Getting Pregnant With Diabetes
Approximately 1 in 10 Americans have diabetes, and more than 1 in 3 have prediabetes. Women with diabetes may wonder if pregnancy is possible. Although the condition can negatively affect fertility, assisted reproductive treatment (ART) options like in vitro fertilization (IVF) can help people with diabetes get pregnant.
Types of diabetes
There are several different types of diabetes. Type 1 diabetes is an autoimmune disease where the immune system attacks and destroys insulin-producing cells in the pancreas. This type of diabetes is commonly diagnosed in childhood and makes up about 10% of total diabetes cases. Type 2 diabetes is when the body doesn’t make enough insulin or doesn’t respond well to the insulin produced. People who are overweight are more likely to develop type 2 diabetes, which is usually diagnosed in adulthood. Prediabetes is the stage before a type 2 diabetes diagnosis is made. Blood sugar levels are higher than normal but can still be corrected. Gestational diabetes is a form of diabetes that develops during pregnancy.
Effects on fertility
Women with diabetes often experience lower rates of fertility. Many factors associated with the disease can make conception more difficult, including polycystic ovarian syndrome (PCOS) and obesity. Women with diabetes often experience irregular periods, or no periods, which can affect proper ovulation. Women with type 1 diabetes are more likely to experience premature menopause, meaning fertility is halted before age 40. Diabetes is also associated with lower egg quantity and quality in women and reduced sperm quality in men.
Getting pregnant with diabetes
Although conception is more difficult with diabetes, pregnancy isn’t impossible. Women with good blood sugar control, maintaining a healthy weight, and exercising regularly are more likely to conceive. When trying to conceive (TTC) the healthcare provider may order a hemoglobin A1c (HbA1c) blood test to check glucose levels over the past 2-3 months. Depending on the results, the doctor may recommend additional at-home blood testing to keep levels in check. Ideal blood glucose levels for people with pre-existing type 1 diabetes or type 2 diabetes who become pregnant are HbA1c below 6% and fasting glucose below 95mg per dL. In addition to improving fertility, keeping glucose levels within normal range can prevent complications during pregnancy, such as miscarriage, congenital disabilities, and macrosomia.
Is IVF the answer?
When women with diabetes have been unsuccessful at getting pregnant naturally, IVF is an option. Since diabetes can affect egg quantity and quality, the IVF approach allows the doctor to stimulate multiple eggs to grow and ideally extract more than during a single cycle. The egg is combined with sperm in the lab and allowed to grow under controlled circumstances. The embryo is then transferred back into the uterus for pregnancy. During IVF, the fertility specialist can also keep a close eye on glucose levels and provide lifestyle and medication counseling to control levels, increasing pregnancy chances.
Control sugar, get pregnant
Women with diabetes can get pregnant. Controlling blood sugar and maintaining a healthy weight are the best ways to ensure increased chances of conception and a healthy pregnancy. IVF can be performed if needed to increase the number of eggs available for use.