Blood Sugar, Insulin & Your Fertility

When I talk to my patients about which foods most dramatically affect their fertility, sugar and simple carbohydrates are one of the first topics we cover, especially because blood sugar imbalances can easily lead to endocrine and hormone imbalances. With Type II Diabetes is on the rise and Polycystic Ovarian Syndrome (which often involves Insulin Resistance) being the most common cause of infertility in America, I'm seeing more and more cases where diet and blood sugar levels make a huge impact on whether a woman can successfully conceive.

So let's talk about what causes these blood sugar and insulin imbalances, and what can be done to treat them.


Blood Sugar & Insulin

When we eat food our blood sugar goes up. Our cells need some sugar to use as fuel, but if blood sugar rises too high it is dangerous because it causes damage to tissues, nerves, brain cells, even developing eggs in the ovaries.

Typically, our body has systems in place to protect us from high blood sugar levels. The pancreas releases insulin in response to blood sugar, which brings the sugar out of the blood and stores it for later use.

If we get a big peak in blood sugar, known as a sugar "rush," then it will be followed by a big rise in insulin which causes blood sugar to "crash." Typically these dramatic rises and crashes are caused by diet. If your body becomes used to these rushes and crashes you may develop symptoms of blood sugar imbalance:

  • Frequent sugar “rushes” and “crashes”

  • Fatigue, especially after eating

  • Insomnia, you may wake up feeling jittery

  • Frequent and/or intense sugar cravings

  • Frequent and/or intense hunger, feeling emotional when you're hungry (the word hangry was invented for this reason)


Insulin Resistance


If we regularly experience these rises in blood sugar, followed by rises in insulin, overtime our body may become less and less sensitive to insulin's message and thus less and less efficient at actually pulling the excess sugar out of the blood. The body will keep making more insulin, but the feedback system is broken, blood sugar remains dangerously high.

This pattern of Insulin Resistance (IR) typically leads to pre-diabetes or diabetes. It's also linked to low ovarian function, infertility, and Polycystic Ovarian Syndrome (PCOS.)

Here are some signs of IR, pre-diabetes, or diabetes:

  • Increased thirst or hunger

  • Frequent urination

  • Fatigue

  • Blurred vision

  • Tingly hands and/or feet

  • Hormone imbalance and/or irregular cycles

Other factors that may contribute:

  • Weight gain, especially around the waist

  • Family history of diabetes

  • Sedentary lifestyle

  • Sleep - there's a link between people who get very little sleep/work a night shift and IR

If you have developed IR, pre-diabetes, or diabetes, treatment is necessary. Depending on severity, your recommended treatment may include medication, dietary recommendations, and/or blood sugar monitoring. But it is important to work with a physician to create a treatment plan that works for you, because this condition can become quite serious if it goes untreated. 


Hemoglobin A1C

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Hemoglobin A1C rises in response to the average levels of blood sugar in your body over the past 3-4 months. I think of it as your blood sugar report card.

It's one of the main factors used to diagnose IR, pre-diabetes, and diabetes. It is also monitored in patients who already have pre-diabetes and diabetes to make sure their blood sugar levels are being controlled. 

Typically hemoglobin A1C is screened as part of standard blood work, but if you have any symptoms of IR, pre-diabetes, or diabetes, or if you've been trying to conceive for over a year and have not yet gotten pregnant, see your doctor and ask to have your A1C screened.


Glycemic Index

Keeping blood sugar balanced is important for everyone, especially those focusing on fertility or anyone who has already developed IR or some level of diabetes.

Some people have an easier time responding to high blood sugar levels than others, but even then dealing with these spikes is a strain on the body. There's really no "benefit" to rises in blood sugar, so learning to keep your levels balanced is really a benefit to everyone.

The Glycemic Index estimates how our blood sugar will respond to certain foods. High glycemic means the food is more likely to spike blood sugar, while low glycemic means it's less likely to spike blood sugar.

To keep blood sugar balanced, incorporate low glycemic foods often:

  • Any low carbohydrates whole foods, such as meat, fish, eggs

  • Most fruits and vegetables

  • Minimally processed whole grains, beans, and legumes

  • Nuts and seeds

Enjoy moderate glycemic foods in moderation:

  • White and sweet potatoes

  • Cous Cous

  • Corn

  • Whole grain products, such as bread or crackers

  • Sweet fruits, especially tropical fruits, dates, dried fruit

Avoid high glycemic foods as much as possible, or only eat infrequently/small amounts:

  • White bread, pasta, bagels, and other products make with white flour

  • White rice & noodles

  • Crackers and rice cakes

  • Cakes, pastries, sweets, candies & sugary foods

  • Most cereals


Low Blood Sugar

You may not be much of a sugar fiend, but if you find yourself frequently skipping meals, living off of coffee, or eating only small amounts of food, then your blood sugar may actually be too low.

When blood sugar gets too low, our body releases adrenaline in response, which taps into our sugar stores and causes blood sugar levels to rise, even without eating anything. If we make a habit of this, it causes cortisol levels to rise, which acts similarly to adrenaline but with a slower and more consistent release. This can cause chronically high blood sugar levels and inflammation, in fact many people are surprised to find that you can be average or underweight and still develop IR.

Keep blood sugar balanced:

  • Eat balanced meals

    • Made of low and moderate glycemic, whole foods

    • Don't overeat or eat too close to bedtime

    • Make sure you're getting enough protein and calories

  • Eat regularly, don't skip meals

    • Especially breakfast, eat within 1 hour of waking, make sure you include some protein

  • Don't overexercise to do really intense workouts