Impact of Drinking Alcohol & Smoking Nicotine & Marijuana on Fertility | Dr. Andrew Huberman
00:00:00.000 | I think a lot of people aren't aware of just how striking
00:00:04.800 | in effect these certain behaviors that you want to avoid
00:00:08.580 | can have in diminishing your fertility
00:00:10.620 | for both males and females.
00:00:12.000 | So let's talk about those.
00:00:12.840 | So the first one is smoking.
00:00:14.440 | And when we talk about smoking here,
00:00:15.840 | we're talking about smoking nicotine
00:00:18.560 | and we're talking about smoking cannabis.
00:00:20.440 | And indeed there are strong data,
00:00:22.120 | and I will put a reference to one of the better,
00:00:24.240 | larger analyses of these data.
00:00:26.120 | There are strong data showing
00:00:27.320 | that cannabis reduces fertility.
00:00:29.680 | Now I can already hear the screams from the back,
00:00:32.240 | although they're probably fairly drawled out screams
00:00:36.160 | from the back of people saying they smoke cannabis
00:00:38.600 | and they had no trouble conceiving.
00:00:40.800 | Certainly there will be exceptions,
00:00:42.200 | but whether or not you're male or female,
00:00:44.160 | smoking cannabis is a bad idea
00:00:45.900 | if you want to conceive a healthy child.
00:00:47.680 | Can you still conceive a healthy child
00:00:49.080 | while smoking cannabis?
00:00:51.440 | Probably certain people can.
00:00:53.080 | Many people will greatly decrease the probability
00:00:56.680 | of a healthy fertilization in pregnancy
00:00:59.180 | by smoking cannabis.
00:01:00.020 | There are excellent data to support that.
00:01:02.760 | As well, nicotine, both smoked or vaped,
00:01:06.040 | is going to disrupt the process of fertilization
00:01:10.920 | and can disrupt pregnancy dramatically, okay?
00:01:13.440 | So just avoid it altogether.
00:01:14.840 | How does this happen?
00:01:15.680 | Well, it turns out that smoking increases
00:01:17.620 | what are called reactive oxygen species.
00:01:19.360 | This greatly disrupts the quality of the egg
00:01:22.480 | at the level of the spindle and mitochondria
00:01:24.120 | and a number of other features.
00:01:25.760 | And in the sperm, turns out that smoking
00:01:28.300 | doesn't necessarily disrupt the sperm directly,
00:01:30.700 | although it can cause DNA fragmentation,
00:01:33.540 | which can cause all sorts of abnormalities,
00:01:35.640 | can prevent fertilization,
00:01:36.980 | can lead to birth defects in the offspring.
00:01:38.880 | But more importantly,
00:01:40.760 | it increases what are called reactive oxygen species
00:01:43.120 | in the seminal fluid, in the semen that contain the sperm.
00:01:45.800 | This very, under normal circumstances,
00:01:48.700 | under healthy circumstances,
00:01:50.000 | beautifully orchestrated chemistry of fluid
00:01:53.000 | that allows the sperm to thrive in their trajectory
00:01:56.920 | and attempt to fertilize the egg
00:01:58.640 | and lead to a healthy pregnancy.
00:02:00.040 | So if you are a smoker and you want to conceive,
00:02:03.580 | the best advice I can give you is to quit smoking.
00:02:05.580 | And yes, that includes cannabis as well.
00:02:07.340 | Now, I am not somebody who believes
00:02:08.960 | that cannabis across the board is not useful.
00:02:10.820 | There are medical applications and other applications.
00:02:12.960 | I talk about that in an episode
00:02:14.580 | all about cannabis for health and disease.
00:02:17.080 | And notice health was in there too.
00:02:18.600 | So you cannabis smokers, don't come after me with,
00:02:21.440 | I guess, whatever it is, with bongs and pipes
00:02:23.760 | or whatever it is that you want, or with vapes.
00:02:25.920 | The point is that while it can be beneficial
00:02:28.960 | for certain populations, it's certainly bad for others.
00:02:32.360 | And if you're trying to conceive,
00:02:34.280 | it is bad for fertility and for a healthy pregnancy, okay?
00:02:37.760 | Now, that's smoking and vaping, by the way, okay?
00:02:41.520 | Vaping is included there.
00:02:43.200 | Now, the next category of don'ts relates to alcohol.
00:02:47.240 | Now, everyone has heard that drinking
00:02:48.840 | during pregnancy is a bad idea.
00:02:50.920 | You may have heard, and some people have talked
00:02:52.560 | about the fact that there are cultures
00:02:54.640 | in which they allow, if you will, or even condone, sadly,
00:02:59.640 | one or two drinks while pregnant,
00:03:01.880 | provided it's just champagne or something of that sort.
00:03:04.560 | That is a terrible idea.
