Fertility in prediabetes and diabetes in Norway

Infertility is increasing in the general population and artificial reproductive therapy (ART) is common. Most investigations of women treated with ART are done before conception, or monitors outcomes (ie live births). Recent studies that ART offspring have increased risk of metabolic syndrome in childhood. How ART treatment influences maternal metabolism during pregnancy and cardiovascular risk factors later is not known. In subproject 1, we will use the STORK cohort (n=1031) to make a detailed investigation of metabolic effects of ART treatment on pregnant women, and how ART influences metabolism and development of cardiovascular risk factor on longer term. 70 women in this cohort underwent ART previous to entry in the STORK study. Controls will be women with gestational diabetes and with normal glucose tolerance.

The ability to conceive and the number of offsping is reduced in type 1 and type 2 diabetes. In subproject 2 we wish to investigate establish rates of fecundability and fertility in males and females with T1DM and T2DM, based on data from the Norwegian Mother and Child Study (MoBa), total number of participants = 90697, which has not been investigated recently in Norway. Necessary registry linkages with data the medical birth registry(MBRN), the prescription database (NorPD) and the Norwegian diagnosis registry (NDR) will be updated. We will also make a questionnaire-based survey of family planning in T1DM subjects compared to subjects with other chronic disease.

An improved understanding of how ART, hyperglycemia, other gestational influences and environmental effects interconnect, could result in improved prevention strategies, primarily by pregestional lifestyle modification. Furthermore, an improved understanding of how diabetes, gestational influences and environmental effects interconnect with fecundability and fertility, could result in improved planning for pregnancy, and thus better prevention of pregnancy complications, primarily by lifestyle modification and improved diabetes therapy. 

This project will establish rates of fecundability and fertility, based on registry data in subjects with T1DM and T2DM, which has not been investigated in recent years in Norway. In addition, the project will make a detailed investigation of metabolic effects of ART treatment on pregnant women, how ART influences metabolism and development of cardiovascular risk factor on longer term.

Project participants:

E.Qvigstad, Associate Professor, MD, PhD, Senior Consultant in Internal Medicine and Endocrinology at the Department of Endocrinology, Oslo University Hospital/University of Oslo. Main supervisor

S. Steintorsdottir, MD, MSc, junior consultant in the Department of Endocrinology, Oslo University Hospital, PhD candidate.

H.L.Gulseth MD, PhD, Department of Endocrinology, Oslo University Hospital, and researcher at the Norwegian Institute of public health. Co-supervisor.

T.J. Berg, Associate Professor, MD, PhD, Senior Consultant in Internal Medicine and Endocrinology at the Department of Endocrinology, Oslo University Hospital/University of Oslo/Norwegian Diabetes Center, Oslo. Co-supervisor. L.C.Stene MSc, PhD, senior researcher at the Norwegian Institute of public health.

T.Lekva, post doc, MSc, PhD , Research Institute for Internal Medicine, Oslo University Hospital.

T. Tanbo, Professor, MD, PhD, Senior Consultant in Gynecology and Obstetrics, the Fertility center at Oslo University Hospital, Rikshospitalet.

J.R. Mellembakken MD, PhD, Senior Consultant in Gynecology and Obstetrics, the Fertility center at Oslo University Hospital, Rikshospitalet.

J. G.Cooper, MD, PHD, Senior Consultant in Internal Medicine and Endocrinology at the Department of Endocrinology, Stavanger University Hospital and medical head of the Norwegian Diabetes Registry for Adults.