History of infertility, risk of type 2 diabetes and HbA1c levels in the Nurses’ Health Study II
Authors' conclusion
Women with a history of infertility had a greater risk of developing type 2 diabetes, particularly prior to the age of 51 years. Specific reasons for infertility were associated with an elevated type 2 diabetes risk, including ovulatory disorders and tubal factors. These associations were independent of BMI.
Study context
- Population
- Participants in the Nurses' Health Study II
- Participants
- 116,429 participants
- Exposure
- History of infertility vs gravid women with no history of infertility
- Outcome
- Risk of T2D
Methodological detailsCox proportional hazard models, adjusted for a priori potential confounding variables, stratified a priori by age (≤50 and >50 years)
- Cox proportional hazard models
- Adjusted for a priori potential confounding variables
- Stratified a priori by age (≤50 and >50 years)
Main finding
As reported in the abstract
T2D · up to 50 years of age
Association differed before and after age 50 (test for interaction)
p value, test for interaction: 0.0004
Tubal blockage, HR
1.29
95% CI 1.01, 1.64
Male factor infertility, HR
1.30
95% CI 1.08, 1.57
'Cause not found', HR
1.26
95% CI 1.05, 1.51
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| T2D after age 50 · >50 years | 1.12 (1.06–1.19) | |
| T2D, BMI <25 kg/m² at age 18, ≤50 years | 1.32 (1.20–1.44) | |
| T2D, BMI <25 kg/m² at age 18, >50 years | 1.11 (1.04–1.19) | |
| 0.512Hazard ratio (log scale) |
| Outcome | Relative difference (%) (95% CI) | |
|---|---|---|
| Mean HbA1c (log-transformed), measured on average at age 44Minimal absolute difference in HbA1c | 0.7 (0.04–1.32) | |
| −1012Difference, % (linear scale) |
- T2D after age 50 — Ovulatory disorders, HR
- 1.18 (95% CI 1.05, 1.32)
- T2D after age 50 — Tubal blockage, HR
- 1.26 (95% CI 1.05, 1.51)
- Mean HbA1c (log-transformed), measured on average at age 44: subset n=2399
Original publication
History of infertility, risk of type 2 diabetes and HbA1c levels in the Nurses’ Health Study II. Diabetologia. Published 30 June 2026. doi:10.
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