LIMIT CAFFEINE AND COFFEE
Caffeine
can decrease the flow of blood to the uterus, which can interfere with
implantation. Too much caffeine may increase the risk of clotting and
miscarriage.
Caffeine can also increase stress and anxiety levels. Studies on
caffeine and fertility in general are inconclusive, but you’ll do best to avoid
it if blood flow or implantation problems or miscarriage is your main fertility
issue. Some fertility types are more prone to negative effects of caffeine than
others (see part V), but for almost everyone, up to 90 mg a day is generally
safe. That’s the equivalent of about one cup of regular brewed coffee, two cups
of black tea, or three cups of green tea. The caffeine in colas and chocolate
counts, too.
It’s
best to limit coffee, whether it’s regular or decaf. Coffee is acidic and can
make the body and the cervical mucus acidic, too. Several studies have
concluded that coffee (with or without caffeine) diminishes fertility. A recent
large Dutch study determined that four cups of coffee a day lowered a woman’s
chances of having a baby by more than 25 percent—comparable to the fertility
damage done by smoking, being overweight, or having three or more alcoholic
drinks a week. Some studies have linked coffee and miscarriage, and some have
linked coffee and low sperm count. But not all studies have found a problem
with coffee. So as with most things, we recommend moderation. If you drink a
lot of coffee, cutting back may be a good idea, perhaps to just one cup in the
morning. (We’re talking about a normal six- to eight-ounce cup, not the huge
super-grande “to go” cups that everyone seems to be carrying around these
days.) Many of our patients have made the switch from coffee to tea, and that’s
another good option. If you find you are having fertility problems, you may
want to eliminate coffee altogether.
AVOID ALCOHOL
Many
women avoid alcohol while trying to conceive, on the theory that since they
won’t drink at all while pregnant, they shouldn’t drink at any time when they might be pregnant. But being cautious
about alcohol while trying to conceive is not just about potential effects on
the fetus. Alcohol affects fertility, too.
The
research on this subject is something of a mixed bag. Some studies have found
no link between moderate drinking and fertility issues. But some show that even
low levels of alcohol can cut fertility by as much as one-half. For example,
one large study concluded that women who had fewer than five drinks a week were
twice as likely to get pregnant in a given six-month period compared to women
who drank more. Another study demonstrated that men who drank alcohol regularly
took twice as long to get their partners pregnant as men who didn’t drink at
all. In both sexes, the more alcohol consumed, the less likely conception is.
Most studies agree: high alcohol intake significantly impairs fertility.
Alcohol
is one of the most common factors affecting fertility in men. It is toxic to
sperm, and overuse can reduce sperm quality, increase abnormal sperm, and lower
motility. Men who drink have been shown to have lower sperm counts and lower
testosterone than teetotalers, as well as decreased libido and increased risk
of erectile dysfunction (ED). In women, alcohol can be a risk factor for
ovulatory infertility.
Drinking
alcoholic beverages has also been shown to decrease the success rates of ARTs,
including IVF. According to one study of couples undergoing IVF, women who had
one drink more per day than others tripled their risk of not getting pregnant
in any given cycle and more than doubled their risk of miscarriage. When it was
the man who had that extra daily drink, the risk of miscarriage was between two
and thirty-eight times greater,
depending on the timing of the drinking in relation to the IVF cycle. One month
before IVF and during IVF were the most hazardous times.
Besides
its direct effects, alcohol also interferes with the body’s ability to absorb
nutrients from food. That includes zinc, which is key for male fertility in
particular. Alcohol interferes with the action of folic acid as well, which
plays an important role in the maturation of an egg for ovulation. Finally,
alcohol acidifies the body, including the cervical mucus. If the mucus gets too
acidic, sperm can’t survive in it, and so can’t reach the egg.
What You Can Do About ItMost people will need to moderate their alcohol intake, and some will need to cut back substantially or eliminate it altogether. Some women actually benefit from a glass of wine or beer now and then. In general, women should have no more than one small glass of wine or beer per day, and men no more than two small glasses or one mixed drink. For most people it’s best not to have a daily drink while you’re trying to conceive; reserve drinking for social occasions. See part V for specific advice about alcohol consumption tailored to your individual fertility type.
Case Study: Annie and Kevin
By the time Annie and Kevin
came to see me (Jill), they had been through one unsuccessful IVF and one IVF
that had ended in miscarriage due to chromosomal abnormality. Annie seemed
quite healthy to me, and I could see no good reason why she was unable to
conceive.
She told me that her husband, Kevin, had been diagnosed with poor
sperm motility and morphology, but the doctors had reassured them that although
this may have been the reason they couldn’t conceive naturally, it shouldn’t
get in the way of IVF. I thought a session with Kevin would be in order.
In my
office, he said that he guessed he drank rather a lot of alcohol, unwinding in
the evening after stressful workdays with a gin and tonic and a couple of
glasses of wine. He said that he would cut that out if I thought it would help,
and he would overhaul his diet while he was at it. Five months later, he had a
perfect semen analysis, and they immediately scheduled another round of IVF—with
healthy sperm this time—for the next month. Annie and Kevin are now the proud
parents of a healthy baby girl.
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