Is HbA1c useful for Fruchtbarkeit?

HbA1c is a long-term blood glucose marker reflecting average levels over 2–3 months. For fertility, there is no routine recommendation to measure HbA1c. However, evidence suggests that poor glycemic control – especially in women with PCOS or diabetes – can negatively affect egg quality, menstrual cycles, and implantation rates. Elevated HbA1c (>5.7 %) indicates increased risk of insulin resistance, which is linked to ovulatory infertility. In men, high HbA1c may impair sperm quality (motility, DNA fragmentation). Nonetheless, HbA1c is not a specific fertility test; it is used primarily for diabetes screening or metabolic syndrome assessment. The evidence is moderate: observational studies and mechanistic links exist, but no large randomized trials prove a causal benefit for fertility outcomes. For a comprehensive fertility workup, other parameters (hormones, ultrasound, semen analysis) are more relevant. A normal HbA1c does not rule out fertility issues. Caveat: marketing HbA1c tests as a 'fertility marker' is often overstated.