Alcohol, Smoking & Caffeine While TTC
The negative effects of alcohol on pregnancy are well documented. It is not safe to drink while pregnant, and alcohol should be avoided prior to conception because even moderate amounts have been linked to early miscarriage.
A good rule of thumb is no drinks while you are a patient in cycle at CC. If you are not currently in a treatment cycle, ARE NOT PREGNANT, and feel like you’d like to have a glass of wine, a little in moderation is OK in the first half of your cycle while you are on your period. After your period ends, your body will enter its “fertile window” and all alcoholic beverages should be avoided in hopes of conception after ovulation.
Several studies have been performed that show the negative health effects of alcohol. Alcohol affects the vital systems in the body, slowing body functions, causing dehydration, and stressing and damaging the liver to name a few effects. Alcohol also interferes with the absorption and metabolism of important vitamins, minerals, and antioxidant such as calcium, potassium, magnesium, B-Vitamins, DHA, and CoQ10. The link between infertility and alcohol consumption has been established, though it is not entirely clear what amount correlates to an increased risk.
In men, deteriorating semen quality is linked to increasing alcohol intake. It’s clear that heavy alcohol use over time in addition to multiple health problems causes problems with male infertility including testicular atrophy, decreased libido, and decreased sperm count. In addition, a link between alcohol, sperm morphology (shape), and motility (movement) has also been found. One study showed that upon alcohol withdrawal, dramatic improvement of semen characteristics was noted within 3 months.[i] As mentioned before, the exact amount of alcohol intake that corresponds with increased fertility risk is not clearly known. However, it is recommended that for overall health men limit alcohol intake to <2 drinks a day.
In women, the higher the alcohol consumption the greater chance of experiencing infertility including problems with ovulation, decreased probably of conception, decreased implantation rate, and increased risk of spontaneous abortion.[ii] In pregnancy no amount of alcohol is recognized as safe. It’s recommended that women attempting pregnancy consider abstaining altogether or limiting alcohol intake to < 1 drink/day.
Alcoholic equivalents for 1 drink:
Smoking & drug use
There is no question that smoking is harmful to fertility. Women who smoke are more likely to experience infertility and enter menopause at an earlier age. Research shows that smokers are less likely to respond to fertility medications and tend to produce fewer eggs when going through IVF. Quitting smoking should be a priority when trying to conceive.
Recreational and illegal drugs should be no where near your body if you are trying to conceive due to the detrimental effects that can occur with an ever-changing fetus.
It is well supported by scientific data that smoking has many negative health effects including diseases of the heart, lungs, and blood vessels. It affects nearly every organ of the body, increasing inflammation and lowering immune function. Smoking is a cause of Type 2 Diabetes Mellitus and those who smoke have a 30-40% greater risk for developing diabetes than nonsmokers[iii]. Perhaps not as widely know is that smoking has damaging effects on fertility. Smoking by either partner is harmful and the effects of second-hand smoke are only slightly smaller that active smoking.
In men who smoke, total sperm count, concentration, volume, sperm motility, sperm morphology (shape), and fertilizing capacity is decreased. In addition, smoking damages sperm DNA and can also lower testosterone leading to increased risk for impotence.
In women, smoking significantly increases the odds of infertility and causes a longer time to conception in comparison to non-smokers. Smoking ages eggs, leads to loss of reproductive function, and may advance the time of menopause by several years. Women who conceive while smoking have an increased risk of ectopic pregnancy (embryo implants outside of the uterus which is non-viable and dangerous to the mother), and have an increased risk of miscarriage. Nicotine exposure during early pregnancy, a crucial time of fetal development, has lasting adverse affects on brain development and can cause birth defects including orofacial clefts in infants. Women who smoke during pregnancy have a higher risk of having low birth weight babies, preterm delivery, and stillbirth. The incidence of Sudden Infant Death Syndrome (SIDS) is increased in a household where someone smokes.
Studies have shown that smokers who proceed with an IVF cycle require twice as many attempts, require higher doses of gonadotropins to stimulate the ovaries, have fewer eggs retrieved, have more cancelled cycles, and lower implantation rates. The reduction in natural fertility associated with smoking may not be overcome by assisted reproductive technologies.
It should also be noted, that smoking marijuana is also harmful to fertility. Marijuana contains cannabinoids which in addition to other effects, negatively impact male and female reproductive organs. In males, cannabinoids cause reduced testosterone and decreased sperm production and motility. Females who use marijuana are at an increased risk of infertility. Cannabinoids negatively affect placental and fetal development and may even cause stillbirth.
There are many health benefits to stop smoking, including improved chances for conception and a healthy pregnancy. One study showed that cessation of smoking for at least two months before attempting IVF significantly improved chances for conception. While long-term smoking can permanently damage ovarian function, the harmful effect on treatment outcome, can be reversed if smoking cessation occurs prior to attempting pregnancy.[iv]
Many patients wonder about the safety of caffeine during conception and pregnancy because they have come to love their morning coffee or afternoon soda. Research here is conflicting and inconclusive. Some studies connect increased early miscarriage risk to caffeine intake. We feel if you’re trying to conceive, experiencing infertility, and considering investing in expensive fertility treatments, it makes sense to start cutting back on your caffeine intake if you haven’t already.
BabyCenter.com has a great article on Caffeine During Pregnancy if you’d like to learn more. The article describes how caffeine crosses the placenta and provides a chart detailing the amounts of caffeine found in common beverages and foods. Some doctors may recommend completely cutting out caffeine. However, most studies show that caffeine only increases miscarriage rates at very high amounts (think 5-6 cups of coffee daily!). Therefore, other physicians consider caffeine in moderation (under 200 mg of caffeine daily) to be reasonable for infertility patients to consume.
[ii] Sharma et al. Reproductive Biology and Endocrinology 2013, 11:66
[iii] www.surgeongeneral.gov 1/23/14 http://www.surgeongeneral.gov/library/reports/50-years-of-progress/exec-summary.pdf
[iv] J Hum Reprod Sci. 2012 May-Aug; 5(2); 226-228