When evaluating a patient for possible causes of infertility or pregnancy loss, one condition I often look for is insulin resistance (IR).
What Is Insulin Resistance?
Our bodies produce insulin, a hormone that signals our cells to open up and allow glucose (sugar) to enter. When we eat carbohydrates, blood glucose levels rise, prompting insulin to help transport that glucose into our cells for energy.
In individuals with insulin resistance, the cells become less responsive to insulin’s signal. To compensate, the body produces more insulin in an attempt to “speak louder” to the cells. Over time, this can lead to chronically elevated insulin levels, higher blood sugar, and eventually Type 2 diabetes if left unaddressed.
How Insulin Resistance Affects Fertility
- Polycystic Ovarian Syndrome (PCOS): IR commonly occurs alongside PCOS, contributing to irregular or absent ovulation. Each condition can worsen the other, creating a cycle that’s difficult to break.
- Uterine Lining: IR can interfere with the proper development of the uterine lining, making embryo implantation less likely.
- Egg Quality: Insulin resistance is linked to lower egg quality.
- Oxidative Stress: Elevated glucose levels increase the production of reactive oxygen species—damaging byproducts of metabolism that can harm DNA in both eggs and sperm.
- Embryo Development: IR can slow or even halt early embryo growth.
Testing for Insulin Resistance
Testing is simple and can be done through standard blood work. Measuring fasting glucose and fasting insulin allows calculation of a HOMA-IR score—a value above 2 to 2.5 suggests insulin resistance.
For a more detailed assessment, Quest Diagnostics offers an Insulin Resistance Panel that includes C-peptide, a marker that provides additional insight into insulin production.
Supporting Healthy Insulin Sensitivity
The cornerstone of treatment is lifestyle management, including nutrition and regular physical activity. To help accelerate progress, I often recommend targeted supplementation such as:
- Inositol (also known to support egg quality)
- Berberine and other insulin-sensitizing herbal medicines
- Key minerals such as magnesium and chromium
In some cases, metformin may be prescribed, particularly when blood sugar levels are elevated.
If you suspect insulin resistance may be affecting your fertility—or simply want a deeper understanding of your reproductive health—we’d be happy to help you explore this further.
Resource:
Lei R, Chen S, Li W. Advances in the study of the correlation between insulin resistance and infertility. Front Endocrinol (Lausanne). 2024 Jan 26;15:1288326. doi: 10.3389/fendo.2024.1288326. PMID: 38348417; PMCID: PMC10860338.