How are HbA1c and Fruchtbarkeit related?

HbA1c (glycated hemoglobin) is a marker of average blood glucose over the past 2–3 months. Elevated HbA1c indicates poor glycemic control, which is linked to reduced fertility in both sexes. In women, high HbA1c can disrupt ovulation, worsen PCOS symptoms, and increase miscarriage risk. In men, it is associated with lower sperm quality (motility, DNA integrity). Improving HbA1c through lifestyle changes and medication can enhance fertility outcomes. However, most evidence is observational; large RCTs directly testing HbA1c reduction on fertility are lacking. Pregnancy itself lowers HbA1c physiologically. Thus, HbA1c is a useful but not standalone marker. Individualized care by endocrinologists and reproductive specialists is crucial. The relationship is well-established in clinical practice, but genetic and lifestyle factors also play major roles.