I’m starting off the week with a research paper from the field of medicine; specifically related to in vitro fertilization and effects of alcohol consumption on its success. Though never experiencing the implantation portion of in vitro fertilization, I have undergone egg donation surgery, and have experienced some of the same initial procedures the couples in this study have experienced. The study I will present to you today does not deal with donated eggs, but it is a topic that I have a soft spot for, and am very excited to present it to you today.
(As a side note: visit my first guest post on the My Personal Finance Journey blog dealing with the ethical, physical, and financial concerns of egg donations. Click here to view that post and check say “hi” to the blog’s author, Jacob!):
http://www.mypersonalfinancejourney.com/2011/06/to-donate-or-not-to-donate-financial.html
The title of today’s paper is: Effect of Alcohol Consumption on In Vitro Fertilization; by Brooke V. Rossi et al, from Brigham and Women’s Hospital in Boston, MA).
Introduction
As you all probably know, alcohol consumption by pregnant women is strongly associated with birth defects. Little is known, however, about alcohol consumption and subsequent effects on the in vitro fertilization process. Some studies have found that consuming high amounts of alcohol decreased fertility among women, and that women who consumed alcohol moderately showed no changes in their fertility. An interesting find from these past studies is that the amount of time needed to get pregnant was shorter for wine drinkers, unchanged with beer drinkers, and variable for liquor drinkers (so since I’m primarily a wine drinker, does that mean I have a greater chance of getting pregnant sooner than later? Hmmmm…fascinating!).
Not much is known about men’s alcohol consumption habits and effects on male fertility. The studies so far have been contradictory, in that some show that heavy alcohol consumption decreases fertility, whereas other studies have shown no significant effect.
In regards to alcohol consumption studies and effects on in vitro fertilization are concerned only one other study prior to the current one under review had been completed (Klonoff-Cohen et al, 2003, in issue 79 of the journal Fertility and Sterility). That study found that even at one drink per day, women had 13% fewer oocytes (eggs) retrieved. Those with moderate consumption habits were shown to have a decreased chance of pregnancy. In men, the closer to semen collection they consumed alcohol, the more likely the chance of the woman having a spontaneous abortion.
According to the American Pregnancy website (www.americanpregnancy.org), there are many factors that determine the success of in vitro fertilization. Some average statistics for live birth rates in the United States are:
· 30-35% success in women under the age of 35
· 25% success in women between the ages of 35 and 37
· 15-20% success in women between the ages of 38 and 40
· 6-10% success in women over the age of 40
Since success of complete a pregnancy is relatively low, no matter what the woman’s age, it’s important that the entire cycle be completed with utmost care. If studies show that alcohol consumption affects the success of completing a pregnancy, then it would be worth it, both emotionally and financially, to abstain from drinking any type of alcohol for the duration of the cycle.
Methods
Detailed methods may be found in the paper itself, though are not necessarily required for me to disclose for this review. (If you have specific questions about the methods and cannot access the paper, feel free to comment below and I’ll answer them to the best of my ability.)
Couples enrolled in the In Vitro Fertilization (IVF) treatment program between 1994 and 2003 at three Boston-area hospitals were eligible for this study.
Alcohol consumption habits as well as other factors of interest were determined via a self-administered questionnaire. Alcohol consumption at the start of the IVF cycle was of interest, and not alcohol consumption during the cycle. The questions asked also sought to determine the type of alcohol consumed (beer, white wine, red wine, and liquor).
The primary outcome of interest was live birth rate (since that’s the most desired result at the end of an IVF cycle), though the following secondary outcomes were also studied: points of failure in the IVF cycle, and cycle characteristics. To be more specific, points of failure in the IVF cycle included; rate of cycle cancellation (no eggs retrieved), fertilization failure (no embryos to implant), implantation failure (no biochemical/clinical pregnancy), and spontaneous abortion (clinical pregnancy with no delivery). They not only looked at these factors, but also considered sperm concentration, sperm motility, sperm morphology, estrogen levels, number of eggs retrieved, and the fertilization rate. Confounding factors were measured and adjusted for each analysis (included age, body mass index/BMI, number of cycles performed, and cigarette usage).
Results
Some basic information pertaining to the demographics of the study:
The average age of the women participating in this study was 35 (+/- 4) years, and the average age of the men was 37 (+/- 6) years.
11% of women and 17% of men had BMI’s of 30 or above.
9% of women and 10% of men were smokers.
87% of women were going through IVF for the first time.
51% of women and 26% of the men’s partners had experienced a previous pregnancy.
(All of these confounding factors were taken into consideration and dealt with in a statistically appropriate manner.)
Results of the Primary Outcome: Live Birth Rate
· Women who drank at least four drinks per week (50g) had a 16% lower chance of having a live birth than those who drank fewer than this.
o Women drinking WHITE WINE weekly showed this decrease in likelihood of having a life birth.
· Male drinking did not appear to be statistically significantly associated with live births, though there was a decreasing trend for those men drinking beer.
· The odds of having a live birth were 21% lower in couples where both the man and the woman drank at least four drinks per week.
Results of Secondary Outcomes:
· There was no significant effect of alcohol consumption on women who had embryos implanted, therefore the authors suggested that alcohol consumption may have stronger effects on the IVF cycle before embryo transfer.
· Women drinking white wine weekly had a 22% greater chance of a failed embryo implantation.
· Men drinking beer daily also showed a greater chance of failed implantation of the embryo in the woman.
· Women drinking white wine weekly had significantly fewer eggs retrieved compared to women non-white wine drinkers.
· Men consuming beer daily had 27% lower odds of having poor sperm motility.
· Men consuming wine daily was shown to be inversely associated with sperm morphology and concentration. In other words, the more wine consumed, the poorer the morphology and lower the concentration of sperm.
o Weekly white wine consumption in males increased the odds of poor sperm morphology by 43%.
o Weekly red wine consumption in males increased the odds of poor sperm concentration by 23%.
What does this all mean?
It doesn’t take rocket scientist to see that alcohol consumption, including wine consumption, has a negative effect on In Vitro Fertilization procedures. It’s clear that any alcohol consumption lowers the chance of a successful pregnancy, be it directly through live births, or more indirectly through lower sperm concentrations and poor sperm morphology.
The current study indicates that there may be differing effects based on what type of alcohol is consumed, but the mechanisms behind such differences have yet to be understood. Red wine has been shown to be beneficial in other aspects of health (cardiovascular, in particular), but its’ role in IVF may be more detrimental. This study was able to show that for wine, white wine appears to be more detrimental to the IVF process, but more work needs to be done to further understand the mechanism.
It is important to note that this study found significant negative effects at 4 drinks per week, but did not appear to consider consumption at lower levels.
In summary, if you are trying to conceive, be it using IVF procedures or more natural ways, it is important to avoid alcohol (even red wine!) not only during the actual pregnancy (if an embryo even implants), but PRIOR to conceiving as well.
Full citation:
Rossi, B.V., Berry, K.F., Hornstein, M.D., Cramer, D.W., Ehrlich, S, and Missmer, S.A. 2011. Effect of Alcohol Consumption on In Vitro Fertilization. Obstetrics and Gynecology 117 (1); 136-142.
I am not a health professional, nor do I pretend to be. Please consult your doctor before altering your alcohol consumption habits. Do not consume alcohol if you are under the age of 21. Do not drink and drive. Enjoy responsibly!
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