Fecundability among women with type 1 and type 2 diabetes in the Norwegian Mother and Child Cohort Study

Abstract

Aims/Hypothesis We assessed the effects of type 1 diabetes and type 2 diabetes on fecundability (as manifest by increased time-to-pregnancy (TTP)) in a large cohort of pregnant women. Methods This study is based on the Norwegian Mother and Child Cohort Study (MoBa). Members of this large cohort were enrolled early in pregnancy and asked about TTP and other factors. Among the 58,004 women included in the analysis, we identified 221 cases of type 1 diabetes and 88 cases of type 2 diabetes using the Medical Birth Registry of Norway. A logistic analog of the proportional probability model, a Cox-like discrete-time model, was used to compute fecundability odds ratios (FOR) and 95% CI for type 1 diabetes and type 2 diabetes, adjusted for maternal age and prepregnancy BMI. Results Compared with non-diabetic women, the adjusted FOR for women with type 1 diabetes was 0.76 (95% CI=0.64, 0.89) and the adjusted FOR for women with type 2 diabetes was 0.64 (95% CI=0.48, 0.84). These FORs did not change substantively and remained statistically significant after excluding women with irregular menstrual cycles and accounting for cycle length. Conclusions/Interpretation The results from the present study provide evidence of substantially decreased fecundability for women with type 1 and type 2 diabetes, even among those with normal menstrual cycles.

Detailed description of a prepregnancy care program and its impact on maternal glucose control, weight gain, and dropouts

“…Although infertility was the reason for dropout in only one‐third of the women, family issues and unexplained loss to follow‐up might also be attributed, in part, to infertility problems. Type 1 diabetes significantly affects fertility (especially in complicated type 1 diabetes) and increases time‐to‐pregnancy in 1 month compared with the general population . The patients who discontinued PPC in our study were older and more overweight compared with those completing PPC, and the time from HbA 1c target to the final PPC was longer in agreement with the theory that infertility plays an important role in dropouts during PPC…”

“…Type 1 diabetes significantly affects fertility (especially in complicated type 1 diabetes) and increases timeto-pregnancy in 1 month compared with the general population. [34][35][36] The patients who discontinued PPC in our study were older and more overweight compared with those completing PPC, and the time from…”

Metabolic Syndrome and Infertility in Women

“…Hyperglycemia and impaired regulation of glucose have also been shown to promote the growth of cancer cells (73). Cancer cell glucose transporting proteins have been shown to increase in an attempt to respond to the increased glucose demands (74). Epidemiological studies have also shown that there is an association between diabetes and endometrial cancer (75).…”

Nutrition in Human Fertility

“…For example, insulin resistance and postprandial hyperinsulinemia are more prevalent among oligomenorrheic non-PCOS infertile women than among eumenorrheic infertile women [ 105 ]. Likewise, diabetic women in the general population have lower fecundability than nondiabetic women [ 106 ]. Moreover, HbA1c levels within the nondiabetic range are inversely related to fecundability and positively related to characteristics of PCOS (free testosterone levels and cycle irregularity) among healthy pregnancy planners in the general population [ 107 ].…”