Fertility And Diabetes
There was a time when diabetes placed a woman outside the realm of childbearing because it was too dangerous. Out of control blood sugar and insulin troubles could easily leave a woman very ill or dead and the risk to the unborn baby was about the same. Today, thanks to advances in insulin and diet management, women with diabetes can have a healthy pregnancy and delivery.
Make A Plan And Stick To It
The secret is in the planning and in creating a regimen that safeguards both mother and baby. Gestational diabetes, which only happens during the second and third trimesters of pregnancy, and pre-existing diabetes, both require blood sugar control and management throughout the entire pregnancy. However, women with pre-existing diabetes must gain control of their blood sugar and maintain tight control before conception. They have to maintain that control and balance throughout the pregnancy as well. In the early months of pregnancy, the baby's vital organs are developing and in the later stages of pregnancy, the size of the baby is affected by blood sugar, so managing blood sugar is not optional.
This Isn't Going To Happen Overnight
Since it takes time to get all parts of a regimen together, such as diet, exercise program, and insulin, it is wise to achieve blood sugar control at least six months before conception. If a woman has high blood sugar when she conceives, the risk to her baby is great. Diabetic-related fetal birth defects happen before a woman even knows she is pregnant, occurring in the first two weeks of development. Good sugar control after the fact does nothing to address serious birth defects that happen in the beginning weeks of gestation.
How Diabetes Affects Fertility
Diabetes affects fertility in cases where the disease is out of control and blood sugars are extremely high. When control is poorly managed fertility suffers. There is also an increased risk for miscarriage in the early weeks of pregnancy for those women with diabetes that is not under control.
Many women with type 2 diabetes also have polycystic ovarian syndrome (PCOS) which is associated with insulin resistance. The resistance means that more insulin is required in order to maintain sugar balance and the effects of PCOS make it difficult for women to conceive and carry a pregnancy. Typically, women with PCOS and type 1 diabetes deal with weight issues, also a major problem in conception.
Metformin, PCOS And Diabetes
The insulin-sensitizing drug, metformin, designed to decrease insulin resistance, is frequently used in cases where a woman with PCOS and diabetes is being treated for infertility. This drug has been used with good success.
At the end of the day, when a woman with diabetes wants to conceive, she is wise to ensure her blood sugar is under strict control several months before she conceives, during the entire pregnancy and long afterward.