People who are trying to get pregnant have a lot of substances to avoid to improve their odds of success. Smoking, drinking, and exposure to other toxins are a clear no.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ba733c95-da57-4a78-b6f5-d224d78284d6 But research suggests that use of antibiotics may also have an impact on fertility, causing concern that these drugs might somehow throw off the reproductive system.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f024f6e4-5b7a-4ce3-b63a-bd84daf6399f “There is some evidence that certain antibiotics can influence reproductive function, but the effects vary widely depending on the medication and the situation,” says Lisa Marii Cookingham, MD , a clinical assistant professor and medical director of the Fertility Preservation Program at The University of North Carolina School of Medicine in Chapel Hill. Fertility experts don’t consider antibiotic use a huge risk for people who are trying to have a baby. And Dr. Cookingham says that this group of people is not advised to avoid antibiotics when doctors deem them medically necessary. Here’s what to know about the relationship between antibiotic use and fertility, which classes of these drugs aren’t compatible with pregnancy, and when you’re better off taking them.
How Taking Antibiotics May Negatively Affect Fertility Potential Negative Effects A recent meta-analysis of studies found that taking antibiotics in the months or weeks before pregnancy increases the risk of infertility, miscarriage , and birth defects.e60dc2a1-f33c-4a05-9b50-8e3e8e597629dd4cc840-d164-481f-8773-0e8892a32923 Specifically, the researchers found these risks to be linked with classes of antibiotics known as microlides and sulfonamides, and the antibiotic trimethoprim. But just how concerned should you be if you’re trying to get pregnant? “I am more concerned about women reading [about] this and being scared to use necessary antibiotics,” says Veronica Vernon, PharmD , chair and associate professor of pharmacy practice at Butler University of College of Pharmacy in Indianapolis. “There are very real and significant health risks if someone does not treat a bacterial infection.” She also points out that some of the studies analyzed didn’t examine why the participants were taking antibiotics or what other fertility concerns they may have had before taking them. ”If individuals were being treated for sexually transmitted infections (STIs), it is more likely that the STIs led to fertility concerns and not antibiotic use,” she says. Still, other research suggests that antibiotic use may disrupt the vaginal microbiome, creating a potential impact on fertility.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fd7565e6-7c18-48f7-8243-a53ea1eb4624 The vaginal microbiome is composed of the “normal” microorganisms that live in the female genital tract, and they can be affected by antibiotics.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295c886873-406f-458f-941c-6c7e67f075ad “[Antibiotics] alter the gut and vaginal microbiome, which can influence hormone metabolism, including how estrogen is processed in the body,” says Cookingham. “Some antibiotics may also affect inflammatory pathways that are important for embryo implantation, but these effects are not universal, and many antibiotics appear neutral or even protective in some studies.”
Antibiotics to Take or Avoid While Trying to Conceive Antibiotics to Take or Avoid Vernon says that antibiotics are one of the most commonly prescribed medications for pregnant women. Several types of antibiotics are well-studied and are generally considered safe during pregnancy and while trying to conceive. These include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976295d4420ab-b686-4a35-b25a-5b8d004b4182 Beta-lactams , such as penicillins, cephalosporins, beta-lactamase inhibitors, and carbapenems Glycopeptides and lipopeptides, such as vancomycin and daptomycin Lincosamides, such as clindamycin Some types of antibiotics should be avoided or used with extreme caution during pregnancy or while trying to conceive. Those include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976295d4420ab-b686-4a35-b25a-5b8d004b4182 Animoglycosides, which pose a risk of irreversible deafness in the fetus Fluoroquinolones , which can cause kidney, heart, and central nervous system issues in the fetus Lipoglycopeptides , which increase the risk of developmental defects Macrolides and sulfonamides , which are linked to birth defects and pregnancy loss Tetracyclines , which may harm the fetus and cause tooth discoloration Antibiotics should always be taken under a doctor’s care. If you think you might have an infection and are trying to become pregnant, see your doctor. The doctor will do the necessary tests to figure out if you need antibiotics and which ones might be best for you.
