Juggling The Jonesings- How Much Caffeine is Safe When Trying to Conceive
Can Caffeine Affect Fertility?
This is a messy discussion out there among researchers, and if you're anything like me (totally paranoid and zero threshold minded until proven otherwise with hard facts *eyelid twitch*) you're looking at hours and hours of getting lost in the wormholes of online discussion forums. Caffeine isn't an easy thing to give up. Factor in all the scheduled baby making grind sessions and the emotional stress of trying to conceive and it seems a cruel thing to deny anybody. Dare I even mention chocolate in this category of offenders? Cocoa, the universal ambrosia, has anywhere between 9-21 milligrams of caffeine per bar, almost as much as 12 ounces of soda. I know- it's like taking candy from a baby. But if babies are on your mind (and if the conviction is in your loins!), then it's important to understand the risks of caffeine, in any dose when trying to conceive.
According to the National Infertility Association, avoiding caffeine altogether for women trying to conceive may be the safest way to go, "as no “safe” level of consumption has been documented."* Naturopathic medicine experts would agree. Dr. Amy Terlisner, woman's health NMD, puts in her fertility checklist front and center that caffeine should be totally excluded from TTC diets.** I will raise my surrender flag and walk to my imminent death as I also tell you that this warning includes decaf coffee as well, which despite its name still has 2 milligrams of caffeine per 8 ounces. Don't shoot the messenger!
And how exactly is caffeine bad for trying to get pregnant? The final verdict is still out, but emerging speculations from medical journals and researchers can give us a good idea. The Fertility Society of Australia has compiled a number of studies that show evidence that caffeine affects the corpus luteum (the remainder of the egg-containing-follicle left after ovulation, and what is responsible for producing progesterone necessary for implantation). "Caffeine may affect ovulation and corpus luteum functioning through alterations to hormone levels, and has been shown to be associated with higher early follicular E2 levels in females."*** In other words, caffeine could be seriously be messing with the natural and very meticulous timing of things and juices in your uterus.
Most studies exploring caffeine have focused on general populations, but in 1988 The Lancet, a UK-based medical journal conducted a prospective study of 104 women attempting pregnancy. Variables such as caffeine intake, intercourse frequency, and menstrual cycles were recorded at regular intervals for until pregnancy occurred. Woman who consumed less than 1 cup of coffee a day were twice as likely to get pregnant per cycle than moderate coffee drinkers.**** The basis of this study and others like it has gone on to manifest the magic number brought to us by The American Journal of Obstetrics and Gynecology, who warn against exceeding 250 milligrams of caffeine daily for woman trying to conceive.***** They don't, however, confirm in their study that having less than 250 milligrams a day is 100% safe either. There is a lot of ass-covering in this realm, it seems, especially with the big publications.
Now, not all caffeine is created equal, which makes the 250 milligrams rule well, kind of bogus. An 8-ounce cup of drip coffee (like gas station coffee) is around 95 milligrams of caffeine, where as a grande Starbucks coffee is close to 330 milligrams. The fancy-pants lattes lay somewhere in the middle, averaging about 150 milligrams of caffeine per grande serving, but turn that into a mocha and you're easily hitting 250 milligrams. When it comes down to it, trying to decipher your "safe" intake through the myriad of java offerings may not be worth the anxiety, much less potential higher early follicular E2 levels.
And what about tea, you may ask? Black tea can contain anywhere from 14-70 milligrams of caffeine per 8-ounce cup, and green tea 25-45. The health benefits of green tea are practically scripture by now, and its claims to support fertility, commonplace. The basis of these claims lay mostly in the fact that green tea is hydrating (good for cervical mucus) and full of antioxidants, but so is water and garbanzo beans, so maybe better to take your chances on those.******
An interesting opposition to the zero tolerance caffeine model for women TTC is brought to us by a Dr. Zev Williams, spokesman for the American College of Obstetricians and Gynecologists (fancy), who brings caffeine withdrawals into the equation (the struggle is real!). Quoted in Today: Health and Wellness, Dr. Williams points out what he sees regularly when TTC patients go cold turkey on the Joe. "What ends up happening invariably is these women will develop rebound headaches and take medications to treat the headaches. Those medications may be harmful." His professional opinion: "it's probably better just to have one to two cups of coffee a day to avoid having those medications to treat a rebound caffeine withdrawal." ******* Huh? The headstrong warrior princess in me says "headaches be damned-I'm watching out for my corpus luteum!" but then again, ask me in the thick of a 3-day long migraine stint and I may answer differently, accented with some strong four-letter words.
The studies speak for themselves when it comes to caffeine and fertility, despite the lack of conviction the medical field applies to the subject. Less than one cup = twice as likely to conceive. Plus, corpus luteum! It may only be a speculation, but I'm not taking any chances on drying up my fly-trap-sticky progesterone to catch me some implantation!
JEIRAN -Look, I would be a very happy camper if my patients gave up caffeine, but for me, if it means that you are going to be very sluggish, have headaches and miss out on your morning ritual of setting up your Chemex or French Press then I would like you to have balance. That means if you can cut down to a few treats of coffee a week, GREAT! If it means one cup of high quality home-brewed organic coffee then go for it. When I have patients cutting out caffeine I usually have them do it over a 2-4 week period so that they don't have as many side effects and it's not such a shock to their system. I also remind them that when they do get pregnant and they're still drinking coffee, it's not the miscarriage risk but the fact that they are in essence giving their baby a stimulant that matters. Caffeine is caffeine no matter the form when we're talking about fertility both coffee and green tea are antioxidants and can help with some issues, but the jury is out on whether green tea would help with fertility and one study even found that both black and green teas may inhibit the body's ability to absorb folic acid******** - a B vitamin that is necessary to prevent neural tube defects.
THE NITTY GRITTY
**Terlisner, Amy. "Sperm Meets Egg: An Initial Fertility Checklist." Townsend Letter 357 (2013): 48-51. Alt HealthWatch. Web. 19 Feb. 2017.
****Wilcox, A., Weinberg, C. et al. (1988). “Caffeinated beverages and decreased fertility.” Lancet 2(8626-8627): 1453-1456
*****Barbieri, Robert L. "The initial fertility consultation: Recommendations concerning cigarette smoking, body mass index, and alcohol and caffeine consumption. "American Journal of Obstetrics & Gynecology , Volume 185 , Issue 5 , 1168 - 1173, http://www.ajog.org/article/S0002-9378(01)11027-6/abstract. Accessed 20 February 2017
(No conflicts of interest detected in the above sources)