00:03:06.120 | I did an episode all about alcohol,
00:03:08.320 | both its potential health effects,
00:03:10.440 | of which there turned out to be zero.
00:03:12.360 | And yes, that includes red wine.
00:03:14.300 | It is far better to not drink at all.
00:03:16.320 | And if you're going to drink,
00:03:17.280 | the limit, if you're a healthy adult
00:03:18.880 | who's not trying to conceive, not pregnant,
00:03:20.560 | and you don't have issues with alcoholism,
00:03:22.640 | is probably two drinks per week total.
00:03:25.680 | That's right, two drinks per week total.
00:03:27.880 | And that's the level that you really should consider
00:03:30.080 | if you're a drinker,
00:03:30.920 | if you're somebody who's trying to conceive.
00:03:32.620 | However, for a woman who becomes pregnant,
00:03:35.240 | the total number of drinks
00:03:36.360 | that you should allow yourself per week while pregnant
00:03:38.640 | and breastfeeding is indeed zero.
00:03:41.620 | There is absolutely no evidence
00:03:43.520 | that one can "get away" with drinking during pregnancy.
00:03:46.940 | And people say, "Well, I had a perfectly healthy child."
00:03:48.600 | But of course, you don't know
00:03:49.680 | what the health of that child would have been
00:03:51.400 | had you not drank at all.
00:03:53.360 | Now, I'm not here with any generally strong stance
00:03:55.700 | against alcohol.
00:03:56.560 | I myself am somebody who has a drink every once in a while,
00:04:00.960 | although I don't consider myself somebody
00:04:02.640 | who has a strong proclivity for alcohol.
00:04:05.480 | And of course, at this moment,
00:04:07.440 | I'm not trying to conceive children,
00:04:09.140 | and I'm certainly not pregnant.
00:04:10.660 | So that's safe for me.
00:04:12.640 | But frankly, I haven't had a drink in a very long time.
00:04:15.440 | And so I don't miss it, and that's me.
00:04:17.280 | But I do realize that a lot of people enjoy alcohol.
00:04:20.560 | And so it's that two drinks per week limit
00:04:22.680 | that really sets the upper limit and threshold
00:04:25.240 | beyond which you start running into issues
00:04:26.980 | with cellular mutation.
00:04:29.040 | You start running into issues of oxidative stress,
00:04:32.520 | greatly increased cancer risk,
00:04:34.200 | in particular, breast cancer risk.
00:04:35.600 | All of that's covered in the alcohol episode that we did.
00:04:38.680 | You can find it hubermanlab.com and timestamped
00:04:41.200 | if you want to navigate to specific topics and so forth,
00:04:43.480 | find out all about the data supporting the statements
00:04:45.760 | that I'm making, so on and so forth.
00:04:47.840 | Now, if you're somebody who's seeking to conceive
00:04:50.080 | or you fall into this category
00:04:51.560 | that some couples describe themselves as we're not trying,
00:04:54.600 | but we're not not trying,
00:04:55.880 | meaning they're not using birth control,
00:04:57.280 | they're kind of letting chance run its course.
00:05:00.700 | Well, then you should definitely be aware of the data
00:05:03.040 | showing that even just one bout,
00:05:06.160 | one bout of so-called binge drinking,
00:05:08.680 | which is five to six drinks in a given night
00:05:12.200 | or half day in a 12-hour period,
00:05:14.200 | one bout of five to six drinks,
00:05:15.920 | if you're a woman or you're a man,
00:05:19.160 | greatly increases both the likelihood of mutations
00:05:24.160 | in the embryo that would result from a fertilization.
00:05:27.760 | And at the same time, for reasons that should be obvious
00:05:29.920 | to you based on all the biology we've talked about,
00:05:32.080 | a greatly reduced probability of fertilization.
00:05:34.800 | Now, that absolutely does not mean that you should use
00:05:37.560 | the ingestion of five or six drinks
00:05:39.100 | as a method of birth control.
00:05:41.280 | That is not what I'm saying here.
00:05:42.640 | What I'm saying is that if you go out on a given night
00:05:46.280 | and you have five or six drinks
00:05:47.920 | and you happen to become pregnant,
00:05:49.380 | the probability that that pregnancy will be disrupted
00:05:53.040 | in some way is greatly increased.
00:05:55.480 | What the exact consequences are, no one can tell you.
00:05:58.880 | But also if you're somebody who is interested
00:06:01.680 | in conceiving a child, well, then you absolutely
00:06:05.080 | should abstain from ingesting drinks more than one or two
00:06:09.760 | during the time in which you're trying to conceive.
00:06:11.720 | And ideally it would be zero.
00:06:13.560 | And you certainly would want to avoid
00:06:15.440 | drinking multiple drinks per night.
