Management of a diabetic pregnancy after IVF

The issue of diabetes during pregnancy is particularly acute for women who conceived a child using assisted reproductive techniques, such as in vitro fertilization (IVF). The specialists at the NatuVitro clinic, whose main focus is reproductive medicine, have many years of experience in diagnosing and treating infertility, as well as managing complex pregnancy cases, including those suffering from diabetes. They apply modern protocols for managing pregnancies with diabetes after IVF, taking into account the individual characteristics of each patient, which allows them to minimize risks and ensure optimal conditions for the health of both mother and child.

Diabetes and Its Impact on Fertility

Diabetes can have a significant impact on fertility in both women and men. In women, diabetes can cause hormonal disturbances leading to irregular menstrual cycles, anovulation, and reduced chances of conception. In men, the disease can result in poor sperm quality, erectile dysfunction, and decreased libido. Blood sugar control and timely medical intervention can help minimize these risks and improve fertility.

In the most severe cases, diabetes can also lead to infertility. To learn more, please see our article “Diabetes and Infertility: Causes, Risks, and Treatment Methods,” available on our website.

Management of Pregnancy in Cases of Diabetes After IVF

In women who have given birth via IVF, diabetes increases the risks of complications for both the mother and fetus. Special attention is given to patients suffering from gestational diabetes, which develops in 2 to 5% of pregnant women, and to women who already have a diabetes diagnosis. These categories of patients are more likely to experience risks and complications such as late-onset pre-eclampsia (high blood pressure accompanied by edema and protein in the urine), polyhydramnios (excessive amniotic fluid), preterm labor, hypertension, fetal macrosomia (excessive birth weight), and an increased risk of neonatal hypoglycemia and respiratory distress syndrome in newborns. The management of these pregnancies requires a comprehensive approach involving obstetricians, endocrinologists, and reproductive specialists.

Fundamental Principles of Monitoring

• Stable diabetes compensation: normalization of blood sugar to 3.3-4.4 mmol/l fasting and no more than 6.7 mmol/l 2 hours after meals;
• Close metabolic monitoring to prevent complications;
• Adherence to a diet: 1600-2000 kcal with a distribution of 55% carbohydrates, 30% fats, and 15% proteins;
• Timely prevention and correction of obstetric disorders;
• Regular monitoring of the placenta and fetus.

Preparing for Pregnancy in Cases of Diabetes

Diabetic women are advised to carefully plan their pregnancy, especially if antiretroviral treatment is anticipated. Consulting a reproductive specialist, obstetrician-gynecologist, and endocrinologist is mandatory to assess overall health status.

Important Aspects of Preparation:

• Achieving optimal diabetes compensation;
• Blood pressure control;
• Thyroid hormone testing;
• Treatment of diabetes complications (nephropathy, retinopathy);
• Smoking cessation.

Management of Diabetic Pregnancy After IVF

• Adherence to a specialized diet;
• Individual selection of insulin therapy (dosages are determined by the physician);
• Monitoring of glycosylated hemoglobin levels (HbA1c should be less than or equal to 7%) and ketonuria;
• Folic acid supplementation as prescribed by a physician;
• Regular check-ups with an ophthalmologist and other specialists;
• Dynamic monitoring by an obstetrician-gynecologist, endocrinologist, and reproductive specialist.

Assisted Reproductive Techniques and Their Specificities in Diabetes

The specialists at the NatuVitro clinic have experience in managing pregnancy in natural cycles and using medically assisted reproduction:

• Natural cycle pregnancy: preservation of natural hormonal processes, which is important in cases of well-compensated diabetes;
• IVF with egg donation: an effective solution for women with reduced ovarian reserve or genetic conditions, while closely monitoring metabolic status;
• IVF with double donation: recommended in cases where the use of donor eggs and sperm is necessary, particularly when infertility factors are combined.

Each of these methods requires a personalized approach and continuous medical follow-up to ensure a safe and successful pregnancy in cases of diabetes. We offer a personalized approach to each patient, taking into account her medical history and health characteristics, in order to ensure maximum safety for both mother and child.