Insulin resistance and miscarriage

miscarriage

 

The loss of a pregnancy or miscarriage is something that most couples rather not think of. However, it’s important for couples to understand why miscarriages can happen, especially as it can be caused by various factors and steps can be taken to lower the risks. The common causes of miscarriage are anatomical causes (like uterine abnormality), genetic causes, immunological disorders and hormonal imbalance. In this article, I will address one of the most common types of hormonal imbalance known today – insulin resistance.

Insulin resistance is a condition whereby levels of sugar, estrogen and testosterone in the blood are raised, while progesterone levels are lowered. The result is an excess of glucose in the bloodstream, which leads to prediabetes, diabetes and other serious health disorders. In pregnancy, insulin resistance causes a variety of concerns, such as delayed fetal growth and gestational diabetes.

Several scientific studies have also found that insulin resistance can lead to miscarriage. One such study was carried out by a team of researchers at the Reproductive Medical Centre, Peking University, People’s Hospital, Beijing, China. After examining 107 patients that achieved their first pregnancy after infertility treatment, they came to the conclusion the risk of miscarriage can be directly linked to insulin resistance.

A team from the Obstruction & Gynecology Department, Babol University of Medical Science, Babol, Iran offered similar findings, when they proved that women with elevated insulin levels are at a higher miscarriage risk.  As worrying as this is, it must be noted that insulin resistance doesn’t just heighten the risk of miscarriage; in fact, it has been shown to increase the risk of multiple miscarriages.

Several published studies have confirmed this, such as one by a team from the Department of Obstetrics and Gynecology at Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou. After investigating the differences in insulin resistance between women with recurrent miscarriage and those with normal pregnancy, they concluded that insulin resistance increases the risk for recurrent miscarriage during the first trimester of pregnancy.

The crucial link between insulin resistance and recurrent miscarriage was echoed in a prospective clinical study by a team of researchers from the Department of OB & GYN, Shiraz Medical University, Iran. Their study found that 39% of women with recurrent miscarriage have abnormal oral glucose tolerance test (OGTT) results. The OCTT, which measures the body’s ability to use glucose, is often used to check for insulin resistance and gestational diabetes.

Meanwhile, a team from the Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, USA concluded that 27% of women with repeat miscarriage have high fasting insulin, despite normal glucose levels.

Insulin resistance is also associated with Polycystic Ovarian Syndrome or PCOS, which is why women with PCOS struggle with infertility. The condition raises levels of estrogen and testosterone in the body, while lowering progesterone levels. This interferes with the normal development of follicles in the ovaries, causing problems with ovulation.

However, if you have PCOS or insulin resistance and wish to undergo infertility treatment, hope is not lost. There are steps you can take to improve your insulin resistance sensitivity through lifestyle changes or medical intervention, before you undergo infertility treatment. Please don’t hesitate to speak to your infertility consultant should you have any concerns about insulin resistance. Your doctor can advise you on ways to reduce your risks and increase your chances for a safe pregnancy.

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A weighty issue

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A weighty issue
How a woman’s weight impacts the risk of miscarriage

A miscarriage is a devastating experience for couples, perhaps even more so for those who have struggled with infertility and gone through the initial joy of a successful fertility treatment. Statistics have shown that in both natural and IVF conception, about one in six pregnancies will end in a miscarriage before the 20th week, with the rate being higher in older couples.

Understandably, couples are frightened of miscarriages and would rather not think or talk about it. However, it is important for couples to understand why miscarriages happen, as well as what they can do to reduce their risks.

Although the exact reason for a miscarriage is often unexplainable, it can occur due to a number of reasons. These include chromosomal abnormality, improper implantation of the egg and maternal health problems or trauma. The mother’s age also plays a significant role, as does her lifestyle, which includes exposure to stress, smoking, drug use, malnutrition, excessive caffeine, radiation and toxins.

Another well-studied factor than increases a woman’s risk for miscarriage, is her weight. As these studies indicate, if the mother is obese or underweight, this increases her risk of not only infertility, but miscarriage as well, regardless of the method of conception.

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According to researchers at the Department of Obstetrics and Gynaecology, University of Adelaide, Australia, being overweight increase a woman’s risk of miscarriage by 29%, while being obese can increase the risk by 71% or more. However, for women undergoing assisted reproduction, researchers at the Assisted Fertilization Center, Brazil concluded that maternal obesity could increase the risk of miscarriage by up to 1330%.

