[Diabetes mellitus--an epidemiologic study of fertility, contraception and sterility]

Data from 672 female patients with diabetes mellitus between 17 and 42 years of age were collected by questionnaire. Mean manifestation age was 19.9 years (min. 1, max. 38).

72.39% of the patients were treated with insulin; one third had successful pregnancies. Only one of ten diabetics delivered more than once after diabetes had become manifest. At the time of the study, 126 (19.1%) of the patients attempted pregnancy; about one-fifth of these for more than 2 years. Diabetes manifestation occurred significantly earlier in patients who did not achieve conception. Correlation between daily insulin dose and infertility was proved, whereas duration of diabetes had no significant influence on fertility. Habitual abortion was found in 0.62%, among nulliparous patients 1.64%, respectively. Contraception was performed in 64.2% (32.8% hormonal contraceptives, 18.6% IUD, 1.8% natural family planning, 11.0% tubal sterilisation or hysterectomy, 35.8% no contraception). 47% of the used oral contraceptives contained a reduced oestrogen dose (30 micrograms estradiol). In one third of the users, IUD were longer than 5 years in place. Tubal sterilisation was found in 69 (10.44%) of diabetic patients; in 51 cases before the age of 30 years.

Contraceptive methods should be selected carefully. Diabetic patients unsuccessfully attempting pregnancy should be referred early to a centre for reproductive medicine.