If you’ve been trying to conceive or preparing for IVF, it’s possible you’ve explored everything from blood tests ordered by a reproductive specialist to acupuncture, herbs, and other Eastern medicine modalities. If so, maybe you’ve learned how traditional Chinese medicine, often abbreviated to TCM, considers the blood, heart, liver and spleen to be the body parts that principally govern fertility.

If so, it’s possible you’ve wondered: What happens outside the reproductive system that affects our ability to conceive? A new study narrows in on alcohol in a way that helps reveal why diet and lifestyle changes are essential not only after you’ve conceived, but as you’re preparing to, also.

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The review sheds light on consequences drinking can have on reproductive health related to the ways alcohol affects, the liver, gut, hormones, and systemically. Published June 9, 2024 in Animal Models and Experimental Medicine and led by medical researchers in Malaysia, the review examined more than 100 existing pieces of research to find: “[…A]lcohol negatively affects reproductive health by inhibiting the hypothalamic-pituitary-gonadal axis, causing infertility in both men and women.”

The team explains that our bodies break down alcohol through oxidative and non-oxidative pathways. On the oxidative pathway, an enzyme in the liver called “alcohol dehydrogenase” breaks down the alcohol into a harmful substance called acetaldehyde, which can damage cells and tissues and lead to inflammation, heightened cancer risk and organ enlargement.

On the non-oxidative pathway, enzymes CYP2E1 and catalase process alcohol in organs such as the brain, heart and lungs, according to the review. The enzyme CYP2E1 can disrupt the effectiveness of medications and also increase cancer risk if combined with substances like tobacco.

This can lead people with female reproductive organs to experience hormonal imbalances that disrupt menstruation, ovulation, and fertility, potentially triggering early menopause. For people with male reproductive organs, alcohol reduces hormone levels crucial for sperm production and sexual function, which may lead to issues like erectile dysfunction and male factor infertility. Both sexes also experience oxidative stress from alcohol, which can harm reproductive cells even further.

Gut health also comes into play—reports the research team: “Alcohol-induced dysbiosis in gut microbes heightens gut wall permeability to [pathogens], leading to liver cell infection and subsequent inflammation.”

The researchers also found that if an individual regularly consumes alcohol over a long period of time, it can cause their body to overproduce the enzymes that break down the alcohol, leading to a constant state of damage and inflammation. This can eventually lead to ongoing cellular stress and damage that can inhibit fertility.

The researchers conclude: “These findings underscore the profound health concerns associated with alcohol-induced damage.” They add that the research demonstrates “the intricate interplay” between the immune system and organs we might not think of as being susceptible to alcohol-related damage.