Alcohol: Can drinking affect your fertility?

Q:Can drinking alcohol affect your ovulation and cause infertility?

A: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.

If questions about alcohol use have surfaced during an infertility evaluation a cautious self-evaluation of alcohol use is prudent. Many organizations, such as Alcoholics Anonymous, are available to help in situations where alcohol dependence is apparent.

Alcohol abuse and alcoholism are 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. The adverse reproductive consequences of alcohol range from infertility and increased risk for spontaneous abortion to impaired fetal growth and development.

Previous research in lab mice reveals that superovulated oocytes were more susceptible to the teratogenic effects of ethanol (alcohol) than spontaneously ovulated oocytes. Thus, in patients undergoing superovulation with gonadotropins a history of alcohol abuse should be addressed before initiating a cycle.

The 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, brain anomalies are often found. This syndrome occurs in 30 to 40 percent of newborns born to women who are alcoholics. 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.

Excessive alcohol ingestion is associated with numerous ovulatory dysfunctions. If infertility and especially anovulation are recognized disorders, alcohol should be avoided. There are no "safe" levels of maternal alcohol ingestion established, therefore, abstinence is recommended during pregnancy

For couples seeking infertility services, an open discussion about excessive drinking will help to avoid many serious consequences. Patients with an alcohol abuse or dependence who are undergoing an assisted reproductive procedure should seek counseling and treatment prior to undergoing the procedure.

Approximately 70 percent of U.S. citizens imbibe socially. Alcohol abuse is prevalent in our society. While alcohol abuse is often considered a personal problem, it endangers the life and health of the drinker, the family and may affect reproductive function adversely. Drinking patterns which cause one to be unable to fulfill work, school, or home responsibilities; the need to drink while driving; legal problems; or, result in persistent relationship problems are considered alcohol abuse. Alcoholism results in strong cravings for alcohol; the inability to stop drinking; withdrawal symptoms (nausea, sweating, trembling, anxiety); and, increasing amounts of alcohol required to achieve a "high."

One beer, a glass of wine, or a mixed drink contains about one half ounce (15g) of absolute alcohol. Moderate alcohol abuse is characterized by the daily consumption of four to six drinks or two to three ounces of alcohol (60 to 90g). Alcoholism is the ingestion of eight or more drinks per day which is equivalent to four ounces of alcohol per day (120g).

It is estimated that approximately 7.4 percent of the adult population were dependent (4.4 percent) or abusers (3.0 percent) of alcohol. It has been shown that the younger the age of onset of drinking, the greater the chance a person will develop an alcohol disorder. Youth who began drinking before they turned 15 were twice as likely to develop an alcohol abuse problem and four times more likely to develop alcohol dependence, compared with persons who did not begin drinking before age 21. Over 40 percent of individuals who began drinking before age 15 were classified as alcohol dependent at one time in their lives.