When your blood sugar levels are not well controlled, they can cause hormonal changes that interfere with your reproductive system. Even if you are managing diabetes well, it is important to understand that it can still play a role in fertility outcomes. But there's no need to feel discouraged, as many people with diabetes can successfully conceive with proper planning.
In this article:
How Diabetes Impacts Female Fertility
Certain conditions linked to diabetes can make getting pregnant harder:- Polycystic ovary syndrome (PCOS): This hormonal condition is common in individuals with type 2 diabetes if obesity is also a factor. PCOS can cause irregular or absent periods, which may make ovulation unpredictable and lower your chances of conceiving.
- Irregular menstrual cycles: Many people with diabetes experience cycles longer than 35 days or even miss periods for six months or more. This can make it harder to track ovulation and conceive.
- Premature menopause: People with type 1 diabetes may face menopause before age 40, shortening their fertile years.
- Endometrial cancer risk: Individuals with type 2 diabetes and PCOS have a higher risk of endometrial cancer, which can lead to infertility if not caught early.
How Diabetes Affects Male Fertility
Diabetes can also impact men’s reproductive health. These are some of the ways it can influence male fertility:- Erectile dysfunction: High blood sugar levels can damage nerves, making it difficult to maintain an erection. This may complicate conception.
- Ejaculatory issues: Nerve damage may also cause retrograde ejaculation (where semen goes backwards into the bladder) or a complete lack of ejaculation.
- Sperm quality problems: Men with diabetes may have lower sperm counts, poor sperm motility, abnormal sperm shape, or reduced sperm DNA integrity. All of these issues can lower fertility.
- Testosterone levels: Fluctuating blood sugar levels and insulin resistance can reduce testosterone production. This can impact sperm production and quality.
Preparing for Pregnancy with Diabetes
If you have diabetes and are planning to get pregnant, preparation is important to reduce risks for you and your baby. This is what you should focus on before trying to conceive:- Blood sugar control: Aim for an HbA1c level below 7 per cent at least three months before conception. A target below 6.5 per cent is even better. This helps lower the risk of foetal malformations.
- Medical check-ups: Visit your doctor to check blood pressure, blood lipid levels, thyroid function (to rule out hyperthyroidism or hypothyroidism), kidney function and eye health (to detect diabetic retinopathy).
- Folic acid supplementation: Under medical guidance, take folic acid at least one month before conception.
- Stop smoking: Smoking can harm your pregnancy and your baby’s health, so quitting is important.
- Healthy diet and exercise: Follow a diet with carbohydrates, healthy fats, and protein. Choose pregnancy-safe activities like brisk walking, cycling, or swimming to stay active.
- Medication adjustments: If you have type 1 diabetes, ask your doctor if you should change your insulin type or therapy methods. For type 2 diabetes, you may need to switch to insulin therapy, as many oral medications lack safety data for pregnancy. You might also need to learn how to use an insulin pen or pump.
Managing Pregnancy with Diabetes
Once you’re pregnant, keeping your blood sugar levels in check becomes even more important. Here’s how to manage diabetes during this time:- Target blood sugar levels: Your doctor will guide you on the best blood sugar range for you during pregnancy. These targets may vary based on your health, type of diabetes, and treatment plan.
- Frequent monitoring: Check your blood sugar six times a day (before and one hour after meals). Continuous glucose monitoring (CGM) systems can help by tracking levels in real-time and alert you if they go too high or too low.
- Insulin needs: Insulin requirements change during pregnancy due to hormonal shifts. They typically drop in the first trimester, rise in the second trimester, and continue to increase in the third trimester. After delivery, insulin needs drop sharply again.
- Ketoacidosis awareness: High blood sugar can lead to ketoacidosis, a serious condition that happens when your body produces excessive amounts of acids called ketones. Talk to your doctor about when to check for acetone in your urine or blood.
- Iodine supplementation: Your doctor may prescribe iodine supplements to support your baby’s development.
Risks for Mother and Baby
Uncontrolled diabetes in pregnancy can lead to complications:For the Mother
- Large baby (macrosomia): High blood sugar can cause your baby to grow too large. This may increase the need for a C-section or cause birth complications.
- Worsening diabetes complications: Conditions like diabetic retinopathy, kidney issues, or nerve damage may worsen during pregnancy.
- Infections: You’re more likely to get urinary or genital infections.
- Preeclampsia: This serious condition involves high blood pressure and protein in the urine.
For the Baby
- Malformations: Poorly controlled blood sugar in the first trimester can lead to heart, lung, or nervous system defects.
- Premature birth and miscarriage: The risk of premature birth is five times higher, and miscarriage is also a concern if blood sugar isn’t managed.
- Newborn issues: Babies may face low blood sugar, jaundice, or breathing problems right after birth.
Whether you’re trying to conceive or navigating IVF, you’re not alone. Join our supportive communities to connect, share, and find strength with others on the same journey.
FAQs on Facing Infertility Challenges with Diabetes? Here’s What You Should Know
- Can a diabetic woman get pregnant?
Yes, a diabetic woman can get pregnant. She just needs to keep her blood sugar levels under control before and during pregnancy. - Can high blood sugar cause pregnancy complications?
Yes, it can increase the risk of miscarriage, birth defects, and other complications if not controlled.
