It is well known that insulin resistance is the basis of polycystic ovarian syndrome (PCOS) which is a major cause of infertility, but insulin resistance affects other infertility conditions as well.

Many infertility doctors are aware of this.  I had one, non PCOS, client whose fertility doctor prescribed Metformin, a diabetes drug that improves insulin sensitivity, but failed to suggest to her that she had blood sugar problems  (at a stage in her life where she might be able to make changes to avoid diabetes.) Doctors routinely suggest weight loss for infertility which is also known to correct insulin resistance.

But drugs are not the first resource for insulin resistance.  Diet is.  In this piece we will discuss insulin resistance, inflammation and how it affects fertility.

First of all, when you eat sugar- and by sugar I mean not only refined sugar, but starches like bread (even whole grain), pasta, and potatoes and even sweet fruit.  All of these cause blood sugar to significantly rise, which causes an insulin spike.  In a person with normal metabolism, the elevated blood glucose level causes beta (β) cells in the Islets of Langerhans located in the pancreas to release insulin into the blood.  Insulin ferries sugar into the cells under normal conditions and when the sugar is delivered, is broken down.  The beta cells then sense the lower blood glucose and stop producing insulin.

The cells in our bodies are surrounded by a membrane made up by fats and watersolube compounds called the phospholipid bilayer.  The overdose of Omega 6 fats compared to Omega 3 fats makes that layer stiff.  In the bilayer are receptors and gates which require minerals in the form of enzymes to ferry in nutrients like sugar, neurotransmitters and even sperm into an egg.  Our diets are bereft of most minerals, chiefly magnesium and trace minerals.  As a result, the sugar/insulin compound cannot easily get into the cell.

With sugar in the modern diet, we have a second problem.  There is just too much for the cells to absorb.  So the cell starts shutting down GLUT4 receptors, creating insulin resistance.  And the sugar and insulin builds up in the blood vessels.  The pancreas, which senses high blood sugar, sends out more insulin.

The problem is, that insulin and other carriers can be very caustic and inflame the blood vessels, further shutting down receptors.  As a result the level of inflammation grows in endothelial tissue in a vicious cycle.  This causes the body to “bandage” the inflammation with cholesterol.  And that reduces circulation which is necessary for proper development of sex cells, and fetal development.

Insulin also promotes Insulin Growth Factor, which causes things to grow- like cysts, fibroids and even cancer cells.  This can further promote problems with fertility.

Elevated insulin levels contribute to or cause the abnormalities seen in the hypothalamic-pituitary-ovarian axis as well.  This affects hormone levels.  Adaptogens can be used to rebalance the HPA axis after insulin sensitivity is regained.

Insulin resistance leads to abdominal fat.  Visceral fat tissue possesses aromatase, an enzyme that converts androstenedione to estrone and testosterone to estradiol. The excess of adipose tissue in obese patients creates the paradox of having both excess androgens (which are responsible for unwanted hair growth and virilization) and estrogens (which inhibits FSH via negative feedback.)

So if you suspect the begining of any sort of blood sugar problem, there are things you  can do.  Weight loss will lower aromatase levels and reduce insulin resistance.  Exercise reverses the loss of GLUT4 receptors.  At least alter your diet so that most of your calories come from leafy vegetables, protein and fat, as lower carbohydrate diets lower insulin resistance.  Exercise after eating to bring your blood insulin levels down and don’t eat between meals.  And have a very low carbohydrate breakfast- say a vegetable omelet- so that you have the long stretch between dinner and lunch when blood insulin is low.  When blood insulin is low, you can lose weight, build muscle and balance hormones.  Take anti-inflammatory fish oil (with enough DHA to make 1000mg/day), Vitamin D to get your levels up above 50ng/ml of 25 Hydroxy D, magnesium, chromium and vanadium.  And get enough sleep since lack of sleep is known to increase insulin resistance.

Acupuncture and herbs can be quite useful in dealing with insulin resistance and infertility issues.  From cinnamon and fenugreek for insulin sensitivity, to bitter herbs to stimulate proper digestion, to adaptogens and hormonally balancing herbs like shatavari and red clover, your herbalist can find an individualized treatment that addresses your underlying issues.

Related articles:

• Infertility for Men and Women (acupuncturebrooklyn.com)
• Mothers’ high blood sugar in pregnancy is linked to children’s reduced insulin sensitivity (eurekalert.org)
• (Nursing Mothers, Infants and Vitamin D (acupuncturebrooklyn.com)
• What if It Isn’t All Your Fault? (acupuncturebrooklyn.com)
• Self care Products To Avoid  While Pregnant (acupuncturebrooklyn.com)
• Endometriosis and Chinese Medicine (acupuncturebrooklyn.com)
• Reduce,Eliminate PCOS Symptoms with Natural Remedies & Treatments (gynecological-health.suite101.com)
• Insulin Resistence and Infertility (acupuncturebrooklyn.com)