Expert / 19 August, 2021 / Mr Rehan Salim
New research conducted by King’s College London has brought to light a lack of awareness in the UK surrounding our lifestyle choices and the impact they can have on our fertility, most notably drinking when TTC.
It is believed that a woman’s health at the time of conception helps to pave the way for a healthy pregnancy and the future health of both mother and baby. However, this particular study found that many women hadn’t adapted their lifestyles to prepare their bodies for pregnancy and were continuing to drink alcohol, smoke and consume caffeine while trying to conceive.
In the same way that there are proactive steps we can take to improve our health for potential pregnancy (such as eating healthily, taking a folic acid supplement and exercising regularly), unfortunately, lifestyle habits such as drinking alcohol can have a negative impact on our fertility.
To find out more about planning a pregnancy, and understand the impact that alcohol can have on our fertility, we spoke to Mr Rehan Salim, Consultant Gynaecologist and Specialist in Reproductive Medicine, at The Portland Hospital, in partnership with Lister Fertility Clinic and HCA Healthcare UK.
Alcohol is a strong chemical that can affect our bodies in a number of different ways and can have varying impact on our health depending on the amount of alcohol we drink.
For instance, after drinking just 2 units of alcohol our heart rate increases and blood vessels expand; if you drink more than 12 units consistently, you’re at risk of alcohol toxicity, which can interfere with your body’s normal functions, including coordination and even breathing. In addition, long term alcohol misuse can take its toll on the body. Along with damaging the liver, heart and brain, too much alcohol can have a negative impact on our fertility.
It is for these reasons that the UK’s Chief Medical Officers advise that we drink no more than 14 units a week to keep the health risks from alcohol to a low level, and to spread these units over three or more days to avoid ‘binge drinking’.
Lifestyle factors can have a profound effect on our overall health and our reproductive health is no exception to this rule. Once you start trying for a baby, it is unlikely that you will know if you are pregnant in the first few weeks, so reducing or changing any unhealthy habits will give you peace of mind if you fall pregnant.
In women, heavy drinking can cause a change in the menstrual cycle and can affect ovulation, which can cause difficulties in conceiving and overall can increase the time it takes to fall pregnant. Alcohol consumption may also affect a woman’s ovarian reserve and prevent proper implantation in the uterus.
In addition, drinking high quantities of alcohol regularly can lead to weight gain for both men and women; this affects our fertility as it reduces the quality of eggs and sperm and can lessen the chance of a successful pregnancy.
If a man regularly drinks more than the recommended 14 units of alcohol per week, it can significantly reduce a couple’s chance of conceiving, as alcohol can lower testosterone levels and the hormones needed for sperm production. It can also have a negative impact on the libido and sperm quantity and quality.
It isn’t known exactly how small amounts of alcohol can affect an unborn child; however, large quantities of alcohol can cause a number of serious complications during pregnancy and could lead to miscarriage.
This is especially true in the first three months of pregnancy as the baby’s brain is still developing. Excessive alcohol during pregnancy is although thought to cause learning difficulties and behavioural problems. When trying for a baby, the safest option is to avoid alcohol altogether and to speak to your midwife or GP if you are worried that you have had excessive amounts of alcohol whilst pregnant.
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Many people who are struggling to conceive look to fertility treatments to aid the process. One such treatment is In Vitro Fertilisation (IVF). This is where a woman’s egg is removed and fertilised in a lab with sperm and then returned to the woman’s womb to grow and develop. If successful, the fertilised embryo attaches to the wall of the woman’s uterus, resulting in pregnancy.
However, regular drinking when TTC causes hormonal fluctuations in men and women and lead to irregular ovulations and periods. These issues may cause delays to the IVF process and reduce the quality of the eggs being collected.
While the exact effect of alcohol on IVF treatments is unknown, one study has found that consumption of as few as four alcoholic drinks per week is associated with a decrease in IVF live birth rate.
Another study found that women going through IVF treatment who drank one or more drinks a day had more than twice the risk of miscarriage. The increased risk was higher if the drinking happened the week before the IVF treatment. Similarly, men who drank just one serving of alcohol a day from a week or a month before IVF treatment saw an increased risk of a miscarriage of 38 times.
In general, it can take up to three months for eggs and sperm to develop, so to reduce any risk to fertility treatment, it is advisable to avoid alcohol at least three months before you begin trying for a baby.
A number of women who would like to have children also make the decision to freeze their eggs for later use. This may offer a better chance of a successful pregnancy in the future than using older “fresh” eggs, which may be lower in both quality and quantity.
During the egg freezing process, the patient is given fertility drugs to help to stimulate the ovaries and assist with the cycle. It is thought that a small amount of alcohol here and there will not drastically affect the quality of the eggs in this process; however alcohol may interact with these medications and cause delays in the process. It is also important to remember that as alcohol can impact our health more generally, this could in turn impact the quality of the eggs bring frozen.
Ultimately, there is no known safe amount of alcohol to drink when TTC or while pregnant but we know that alcohol can pass through the bloodstream into the placenta and to the baby. This can seriously affect the baby’s development, can lead to a small birth weight or cause miscarriage, stillbirth, premature birth or Foetal Alcohol Spectrum Disorder (FASD).
As many people are unlikely to be aware of their pregnancy in the first few weeks of conception, I would advise patients who are trying to conceive to avoid alcohol altogether to increase their chances of falling pregnant and keep any health risks to the baby as low as possible.
Keeping your future baby healthy starts long before you fall pregnant. For guidance and advice on how to maximise your chances of conception and ensure a healthy pregnancy, I recommend consulting a fertility specialist or medical professional about how to adapt your lifestyle appropriately.
Article by Mr Rehan Salim, Lister Fertility Clinic at The Portland Hospital
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