00:06:17.400 | And so this idea of going out and having, you know,
00:06:19.760 | three or four drinks or four or five drinks in a given night
00:06:23.600 | at a time in which you're also trying to conceive children,
00:06:27.200 | the biology tells us, the epidemiology tells us
00:06:29.740 | that this is just a terrible idea.
00:06:31.400 | It's going to reduce the likelihood of fertility
00:06:33.980 | and successful pregnancy.
00:06:35.480 | And if there is a successful pregnancy,
00:06:37.520 | the word success needs to be in quotes, right?
00:06:40.120 | I mean, I think every parent, every species for that matter,
00:06:43.960 | wants to increase the probability
00:06:46.200 | of having healthy offspring.
00:06:48.160 | And so to my mind anyway,
00:06:50.200 | and to the OBGYNs and the urologists
00:06:52.440 | that are focused on fertility that I spoke to,
00:06:54.720 | everyone will say, try as hard as you can
00:06:57.480 | to avoid the so-called binge drinking episodes.
00:07:00.400 | And again, these episodes are one night
00:07:01.880 | of consuming five to six drinks.
00:07:03.480 | Now, another important thing to remember in this context
00:07:05.800 | is that the negative effects of consuming five or six drinks
00:07:09.760 | in a given night extend over many weeks
00:07:12.960 | following the ingestion of that alcohol.
00:07:15.600 | If you're a male,
00:07:17.320 | what that means is that's going to impact
00:07:19.360 | the quality of your sperm
00:07:21.680 | and greatly decrease the likelihood of successful
00:07:24.720 | fertilization and/or healthy pregnancy
00:07:28.520 | over the period of that entire spermatogenesis window,
00:07:31.920 | which is, as we talked about before, 60 to 90 days, right?
00:07:35.820 | 60 to generate the sperm,
00:07:37.000 | and then in some additional time for the sperm
00:07:38.400 | to be transported to the point
00:07:39.420 | where they could be ejaculated.
00:07:41.960 | If you're a woman and you have five or six drinks
00:07:43.960 | on a given night,
00:07:44.800 | well, then you are going to disrupt the quality,
00:07:47.560 | not of just the egg that eventually ovulates,
00:07:50.720 | but indeed the entire pool of follicles
00:07:52.900 | that leaves the ovarian vault and reserve,
00:07:55.040 | and from which the one egg will be selected.
00:07:57.480 | In other words, you are reducing the quality
00:08:01.040 | of all of the eggs that you happen to deploy that month.
00:08:04.160 | Now, some of you who were really
00:08:05.720 | following the biology earlier might say,
00:08:07.520 | well, what if I have those five or six drinks
00:08:09.000 | during the time in which I'm menstruating,
00:08:11.120 | in which there's bleeding present,
00:08:13.600 | and therefore I haven't yet ovulated?
00:08:16.340 | Ah, but if you remember the biology
00:08:18.060 | we talked about earlier specifically,
00:08:21.220 | there is a subset of follicles and eggs
00:08:23.000 | that leave that ovarian reserve
00:08:24.720 | quite a bit before that one egg is selected for
00:08:29.240 | and ovulates, and of course,
00:08:30.500 | there are all the different hormonal cascades
00:08:32.440 | in the general milieu of the ovary,
00:08:34.320 | which are important and are being regulated
00:08:36.320 | by different hormones, and yes, indeed,
00:08:38.280 | the regulation of those hormones
00:08:39.680 | is strongly impacted by alcohol
00:08:41.840 | through a number of different pathways,
00:08:43.120 | through the regulation of the neurotransmitter GABA
00:08:45.440 | up in the brain, right?
00:08:46.600 | It's actually a lot of GABA and GABA receptors
00:08:48.560 | in the hypothalamus, the very region
00:08:50.000 | from which gonadotropin-releasing hormone,
00:08:52.160 | our old friend from a couple hours ago in this discussion,
00:08:55.640 | going to disrupt GnRH secretion.
00:08:57.920 | You can disrupt pituitary function with alcohol.
00:09:00.880 | Again and again, what we're seeing is that consuming
00:09:04.040 | more than one or two drinks per week of alcohol
00:09:07.360 | is really detrimental to the entire process of fertility
00:09:10.440 | and the entire process of healthy pregnancy,
00:09:13.160 | and that's true from both the male side and the sperm,
00:09:15.880 | and it's true from the female side and the egg.
00:09:18.480 | So my simple advice on this is if you are wishing
00:09:21.420 | to have a healthy fertilization and pregnancy,
00:09:24.760 | the best thing to do would be avoid alcohol together,
00:09:26.960 | and if you're going to drink,
00:09:27.920 | to really limit that drinking
00:09:29.360 | to one or two drinks per week maximum.
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00:09:38.720 | you