Live-born children after assisted reproduction in women with type 1 diabetes and type 2 diabetes: a nationwide cohort study

Abstract

Aims/hypothesis Type 1 and type 2 diabetes are among the most prevalent chronic diseases in women in the fertile years and women with diabetes may experience several reproductive issues. We aimed to examine the chance of biochemical pregnancy, clinical pregnancy and live birth after assisted reproductive technology (ART) treatment in women with type 1 and type 2 diabetes and whether obesity per se influenced the results. Methods This nationwide register-based cohort study is based on the Danish ART Registry comprising 594 women with either type 1 diabetes or type 2 diabetes from 2006 to 2017. Results Relative to women without diabetes, the adjusted OR (95% CI) of a live birth per embryo transfer was 0.50 (0.36, 0.71) in women with type 2 diabetes and 1.10 (0.86, 1.41) in women with type 1 diabetes. Conclusions/interpretation Our data on the efficacy of ART treatment in women with type 1 and type 2 diabetes is the first in this field. When compared with women without diabetes, women with type 1 diabetes had an equivalent chance of a live birth per embryo transfer whereas women with type 2 diabetes had a reduced chance. The findings in women with type 2 diabetes did not seem to be driven by obesity per se as the same pattern was seen in both normal-weight and obese women.

The Efficacy of Assisted Reproduction in Women with a Wide Spectrum of Chronic Diseases – A Review

“… No adjustment for confounding. Larsen et al 2020 20 Live-born children after assisted reproduction in women with type 1 diabetes and type 2 diabetes: a nationwide cohort study Cohort study Diabetes Mellitus type 1 532 embryo transfers in 180 women with type 1 diabetes, and 126,113 embryo transfers in 42,626 women without diabetes. Biochemical pregnancy per embryo transfer OR 1.10 (0.90–1.35) aOR 1.00 (0.79–1.26) g Analyses adjusted for confounders.…”

“…In women with type 1 diabetes undergoing ART treatment, the chance of a biochemical pregnancy and clinical pregnancy was not decreased, adjusted OR 1.00 (95% CI: 0.79 to 1.26) and 1.36 (95% CI: 0.81 to 2.29), respectively ( Table 2 ). 20 In women with type 2 diabetes, the adjusted OR of a biochemical pregnancy was 0.57 (95% CI: 0.43 to 0.76), and the adjusted OR of a clinical pregnancy was 0.91 (95% CI: 0.50 to 1.66). 20 …”

“… 72–75 The efficacy of ART treatment in women with diabetes was first examined in 2020. 20 An impact of female body mass index had been studied in relation to ART, but the results did not include information on diabetes. 76 …”

“…In a nationwide Danish cohort study, 187 women with type 1 diabetes and 170 women with type 2 diabetes, having 538 and 518 embryo transfers, respectively, were identified. 20 The unexposed cohort compromised 127,599 embryo transfers in 42,688 women without a history of diabetes before embryo transfer. A total of 26.4% of the women with type 1 diabetes had a live born child per transfer, and this was similar to the unexposed cohort (23.9%), and corresponding to an adjusted OR of 1.10 (95% CI: 0.86 to 1.41) ( Table 1 ).…”

“…The result showed that women with normal weight had a reduced chance for a live born child, adjusted OR of 0.37 (95% CI: 0.16 to 0.85), and women with overweight-obesity also had a reduced chance of a live born child, adjusted OR of 0.52 (95% CI: 0.36 to 0.77). 20 These results included an adjustment for maternal age.…”