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  1. 5X5
  2. Infertility Discussion
  3. Tuesday, 09 September 2014
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I am 35 and have had several early miscarriages. We have been trying on our own for 6 years and have done 3 IUIs--one resulting in a chemical pregnancy. I have been thoroughly tested by 2 Endos and other than a very slightly arcuate uterus, (tiny septum was removed) and obesity (working on losing weight) my infertility and inability to maintain a pregnancy past 9 weeks is unexplained. When trying on our own, it took at least a year to get pregnant each time.

My husband was recently diagnosed with Type 2 Diabetes and tested to have an A1c level over 12. Could his out of control blood sugar have contributed to difficulty getting pregnant and/or repeat miscarriages?

His sugar is under control now and down to pre-diabetic levels. Do we have a better shot at IUI working now? Or should we move on to IVF? Insurance covers unlimited IUI but only 1 IVF per lifetime.

Thanks for offering a place to ask these questions.

Edited by 5X5 - 09.09.2014 15:29
Accepted Answer
DrNorian Accepted Answer Pending Moderation
Thanks for your email. Regarding recurrent miscarriages, many reproductive endocrinologists believe that males can also be a contributing factor. This is particularly so when the DNA fragmentation levels of the sperm are very high. A specialized sperm test (the SCSA) may be performed to help give further insight into this. Men with poorly controlled diabetes and insulin resistance have been noted to have lower sperm morphology and increased DNA fragmentation in addition to increased rates of infertility. The link between poorly controlled diabetes and miscarriage is not as clear. Weight loss and nutrition modification though are always good things for both men and women who have high BMIs.

In terms of IUI vs IVF in a 35 year old woman with improving male parameters, the shortest time to pregnancy will be with IVF. However, if you have not been trying for too long (ie., less than 3 years) and your testing has been within the normal ranges (eg., AMH or Day 3 FSH/Estradiol levels), IUI may be appropriate.

I hope that this helps. Best of luck and I look forward to meeting with you in the future.

Edited by DrNorian - 11.09.2014 13:53
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