Insulin and IVF Treatments

[shoegal]

I'm currently on glicilazide tablets but soon will be trying for a baby. My last pregnancies where naturally conceived and I was on Lantus slow release and Nova Rapid. However, this time I will be having IVF treatment and wanted to know if it was ok to go back on the above meds with IVF treatment.

I have been trying to find out but unfortunately there is no one at the my diabetic centre nor does my GP know.

 

[LadyJ]

Shoegal,

I'm not 100% sure, but I would think you'd be better on the insulin than the tablets. Since insulin is a naturally occuring hormone, it wouldn't cause a baby - or your chances of trying to conceive - any harm, I wouldn't think.

Whereas the gliclazide is NOT natural and could cause harm.

 

[DiabeticGeek]

You probably shouldn't take gliclazide while you are pregnant, or if there is any likelihood of you getting pregnant. Pregnancy is listed as a contraindication for gliclazide, although based upon a quick Google Scholar search this seems to be because it isn't known to be safe rather than because it is known to be dangerous. However, I believe the usual practice is to switch to insulin during pregnancy and that seems to be a sensible precaution.

 

[Katharine]

It is very unlikely that you would be kept on gliclazide after you become pregnant. Normally you would be put on insulin.

As anything less than normal blood sugars raises the risk of miscarriages and fetal abnormalities it is important to get normal blood sugar control to maximise your chance of success. I expect that you will be put on insulin by the diabetes team prior to an ivf attempt.

Your GP could refer you to the diabetic clinic for specialist support once you are accepted on the ivf waiting list. It could take 6 months to get your diabetes control completely tip top. You could end up at a "tertiary centre" and not just the local diabetic clinic as the management of diabetic pregnancies is becoming more of a specialised team approach.

Lois Jovanovich's centre in Santa Barbara specialises in this. She has a lecture at presentdiabetes.com which you can view. This could give you an idea of what state of the art blood sugar management involves. (Not that this is available on the NHS!)