Lifestyle Factors That Affect Fertility
Dealing with infertility is particularly difficult because couples find that they are no longer in control of their reproductive choices. They can't decide when to have a baby, how many they will have, or how far to space children apart. Success is largely dependent on a wide combination of factors ranging from emotional and financial resources, access to adequate medical care, and sometimes, just blind luck. However, there are some lifestyle factors that affect fertility. Couples trying to conceive can take greater control over their fertility by looking at lifestyle choices that may significantly impact and/or impair their chances of conception.
Affects of Tobacco Use:
Smoking can affect fertility in a number of ways. Chemicals in tobacco smoke can alter important reproductive hormones (such as estrogen, progesterone, and testosterone), creating an imbalance which may stand in the way of conception; those same chemicals can damage paternal chromosomes, leading to increased risk of early miscarriage due to genetic abnormality. In addition, often-undetected negative effects of smoking on maternal health, e.g. hypertensive vascular disease or severe metabolic disorders such as diabetes and thyroid dysfunction, can cause early miscarriage.
In men, vascular effects of smoking have been strongly linked to impotence while women smokers appear to be at greater risk for ectopic (tubal) pregnancies and fallopian infection. Smoking has also been correlated with cervical-factor infertility, defined as a poor postcoital test (of cervical mucus) in the absence of infection. According to a Fertility and Sterility journal article, smokers have lower sperm counts. Smokers' sperm counts are on average 13%-17% lower than nonsmokers. Fortunately, stopping smoking increases sperm counts. A study of three smokers who were followed for 5-15 months after stopping smoking reported that their sperm counts rose 50-800%, suggesting that toxic chemicals in the smoke are responsible and any reduction in sperm count is fortunately, reversible.
Many studies have been conducted since the 1980 Surgeon General's report stated that "cigarette smoking appears to exert an adverse effect on fertility". Apparently, the related processes most affected by hormonal alterations (caused by tobacco smoke) would likely be ovulation and perhaps implantation. While the exact reasons are still being uncovered, researchers now believe that smoking can significantly delay conception. In addition, menopause begins as much as two or more years earlier in women who smoke, thought to be related to the toxins in cigarette smoke or to the effects of smoke on hormone regulatory mechanisms. Even when IVF is used as a means of bypassing some potential infertility factors caused by smoking, the use of tobacco is seen to negatively impact IVF outcome.
As more research is conducted and more is learned about how our bodies respond to toxins in our environment, the news for smokers can only get worse. While some physicians choose to take a quieter stand on the issue, even in cases of infertility and other disease, the evidence which is already in is enough to convince most infertile couples that, if conception is the primary goal, smoking is best avoided. The good news is, once smoking is stopped, many of the negative consequences can be reversed.
Alcohol Use and Conceiving:
Alcohol use in both men and women is thought to reduce fertility. The total effect of alcohol on fertility is not as well established as with cigarettes and other substance abuse. Additionally, alcohol use may be the true factor behind some women's cases of "unexplained infertility." And, you don't have to be abuse alcohol to suffer from its effects. While the effects of alcohol on fertility are real, it is not clear how much must be consumed to affect fertility, or conversely, how much consumption is safe.
The affects on Women:
There are already enough reasons for a woman to limit her alcohol consumption, like the risk of developing liver disease, heart disease, depression or breast cancer. Now infertility has been added to the list of potential problems for women who drink too much. The adverse effects of chronic alcoholism on reproductive function are well recognized. Only recently have the adverse reproductive effects of moderate alcohol intake been characterized.
Research shows that the probability of conception in a menstrual cycle decreased with increasing alcohol intake in women, even among those drinking five or fewer drinks a week. In test animals, a 50% reduction in conception was found in animals given "intoxicating" doses of alcohol 24 hours prior to mating.
Excessive alcohol ingestion is associated with numerous ovulatory dysfunctions. If infertility and especially anovulation are recognized disorders, alcohol should be avoided. Alcohol use is associated with hypothalmic-pituitary-ovarian dysfunction resulting in amenorrhea (absence of menses), anovulation (lack of ovulation), luteal phase dysfunction (abnormal development of the endometrial lining) and hyperprolactinemia. It has been shown to alter estrogen and progesterone levels as well. Other consequences of alcohol range from infertility and increased risk for spontaneous abortion to impaired fetal growth and development.