Obesity also compounds miscarriage rates in women with PCOS. The Department of Obstetrics and Gynecology, Faculty of Medicine, Erciyes University, Turkey found that the miscarriage rate in obese women with PCOS is about nine times higher than average.

And while miscarriage is often the result of an unhealthy fetus, researchers from the Department of Obstetrics and Gynecology, Stanford Hospital and Clinics, CA, USA found that the risk of miscarriage of a healthy fetus is significantly higher in obese women (with BMIs of 25 or more).

While obesity has been identified as a risk factor for spontaneous miscarriage, the mechanism for it remains unclear. But a study by The Academic Unit of Reproductive and Developmental Medicine, The University of Sheffield and Sheffield Teaching Hospitals, Sheffield, UK points to the endocrinological changes in obesity as possibily causing complex adverse effects including circulating adipokines, sex steroids and insulin resistance.

Women who are underweight, with a BMI of under 20, also face an increased miscarriage risk. A study by researchers at the German Cancer Research Centre found that pregnant women who were underweight faced a 70 % higher risk of having a miscarriage.

Therefore, it can be concluded that among intrauterine environmental factors, nutrition appears to play the most critical role in influencing placental and fetal growth. Since maternal undernutrition or overnutrition during pregnancy can impair fetal growth, women must adopt healthier diets and incorporate exercise to lower their risk of miscarriage.

If you have any concerns regarding miscarriage, especially after IVF, please do not hesitate to consult with your fertility consultant for advice.

Weight-Loss

The benefits of acupuncture in IVF

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Restoring balance

The benefits of acupuncture in IVF

In recent years, acupuncture has become an increasingly popular complementary treatment for those suffering from infertility, especially women undergoing IVF treatment. But what’s behind the buzz and does it actually work? Let’s examine the known facts.

What is acupuncture?

Acupuncture is a form of traditional Chinese medicine (TCM) and healing method that has been used for thousands of years across the world to treat a variety of ailments. It involves the gentle insertion of thin, sterile needles that are inserted into the skin at strategic points of the body to provide stimulation.

According to TCM practitioners, there are more than 2,000 acupuncture points on the human body, which are connect to 14 major pathways or meridians. These meridians conduct “qi,” which is a form of energy or life force that is believed to regulate our spiritual, emotional, mental and physical balance. Poor health habits can disrupt the proper flow of qi, leading to various ailments, including pain and infertility.

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Benefits for those undergoing IVF

As acupuncture works on the principle of restoring balance, here’s how it can help:

Reduces stress – By lowering the levels of stress hormones released into the blood stream, acupuncture can help restore the body’s hormonal and neurochemical balance.

Improves blood flow – Stimulation at strategic points can increase blood flow to the ovaries and uterus, which increases chances for the egg to be implanted, nourished and carried to term.

Relieves aches – By alleviating existing aches and pains, acupuncture can provide further relief and stress reduction.

Relieves anxiety – By helping to treat conditions like anxiety and insomnia, which can have devastating long-term effects to wellbeing, acupuncture helps restore the body’s delicate balance.

Few side effects – Unlike some forms of Western treatment, which can be invasive and causes undesirable side effects, acupuncture has relatively few to no side effects other than causing bruising at the needle site.

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Scientific research

Some experts in complementary medicine have cautioned that the positive effects of acupuncture may actually be due to a “placebo effect” that is caused by patients expecting acupuncture to work. To understand the phenomenon better, some scientific studies have been carried out to review the benefits of acupuncture in infertility treatments.

One study, jointly-conducted by the University of Maryland’s School of Medicine, Georgetown University School of Medicine, Washington and the University of Amsterdam, Holland, compared the results of needle acupuncture in women receiving IVF, against women who received fake treatments and no treatments at all.

The results were very positive, as according to the study, “IVF with acupuncture increased the odds of pregnancy by 65% (according to early evidence on ultrasound), increased the odds of ongoing pregnancy by 87% (according to ultrasound evidence of pregnancy at 12 weeks) and increased the odds of a live birth by 91% compared with IVF on its own.”

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Conclusion

The researchers concluded that their results suggest that, “Acupuncture given with embryo transfer, improves rates of pregnancy and live birth in women who are undergoing in vitro fertilisation.” While their findings are significant and clinically relevant, the researchers consider them to be “somewhat preliminary” and call for further investigation in the link between pregnancy rates and the effect of acupuncture.

With these encouraging facts and figures, there is no wonder why more and more couples are choosing to include acupuncture in their infertility treatment routine. If you’re interested to find out more about using acupuncture as a complementary form of treatment, don’t hesitate to bring it up to your doctor.

 

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