By Shaun Williams, MD and Carolyn Gundell, M.S.
As much as 50 percent of Hispanic Americans will develop diabetes, a disease where glucose (blood sugar) is too high, according to a 2014 report from the Center for Disease Control (CDC). Diabetes is connected to weight gain, heart disease, vascular damage, infertility and serious health concerns for baby and mother during pregnancy. Few people realize – and even fewer people discuss – that diabetes affects reproductive hormone production, a person’s ability to conceive, and increases the risk for miscarriage and birth defects in early pregnancy.
How Diabetes Affects Fertility
Our bodies rely on hormones to regulate a wide range of functions, including how we process food and energy, as well as when we ovulate (for women) or the ability to produce healthy sperm (for men). At a fundamental level, both diabetes and infertility are evidence of a hormonal imbalance.
Diabetes is a metabolic disease in which the body’s inability to produce any or enough insulin causes elevated levels of glucose in the blood, which causes the pancreas to pump more and more insulin to maintain glucose control.
For a couple trying to get pregnant, hormone production and insulin sensitivity are closely intertwined. Higher levels of insulin production can elevate androgens like DHEAS and testosterone, which interfere with the growth of the ovaries’ follicles. Follicles nurture egg development until it is mature enough to be released down the fallopian tubes in search of sperm cells. Elevated insulin can cause irregular or no ovulation due to elevated androgens’ negative effect on follicle development.
What Patients Can Do
People who suspect that they are at risk for diabetes should talk to a physician. Diabetes is preventable. There are many reasons for avoiding this ubiquitous disease – heart disease, liver disease, macrovascular complications that damage the brain and legs, and microvascular complications that damage eyes, kidneys, feet and nerves. Perhaps one of the most motivating reasons is the desire to start a family.
At our practice, Reproductive Medicine Associates of Connecticut (RMACT), we want our patients to have the best possible chance for success, and this begins with optimizing their health – even if it requires delaying a fertility treatment cycle. RMACT nutritionists are available for counseling (often covered by insurance) and group seminars to help patients improve their impaired glucose and get diabetes under control.
Preliminary tips for managing elevated glucose and its effect on fertility:
- Ask a physician for blood tests. Whether you go to a fertility specialist or internist, ask for hemoglobin A1c, a simple blood test that reports how well a person’s body handles sugar.
- Calculate your BMI. There are several websites that calculate BMI when a person inputs his or her weight and height.
- Talk to a nutritionist. Changing eating habits can be very difficult, but having a coach and educator will help patients create healthy eating habits.
- Get healthy together. Patients have greater success in making changes to their diet and exercise routines if they have a partner who does it with them.
- See a reproductive endocrinologist. Anyone who has been trying to conceive for six to twelve months without success should see a board-certified fertility specialist.
Parents often do things for their children that they would not do for themselves. We see this when patients learn that their health is preventing a couple from having a baby. We find it inspiring and admirable that many of our patients make changes to their habits because they are determined and dedicated to their families.
Dr. Shaun Williams, a fertility specialist at RMACT, is a board-certified OB/GYN and reproductive endocrinologist who sees fertility patients in Trumbull, Danbury, Stamford and Norwalk. He also leads RMACT’s FertiFamilia team, which is a Spanish-speaking team that includes a nurse, financial advisor and patient navigator.
Carolyn Gundell, M.S., leads the Fertility Nutrition Program at Reproductive Medicine Associates of Connecticut (RMACT). She has over 25 years of nutrition experience, counseling patients with conditions associated with infertility, such as insulin resistance, diabetes and Polycystic Ovarian Syndrome (PCOS).
To contact Dr. Williams or Carolyn Gundell, please call 800-865-5431 or go to www.rmact.com; if you prefer to read in Spanish, click the Spanish flag on our website.