Fetal alcohol syndrome was first described by Jones in 1973. The syndrome is characterized by growth deficiency, mental retardation, behavioral disturbances and an atypical heart-shaped facial appearance. Additionally, congenital heart defects and brain anomalies are often found. This syndrome occurs in 30 to 40 percent of newborns born to women who are alcoholics. However, fetal alcohol effects can be seen at much lower levels of ingestion. Excluding genetic causes, alcohol ingestion is the leading cause of mental retardation. No safe level of maternal drinking has been established.
Affects on Men:
For men, according to the Linda Loma Medical Center alcohol increases abnormal shapes in sperm, and can lead to impotence. Additionally, it can also adversely affect male hormone levels. Because their liver function deteriorates, excessive levels of the female hormone, estrogen are released, which has a severe sperm suppressing effect. However, stopping alcohol usage generally reverses problems within several months.
Illegal Drugs and Conception:
In both men and women, chances of conception can be seriously affected by using illegal drugs. Additionally, the chances of birth defects and miscarriages are significantly higher when a pregnancy is achieved when either partner is a drug user. If this is a concern for you, then you and your future child would be better served by postponing trying to conceive until the issue can be resolved. You can speak confidentially to your physician for a referral to an appropriate counseling and/or treatment center.
While cocaine affects men's fertility more than women's, there can be serious consequences if women become pregnant while using cocaine. The most consistent finding in studies to date is an association between cocaine use and intrauterine growth retardation (small for dates babies) which means that the babies are smaller in weight, length, and head circumference. One study said that if women stopped drug use after the first trimester, the risks of fetal effects decreased for every week they were drug free. A recent study did indicate that although cocaine babies are harder to soothe and tend to be more irritable, these effects subside and behavioral and academic performance are not affected.
In men, anabolic steroids, cocaine and marijuana can all interfere with fertility. Cocaine decreases sperm count and motility, while increasing abnormal sperm shapes.. A high number of abnormal sperm heads is associated with decreased fertilization. Cocaine exposure to males before conceiving is linked to abnormal development in offspring. The suspected cause is that concaine binds onto the sperm and therefore, finds its way into the egg at fertilization.
Women's fertility can be affected by marijuana use as well. A Science News report indicated that marijuana use at "moderate" levels was found to stop ovulation in monkeys for 103 to 135 days. Researchers also stated that the THC in marijuana may be directly toxic to the developing egg. The report stressed that women who are attempting to conceive or who are pregnant should not use marijuana.
Marijuana also decreases the sperm count and increases abnormal shapes. And when pregnancy does occur, a University of Arkansas study showed pregnancies achieved with low sperm counts are more likely to end in miscarriage.
Additionally, combining alcohol and marijuana may greatly increase a woman's risk of experiencing infertility. In a study at the Research Institute on Alcoholism, Dr. Ernest L. Abel tested the hypothesis that alcohol in combination with marijuana would increase infertility far more than if either drug was used alone. Using both rats and mice, Dr. Abel exposed 85 of the animals to either alcohol or marijuana, or alcohol plus marijuana, along with a control group that was not exposed. The results were startling. The fertility of the mice exposed to both chemicals were significantly impaired compared to those only exposed to one. The combination of alcohol and marijuana should be considered as high risk factors for increasing infertility problems.
F. Bolumar, J. Olsen, J. Boldsen, and the European Study Group on Infertility and Subfecundity (Department of Epidemiology and Social Medicine, Steno Institute of Public Health, Aarhus, Denmark). Smoking Reduces Fecundity: A European Multicenter Study on Infertility and Subfecundity. Am J Epidemiol 1996;143:578-87.
Hall, C. T., Teen Males Who Smoke Risk Sperm Damage, San Francisco Chronicle, October 2, 1998.
Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Health Effects of Exposure to Environmental Tobacco Smoke, Chapter 5: Reproductive Effects, 1997.
Grodstein F, Goldman MB, Cramer DW. Infertility in women and moderate alcohol use. Am J Public Health 1994;84:1429-32.
Florack EIM, Zielhuis GA, Rolland R. Cigarette smoking, alcohol consumption, and caffeine intake and fecundability. Prev Med 1994;23:175-80.
Dr. Ernest L. Abel, Infertility Increases when Alcohol & Marijuana Combined,
Research Institute on Alcoholism, Buffalo, New York Teratology 31:35-40 (1985)
Dr. Ricardo Yazigi, Cocaine and Abnormal Offspring, Department of Obstetrics and Gynecology, Washington University School of Medicine Journal of the American Medical Association Vol. 66(14), Oct. 9, 1991
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