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Can cocaine use in men prior to impregnation cause birth defects?

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Can cocaine use in men prior to impregnation cause birth defects?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Megha Tuli

Medically reviewed by

iCliniq medical review team

Published At December 28, 2017
Reviewed AtJune 20, 2023

Patient's Query

Hello doctor,

I am a 37 year old male. I had one wild night where we did several lines of cocaine. I have not done it before. And now my wife is pregnant. I have read studies that cocaine use in men prior to impregnation can cause birth defects, etc. Has this one night seven to eight weeks prior cause any risk to our baby? Or is the drug out of the system by then?

Please explain.

Answered by Dr. Megha Tuli

Hi,

Welcome to icliniq.com.

I understand your dilemma, but be assured a gap of seven to eight weeks is pretty long enough for the drug to be out of our system and cause any damage to your baby. The half life of cocaine is 15 to 50 hours in urine. It is completely excreted out of the system in less than a week. So, relax and enjoy the pregnancy time. All the best.

Patient's Query

Hi doctor,

Thank you so much. I have read articles that have shown cocaine use can alter the DNA and also attach itself to the sperm and travel up to the egg. Is this true? What do you think? Thank you so much for your input.

Answered by Dr. Megha Tuli

Hi,

Welcome back to icliniq.com.

I went through the article. One I would like to point out that most of the data was in experimental settings. Also the data is based on cocaine abusers or addicts. And by your case I think it was a onetime binge. Secondly, as your article also states that the binding of cocaine was optimum at 20 minutes and thereafter declined. So, seven to eight weeks is a safe time period. Thirdly, chronic use of cocaine. For that matter even alcohol decreases sperm count and motility thereby decreasing the fertility of males but not causing birth defects. Birth defects can be caused if the mother is a chronic user of cocaine, marijuana or other substances. Such babies are at increased risk of birth defects. Be assured that studies so far have not linked any birth defect to any episodic binge of substance use. What your article suggests is still in experimental stages and has no proof so far. I have read plenty of more articles before answering your query and in none has there been any evidence of cocaine abuse in fathers leading to birth defects or for that matter even decreased IQ (intelligence quotient) on the baby.

Patient's Query

Hi doctor,

Thank you again.

How would alcohol affect my sperm? Will it likely cause birth defect? I have heard that alcohol use definitely can cause lot of problems. I consume around 20 to 30 units per week and this was consistently done prior to getting my wife pregnant.

Answered by Dr. Megha Tuli

Hi,

Welcome back to icliniq.com.

I went through your query.

Yes, you have heard correctly about birth defects and also miscarriages can happen with alcohol intake. Earlier, it was only thought that alcoholic mothers can cause problems to the baby but current research indicates that fathers also contribute to the same extent. In fact, even stopping alcohol two to three weeks prior to conception does not prevent the problem. Alcohol decreases not only the sperm count and its motility but also its shape. Usually, this itself becomes a cause of infertility but even if these abnormal sperms conceive, then they usually result in miscarriages. But, sometimes depending on the severity of sperm malformation, these sperms mate with the egg and lead to a full pregnancy. This pregnancy may or may not show any major physical defects in the baby, but can definitely cause intellectual and behavioral disturbances. I am not trying to scare you, but current data shows such findings in rats and indicate similar findings in humans too. I suggest you to visit your obstetrician and get proper anomaly scans done and screen for Down's syndrome as well as fetal alcohol syndrome.

Patient's Query

Hi doctor,

What is the percentage of birth with these defects if men drink alcohol regularly?

Answered by Dr. Megha Tuli

Hi,

Welcome back to icliniq.com.

Statistics show that 0.3 to 2 births per 1000 births are affected by fetal alcohol syndrome and alcohol related birth defects. Incidence is different in our part of the world. Do not stress over it. Percentage is low but still you need to be cautious. That is why I advised you regarding the fetal anomaly testing at appropriate time.

Patient's Query

Hi doctor,

The old school thinking is that abnormal sperm caused by alcohol and drugs just cannot fertilize an egg and if it does then it will simply result in a miscarriage. It seems there is a lot more evidence recently that says this thinking is really outdated and in fact can result in births with increased risk of defects, etc. How do you feel about this? Why do medical specialists not agree on this? Why do some doctors stick with the old school thinking and not look at the more modern research?

Answered by Dr. Megha Tuli

Hi,

Welcome back to icliniq.com.

You are right. Old school idea is not totally wrong. Abnormal sperms indeed do not likely fertilize an egg and even if they do, there is a more chance of miscarriage. It is just that earlier it was thought that miscarriage was the only end result whereas now data shows that birth defects is more common in such individuals. Miscarriages are nature's way of eliminating beings which are not perfect for survival. But, now because of better medical care available these days, we can now prevent miscarriages. So, that is why the incidence of births defects has increased. And theoretically speaking, there is no definite scientific proof correlating substance abuse with any effect on the DNA structure of sperm, these studies are still in experimental stages, and it is only the DNA which the baby actually gets from the father, rest all is from the mom. But, statistics point differently. More research is actually needed to prove that fathers are directly responsible for defects. In case of cocaine research has proved alteration in DNA of sperm produced during the intake but no such evidence in cases of alcohol, etc. So, I suggest my patients to refrain from all kinds of drug use while planning for pregnancy and do thorough antenatal testing for the same during pregnancy.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Megha Tuli
Dr. Megha Tuli

Obstetrics and Gynecology

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