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Conception rate may increase for Type II diabetics

Catherine McDiarmid-Watt | Wednesday, October 10, 2007 | 0 comments

Women with obesity or Type II diabetes face many challenges including trying to conceive, but hope may be on the horizon. A recent study at Washington University's School of Medicine found that women who are obese, have Type II diabetes, or have a family history of Type II diabetes, could potentially improve their rates of successful pregnancies with drug treatments.

Dr. Kelle Moley, professor of obstetrics and gynecology, wanted to discover the reason why insulin-resistant women faced higher rates of pregnancy loss, either due to obesity or Type II diabetes. Type II diabetes is also known as adult onset diabetes and is commonly observed in obese individuals.

"We found that with insulin-resistant embryos (the same as in pregnant women with obesity), the embryos didn't take up glucose. As a result, [the embryos] had problems implanting [in the uterus], and if they did implant, the women underwent miscarriages," said Moley.

By performing a study on mice, she determined that these women may be able to take Metformin, an anti-diabetes drug, to ensure more successful pregnancies.

"If we gave the embryos Metformin, we were able to rescue embryos from implantation failures," said Moley. "We think that correlates with the fact that if we treat women with Metformin, the drug will have a direct effect on embryos, and will improve insulin sensitivity and result in a better outcome."

Moley decided to study the effects of Metformin because it is often given to women with polycystic ovarian syndrome (PCOS). PCOS is an endocrine disorder that increases the rate of miscarriage due to the increased levels of insulin in the body.

"If women [with PCOS] come to my office because they're trying to get pregnant, the first thing we find out is if they're ovulating. Usually these women won't ovulate unless they're on Metformin because it lowers blood glucose levels," said Moley.

The study suggests that women with PCOS should stay on Metformin even after they get pregnant, and Moley supports keeping them on it for up to ten weeks of the gestation period. In fact, Kristin Bibee, a second year M.D. Ph.D at the School of Medicine who assisted Moley with the study, feels that this is the most important finding.

"We've shown that if you keep women with PCOS on Metformin, it probably would help embryos survive the first few days and be more normal," said Bibee.

Metformin, however, often causes side effects such as nausea and diarrhea, so Moley hopes her study will lead to the development of milder drugs.

"At least in my population of patients, about 10 percent of people give up because there are too many side effects," said Moley.

The study has important implications for college women, even if they are not thinking about pregnancy in the near future.

"Women who are borderline insulin resistant are probably not picked up as readily, and these women are at risk for having a miscarriage and even possible birth defects," said Moley.

If students do have a family history of Type II diabetes, Moley said it is important for them to get their glucose levels checked and start early with diabetes testing. Moley added that they could even start a drug like Metformin in order to prevent insulin resistance from worsening because it could affect future reproduction.

"If you're on the verge of insulin resistance, a healthy lifestyle really would mean a lot in terms of the long run," said Bibee. "Being healthy in your late teens and early twenties can really impact your life down the road, which a lot of times people don't really want to hear."


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About Catherine: I am mom to three grown sons, two grandchildren and two rescue dogs. After years of raising my boys as a single mom, I remarried a wonderful man who had never had a child of his own. Unexpectedly, I found myself pregnant at 49!
Sadly we lost that precious baby at 8 weeks, and decided to try again. Five more losses, turned down for donor egg, foster care and adoption due to my age and losses - we have accepted that there will be no more babies in our house.

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