Alcohol & Smoking While TTC
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:
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]