Antibiotics and Male Fertility Effects on Male Fertility Studies have found that sperm may be affected by antibiotic exposure. But because sperm regenerate quickly, exposure to antibiotics isn’t likely to have a long-term effect.e60dc2a1-f33c-4a05-9b50-8e3e8e597629eb124c14-36ac-4f55-adb9-94762bdf0965 “It depends on how and when you’re using it, but men’s sperm regenerate every two and a half to three months, so any negative effects would only be temporary,” says Bradley Trivax, MD , a reproductive endocrinology and infertility specialist at Stony Brook Medicine’s Island Fertility in Commack, New York. Cookingham agrees that in most cases, antibiotics do not cause permanent harm to male fertility, and infections themselves can negatively impact future fertility if left untreated.
Sometimes Antibiotics Help Fertility Benefits of Antibiotics Bacterial infections such as pelvic inflammatory disease , bacterial vaginosis , and chronic endometritis can directly impair fertility, especially if they aren’t treated.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297cb3ae9f-e43e-4d3a-a582-b8e7ef94347d In these cases, antibiotic use may improve the chances of conception by resolving the infection and reducing inflammation. “Untreated infections can pose serious risks to both fertility and pregnancy, including miscarriage, preterm birth, and other complications,” says Cookingham. “Treating infections remains an important part of optimizing reproductive health.” Dr. Trivax adds that sexually transmitted infections are particularly important to clear up. Untreated bacterial STIs can cause pelvic inflammatory disease, which is an infection of the reproductive organs, including the uterus, fallopian tubes, and ovaries.e60dc2a1-f33c-4a05-9b50-8e3e8e597629cc608b71-47c0-4d48-9136-2fd6241bc0cf For most people, simply be judicious about when and why you take antibiotics — advice that holds true for all people, not only those who are trying to conceive. “Don’t run to your physician every time you have a cold thinking you need antibiotics,” says Robert Atlas, MD , chair of the department of obstetrics and gynecology at Mercy Medical Center in Baltimore. “Most of those symptoms are viral in nature, and antibiotics don’t treat that. However, if you do have a bacterial infection, antibiotics will be required.”
The Takeaway Research suggests that taking certain types of antibiotics may negatively affect fertility when taken in the weeks or months before pregnancy. However, fertility experts don’t consider this a major cause for concern for couples who are trying to conceive. Untreated infections, particularly those that were sexually transmitted, may pose far greater risks to fertility and pregnancy than the medications used to treat them. Always speak to your doctor before taking any medications. Also, try to use antibiotics judiciously, and not for viral infections in which they won’t be effective.
Resources We Trust Cleveland Clinic: 4 Important Facts You Need to Know About Antibiotics Mayo Clinic: Male Infertility Johns Hopkins Medicine: Why Can’t I Get Pregnant? Brown University Health: Tips for a Healthy Pregnancy Centers for Disease Control and Prevention: About STIs and Pregnancy
How Taking Antibiotics May Negatively Affect Fertility Potential Negative Effects A recent meta-analysis of studies found that taking antibiotics in the months or weeks before pregnancy increases the risk of infertility, miscarriage , and birth defects.e60dc2a1-f33c-4a05-9b50-8e3e8e597629dd4cc840-d164-481f-8773-0e8892a32923 Specifically, the researchers found these risks to be linked with classes of antibiotics known as microlides and sulfonamides, and the antibiotic trimethoprim. But just how concerned should you be if you’re trying to get pregnant? “I am more concerned about women reading [about] this and being scared to use necessary antibiotics,” says Veronica Vernon, PharmD , chair and associate professor of pharmacy practice at Butler University of College of Pharmacy in Indianapolis. “There are very real and significant health risks if someone does not treat a bacterial infection.” She also points out that some of the studies analyzed didn’t examine why the participants were taking antibiotics or what other fertility concerns they may have had before taking them. ”If individuals were being treated for sexually transmitted infections (STIs), it is more likely that the STIs led to fertility concerns and not antibiotic use,” she says. Still, other research suggests that antibiotic use may disrupt the vaginal microbiome, creating a potential impact on fertility.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fd7565e6-7c18-48f7-8243-a53ea1eb4624 The vaginal microbiome is composed of the “normal” microorganisms that live in the female genital tract, and they can be affected by antibiotics.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295c886873-406f-458f-941c-6c7e67f075ad “[Antibiotics] alter the gut and vaginal microbiome, which can influence hormone metabolism, including how estrogen is processed in the body,” says Cookingham. “Some antibiotics may also affect inflammatory pathways that are important for embryo implantation, but these effects are not universal, and many antibiotics appear neutral or even protective in some studies.”
