Advice for Preparing to TTC


I’m fairly new to this group, but I’ve been looking at a lot of the previous posts lately. I have some questions that I haven’t yet found any direct answers to yet so I figured I’d create my own post to see if I could get some answers. My husband and I are hoping to TTC as soon as possible, however, my A1C is nowhere near where it needs to be for that. At my last endo appointment it was at 10% (yikes I know!). Obviously I wasn’t taking care of my T1 like I should have been, and it was due to sheer laziness on my part. However, shortly before that appointment I had realized that if I wanted to be able to get pregnant I had to start treating my diabetes as if I was already pregnant. So since my that last appointment (just over a month ago) I’ve been checking my blood sugar every few hours at least, really watching my carb intake, and getting into a exercise routine. My bg’s have been under MUCH better control since. They’ve been mostly in the mid to low 100s with only going up to 220 a couple of times, but I caught those before they stayed up there. I know mid 100s still aren’t the best for bg’s, but they’re only like that because I’ve had to relearn how different foods affect my bg’s and how to bolus for them.

So here are my questions:

  1. If anyone had a high A1C before TTC, how long did it take you to get it low enough to get the go ahead to start trying?
  2. Once you were able to start trying, did your previously high A1C make conceiving difficult?
  3. Was there anything that you found helped get your bgs under better control other than what I’m already doing? (Side note: I am on a pump, but not a CGM. Hoping to get on a CGM soon though.)

Those are the questions that have been plaguing my mind, but if you have any additional advice please share it with me! I’m just hoping to find some people who have been in a similar situation and can tell me what worked for them. I also don’t want to get my hopes up sooner than I should. I’m hoping to be able to start TTC by the end of the year, but I have no clue if that’s a realistic expectation or not. Like I said, just looking for advice from people who might have been there before.

Definitely go for the CGM if and when you can - it helped me a lot. When I got mine a couple years back, my A1C dropped by 1% after just a few months! Once I got pregnant, my A1C kept dropping - it means a lot more to keep good tabs on your BG when you have a tiny human depending on you. :slight_smile: Good luck!

My first pregnancy was unexpected and my A1C was at 8.5% when I discovered I was pregnant at 8 weeks along. It fell considerably (into the 5-6% range) almost immediately because I panicked and started measuring 8x a day or more and really doing my best to bolus correctly. Not waiting too long to bolus was especially challenging for me due to laziness.
So I guess the high A1C didn’t make conceiving difficult. :confused:

My second pregnancy was planned. My A1C was in the 7-8% range when I got a pump and a CGM. 3 months later my A1C fell to 6.8% and I got pregnant. With the pump/CGM system it fell almost on its own - it was SO MUCH EASIER to manage.

Both children were born with no complications at 7+ lbs.

When my husband and I got engaged, my A1Cs were usually anywhere in the low 8’s to sometimes up to 9.5ish. I started trying to bring it down into the low 6’s, knowing that someday after the wedding we would probably talk about TTC. Once we were ready, I delayed TTC for about a year and a half trying to get the “perfect” A1c. I wanted to be under 6.5. The closest I got was 6.7 before rebounding back into the 7s. I was so upset at the time and finally felt defeated. I ended up just stopping birth control and saying “whatever happens, happens” as I was trying my best but not getting the results I thought I wanted.

Of course, I got pregnant almost immediately with an A1C of 7.8. I just worked to lower it from there and spent most of my pregnancy in the low 7s (high 6s toward the end). I came down with preeclampsia and HELLP syndrome, which led to a c-section at 34.5 weeks pregnant. Whether this had anything to do with diabetes or not I’ll never know. However, my little guy was born healthy and just needed a little extra care in the NICU (nothing scary wrong, he just needed some extra help to regulate his body temps). Today he’s a happy and perfectly normal 4 month old.

My point is that control is obviously important, but don’t stress if you don’t get the “perfect” A1c before you conceive. Just do the best you can. Coincidentally, my A1c at one month postpartum was 6.3. Where was that when I wanted it?!?!?! LOL

Good luck!

Thanks everyone for the advice! I am definitely going to try to get on a CGM as soon as possible. Until then I’m watching my bgs like a hawk, been checking like 10 times a day. My averages are still in the mid 100s which is a little higher than I’d like, but that is still a massive improvement over my past bgs! I really feel like my next A1C will be significantly better (probably high7-low 8% range). As a result I’ve kind of developed the “whatever happens happens” mentality as you said @KSmerk12, although not completely. I’m confident enough that my A1C will be so much better at my next appointment that I’ve decided to go off bc so my body can start preparing for TTC. However, until I hear for sure that my A1C has dropped enough I am using alternate forms of bc.

Thanks again for the advice! It’s helped give me a peace of mind and confidence that I’ll be able to bring my A1C down soon enough.

I am also ttc. Endo said I should have my a1c under 6.5 before stopping BC. 8 months ago, it was 6.5, so I stopped. Last month it was 6.2 and I am completely overjoyed. I’m at the point where I am happy with my health, but confused as to why it has taken so long to actually conceive.

My OBGYN will not even talk to me until it’s been a year (I’m 27). So therefore, I feel like a lone-diabetic, searching for some answers. How long did it take you ladies to conceive?

Yes, @CallaNicole, conception is rarely instantaneous and there could be many different reasons for that. However, in well-controlled diabetics this has little to do with the condition per se. Age is a main factor (I am 36 and had to learn all this disappointing info recently, as my husband and I decided to TTC), as are various OB/GYN conditions (policyctic ovary syndrome, for instance, blocked fallopian tubes, or prior history of certain STDs which might have changed the woman’s reproductive organs in other ways). I think the statistic is that during any one monthly cycle, even with intentional timing of intercourse, a woman has only about 30% chance of getting pregnant. That’s why in cases where age is not a factor waiting for an year of active TTC is standard practice. If you are not “temping” (taking your basal body temperature, BBT, every day immediately after waking up and keeping track of the patterns), I would recommend this as a first step to trying to figure out exactly when you ovulate and time intercourse for the 2-3 most fertile days of your cycle. This has been my approach (we’ve only been trying for a couple of months now). Then there are other things one can try (For example, ovulation testing kits, which are quite expensive, but can predictively tell you the right time. BBT does it only after the fact and so is only useful after several periods when you ca establish what your pattern is. Or saliva microscope – I recently added this to my “repertoire” :slight_smile: – which is also supposed to give a predictive picture, but is a little difficult to use.) Ultimately, you want to have the healthiest possible pregnancy for your future baby and yourself, so if I were you, I’d keep working on bringing the HbA1c number lower and lower while “waiting” for conception. Best of luck!