Common Fertility Concerns

Some of the most common questions regarding female infertility have to do with miscarriages and also the effects of alcohol on fertility.

What Are The Effects of Alcohol on Fertility?

The data regarding the effects of moderate alcohol intake on fertility is inconclusive at this time. The largest prospective studies conducted in Europe indicate that high levels of alcohol consumption are associated with greater difficulty conceiving. One small Danish study identified a slight delay in conception even with alcohol ingestion of 5 drinks or less per week. However, this research relies on self-reporting of alcohol consumption which may be inaccurate. In many cases, the studies do not fully account for other factors that could be affecting fertility.

Don’t Overdo It
When you are attempting to conceive, taking a moderate approach to alcohol consumption is the wisest course of action. If having an occasional beer or glass of wine once or twice a week is part of your normal lifestyle, this is unlikely to have a significant effect on your ability to conceive. Drinking every day or consuming several drinks at one sitting is behavior you should avoid. High levels of alcohol can negatively affect many aspects of your health and is probably not good for eggs or sperm development either.

Alcohol and Pregnancy
If you think you might be pregnant, it’s time to stop consuming alcohol. Fetal harm from exposure to alcohol in the womb can lead to lifelong health problems. In fact, Fetal Alcohol Syndrome (FAS) caused by maternal alcohol consumption is the leading identifiable cause of neuro-developmental disorders and birth defects in babies. No “safe level” of prenatal alcohol exposure has been identified, so pregnant women are advised to abstain from alcoholic beverages altogether.

How Common Is Miscarriage?

A high percentage of fertile women who have unprotected sex will experience loss of a pregnancy at some point. According to the American Society for Reproductive Medicine, 25% of recognized pregnancies end in miscarriage. The total number of miscarriages (including cases where the woman is unaware of the pregnancy) is estimated at about 50%. Pregnancy losses occurring within the first 8 weeks are most common. Few women experience miscarriage after the 12th week.

What You Should Know about Recurrent Miscarriage
A single miscarriage is not usually a cause for concern from a medical standpoint. However, consecutive miscarriages are rare, occurring in less than 5% of women. If you experience two or more miscarriages of in a row, you may wish to seek assistance from a reproductive specialist.

In some situations, there is an identifiable, medically treatable factor contributing to the loss of pregnancies. Many pregnancies simply end because of random chromosomal abnormalities in the egg or the developing embryo.

Recurrent miscarriage or early pregnancy loss can be physically taxing and emotionally devastating. Not knowing why this problem is happening can be especially distressing. Patients may experience feelings of self blame, failure, or desperation. It is important for patients to seek emotional support during this time. Professional mental health support may also be beneficial for patients coping with recurrent loss.

Pregnancy after Miscarriage
Fortunately, most women trying to conceive do go on to carry a healthy pregnancy to term after a miscarriage. This includes 60-70% of women who have experienced recurring pregnancy loss with no identifiable cause. Following a healthy lifestyle including good nutrition, diet, weight control, prenatal supplementation, exercise, rest, and general self care is the best course of action for women who wish to increase their chances of a normal pregnancy in the future.

Can Recurring Miscarriage Be Prevented?

Because the underlying cause of most miscarriages is chromosomal abnormalities, the various therapies and techniques typically promoted for prevention are not proven and are unlikely to be useful. This includes over the counter, herbal, and alternative treatments.

Treatable Causes
Occasionally, a patient is diagnosed with a medical condition that may cause or contribute to recurrent miscarriage. Treatment or correction of the underlying disease, deficiency, or abnormality may reduce the chance of future miscarriage for some patients.
Here are a few examples:

Problem: Identifiable genetic abnormalities in one or both parents or advanced maternal age increasing the risk of chromosomal abnormalities in the embryo.
Treatment: During an In Vitro Fertilization cycle, preimplantation genetic diagnosis (PGD) may be used to identify a chromosomally normal embryo for implantation.

Problem: Uterine problems including polyps, fibroids, or a uterine septum (distortion of the interior of the uterus by abnormal tissue formation).
Treatment: Surgery may be suitable for some patients to restore a normal uterine surface to enable implantation and ongoing support of future embryos.

Problem: Diabetes or insulin resistance (such as found in patients with PCOS)
Treatment: Management of blood sugar through lifestyle changes and/or with appropriate medications to consistently maintain blood sugar at normal levels.

Problem: Antiphospholipid antibody syndrome which may cause excessive blood clotting and an antibody reaction to the placenta.
Treatment: Blood thinning therapy with aspirin and heparin may help prevent clotting. According to the American Society for Reproductive Medicine, medical treatments such as leukocyte (white blood cell) immunization and intravenous immunoglobulin (IVIG) therapy for preventing miscarriage have no proven benefit at this time.

If your doctor finds other medical conditions such as low levels of progesterone hormone or other hormonal irregularities, these may be treated as well. The efficacy of such treatment for preventing recurring miscarriage is not yet known.

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