diet changes). Although wrought with its negative effects, Type II diabetes can be controlled and side effects limited, making pregnancy safer.
Controlling Your Diabetes
When it comes to controlling their diabetes to attain a healthy pregnancy, most doctors urge women to plan for pregnancy by doing the following:
Get their weight to a normal level (the more obese you are, the harder it will be to control your glucose levels)
Get your A1C levels below 6.5 before attempting to get pregnant
Controlling your daily sugar levels for 3-6 months (the longer the better) to give your body the chance to prepare for a pregnancy
Diabetes in Men
Men too can experience infertility issues due to high glucose levels. For some retrograde ejaculation, where semen backs up into the bladder, making it impossible to get to the woman’s reproductive organs, becomes a problem, as does erectile dysfunction caused by both diabetes itself as well as medications that may be used to control it.
Still, there is one, the more dangerous reproductive side effect to diabetes in men: DNA damage. According to research diabetes can and does cause serious DNA damage to sperm which can inhibit pregnancy, live birth and even healthy, normal fetus. The results of the study include that:
Diabetic men have much lower semen levels (just 2.6 ml compared to 3.3 ml in their non-diabetic counterparts).
The nuclear DNA in diabetic man’s sperm cells were more (52 per cent versus 32 per cent).
There were more deletions in the mitochondrial DNA of diabetic men’s sperm cells than those of non-diabetic men.
The mitochondrial DNA deletions in the diabetic men’s sperm cells ranged from 3 to 6 and averaged 4, while for the non-diabetic men it ranged from 1 to 4 and averaged 3.
What does all this mean? Simply put, a diabetic man who does not control his glucose levels has less of a chance of impregnating his partner and when he does, the risk of miscarriage and deformities are much higher.
Should Diabetic Partners Try and Conceive At All?
All of this may leave diabetic partners wondering if it is even safe to try and get pregnant at all. While it is important to understand the risks involved in high glucose levels and fertility, it is also important to understand that simply controlling your glucose levels, and getting (and keeping them) at a more normal level will reduce these risks and offer the opportunity for a safe pregnancy resulting in a healthy baby. The key to success, of course, is working with your endocrinologist and obstetrician to ensure that your glucose levels remain stable months before trying to conceive as well as during pregnancy. With a good plan and dedication to eating right and staying healthy, your chances of giving birth are very high, despite a diabetes diagnosis.
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