I am 27 years old and living with diabetes. My partner and I have been trying to have a child for over 2 years now, and I haven’t been able to get pregnant, which has been really upsetting. Given that I really want kids, what should my next steps be?

Written by our medical expert, Stephen Hudson, MD.

Your diabetes may or may not be a factor in why you are having difficulty getting pregnant. However – the most important thing you need to be aware of (and you likely are!) is that with diabetes there are potentially increased risks to both the baby and to Mum in pregnancy.

First of all we like our diabetics to be taking 5 mg of folic acid daily before getting pregnant. With diabetes there may be an increased risk of birth defects, and taking extra folic acid can help reduce that risk.

It is extremely important that your diabetes is well controlled before conceiving. If your diabetes is not well controlled – there are increased risks of infertility, birth defects and miscarriage, as well as increased risk to the baby’s growth and development during the latter stages of pregnancy. Some other increased risks related to diabetes in pregnancy include toxemia (high blood pressure), kidney disease, premature delivery and C-section. So it is very important your diabetes is well controlled and that your endocrinologist is aware you are trying to conceive.

If your diabetes is well controlled, there may be many other reasons why you may not be getting pregnant. In other words it is possible your diabetes has little to do with your fertility difficulties.

At this stage I would recommend you speak with your family doctor and request a referral to a Fertility Specialist so that you and your husband can be further investigated. The usual approach would be as follows:

  1. Make sure your sugars are well controlled and that your lifestyle choices are optimal ( weight/exercise/diet).
  2. Establish that you are ovulating regularly. If you are having regular monthly periods – you are likely ovulating.
  3. Ensure that you are having intercourse at ovulation! (To learn how to calculate your fertile days, click here.)
  4. A clinical exam and pelvic ultrasound to check your uterus and ovaries.
  5. Make sure that your fallopian tubes are open. We usually do a test called a hysterosalpingogram to check this.
  6. Check all your hormone levels – these are done at various stages of your cycle – and would include follicle stimulating hormone (FSH) to check your egg reserve, and your thyroid and prolactin levels. We would also want to check your blood type and do an infectious diseases screen.
  7. Check your husband’s semen analysis to make sure his swimmers are in good form.

Once all these tests have been done – if anything abnormal is identified it can be addressed. It may be that all the tests could come back within the normal range – and it is not uncommon for no obvious explanation to be found (Unexplained Infertility). In this situation there are many fertility promoting treatments which could be discussed with you.

Given your young age – I would be very optimistic that science can help you. So speak with your doctor to be sure your diabetes is well under control, take folic acid daily (5 mg), and see a fertility specialist.

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