Antibiotics to Take or Avoid While Trying to Conceive Antibiotics to Take or Avoid Vernon says that antibiotics are one of the most commonly prescribed medications for pregnant women. Several types of antibiotics are well-studied and are generally considered safe during pregnancy and while trying to conceive. These include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976295d4420ab-b686-4a35-b25a-5b8d004b4182 Beta-lactams , such as penicillins, cephalosporins, beta-lactamase inhibitors, and carbapenems Glycopeptides and lipopeptides, such as vancomycin and daptomycin Lincosamides, such as clindamycin Some types of antibiotics should be avoided or used with extreme caution during pregnancy or while trying to conceive. Those include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976295d4420ab-b686-4a35-b25a-5b8d004b4182 Animoglycosides, which pose a risk of irreversible deafness in the fetus Fluoroquinolones , which can cause kidney, heart, and central nervous system issues in the fetus Lipoglycopeptides , which increase the risk of developmental defects Macrolides and sulfonamides , which are linked to birth defects and pregnancy loss Tetracyclines , which may harm the fetus and cause tooth discoloration Antibiotics should always be taken under a doctor’s care. If you think you might have an infection and are trying to become pregnant, see your doctor. The doctor will do the necessary tests to figure out if you need antibiotics and which ones might be best for you.
Antibiotics and Male Fertility Effects on Male Fertility Studies have found that sperm may be affected by antibiotic exposure. But because sperm regenerate quickly, exposure to antibiotics isn’t likely to have a long-term effect.e60dc2a1-f33c-4a05-9b50-8e3e8e597629eb124c14-36ac-4f55-adb9-94762bdf0965 “It depends on how and when you’re using it, but men’s sperm regenerate every two and a half to three months, so any negative effects would only be temporary,” says Bradley Trivax, MD , a reproductive endocrinology and infertility specialist at Stony Brook Medicine’s Island Fertility in Commack, New York. Cookingham agrees that in most cases, antibiotics do not cause permanent harm to male fertility, and infections themselves can negatively impact future fertility if left untreated.
Sometimes Antibiotics Help Fertility Benefits of Antibiotics Bacterial infections such as pelvic inflammatory disease , bacterial vaginosis , and chronic endometritis can directly impair fertility, especially if they aren’t treated.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297cb3ae9f-e43e-4d3a-a582-b8e7ef94347d In these cases, antibiotic use may improve the chances of conception by resolving the infection and reducing inflammation. “Untreated infections can pose serious risks to both fertility and pregnancy, including miscarriage, preterm birth, and other complications,” says Cookingham. “Treating infections remains an important part of optimizing reproductive health.” Dr. Trivax adds that sexually transmitted infections are particularly important to clear up. Untreated bacterial STIs can cause pelvic inflammatory disease, which is an infection of the reproductive organs, including the uterus, fallopian tubes, and ovaries.e60dc2a1-f33c-4a05-9b50-8e3e8e597629cc608b71-47c0-4d48-9136-2fd6241bc0cf For most people, simply be judicious about when and why you take antibiotics — advice that holds true for all people, not only those who are trying to conceive. “Don’t run to your physician every time you have a cold thinking you need antibiotics,” says Robert Atlas, MD , chair of the department of obstetrics and gynecology at Mercy Medical Center in Baltimore. “Most of those symptoms are viral in nature, and antibiotics don’t treat that. However, if you do have a bacterial infection, antibiotics will be required.”
The Takeaway Research suggests that taking certain types of antibiotics may negatively affect fertility when taken in the weeks or months before pregnancy. However, fertility experts don’t consider this a major cause for concern for couples who are trying to conceive. Untreated infections, particularly those that were sexually transmitted, may pose far greater risks to fertility and pregnancy than the medications used to treat them. Always speak to your doctor before taking any medications. Also, try to use antibiotics judiciously, and not for viral infections in which they won’t be effective.
Resources We Trust Cleveland Clinic: 4 Important Facts You Need to Know About Antibiotics Mayo Clinic: Male Infertility Johns Hopkins Medicine: Why Can’t I Get Pregnant? Brown University Health: Tips for a Healthy Pregnancy Centers for Disease Control and Prevention: About STIs and Pregnancy