PCO, diabetes, infertility

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Viewer Question

It is my understanding that there is a strong association between Polycystic Ovarian Disease and diabetes, insulin resistance in the cells. I also see no clear information about the infertility that often accompanies PCO. I have read that insulin treatment was somewhat successful in treating infertility caused by PCO? Is this information still valid?
Signed, OB

Doctor's Answer

Insulin treatment is not an infertility treatment. However, control of blood sugar is very critical for successful pregnancy in all stages. In fact, doctors often try to make every effort to control elevated blood sugar prior to pregnancy. Because diabetes pills are felt to be dangerous to the fetus, and yet blood sugar needs to be well-controlled to minimize the pregnancy complications, insulin treatment is often used. Insulin can cause weight gain, but here is no choice in the matter in a woman with elevated blood sugars who becomes pregnant, because insulin is the only diabetes drug that is safe in pregnancy. Therefore, it is not uncommon for diabetic women with PCO to either be placed on insulin if pregnancy is anticipated, since blood sugar control prior to pregnancy is required for optimal pregnancy outcome. In addition, women with PCO may be at higher risk of developing diabetes during pregnancy, in which case they will be placed on insulin treatment.

Although insulin is not a fertility treatment, clomiphene and other medications are used to treat PCO-associated infertility. Because they may ovulate intermittently, many women with PCO can become pregnant without fertility treatment, and are only given medications if they fail getting pregnant on their own.

Thank you for your question.

Medical Author: Carolyn Janet Crandall, M.D.
Medical Editor: William Shiel, MD, FACP, FACR
Last Editorial Review: 7/8/2004

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