Fertility Q&A - Alcohol, Low Estrogen, CoQ10, and More

Summary

Dr. Natalie Crawford and Emily Whitlock answer questions about fertility and practical steps people can discuss with their clinicians.

Alcohol and fertility

The presenters say alcohol offers no fertility benefit and may affect inflammation, sleep, stress responses, insulin resistance, hormones, ovulation, and sperm production. Their safest recommendation while trying to conceive is to avoid alcohol; if someone chooses to drink, they suggest keeping it very limited.

To handle social pressure, they suggest ordering sparkling water with lemon or a mocktail, or simply saying they’re focusing on their health.

Preparing for an appointment about low estrogen

Track symptoms, what is normal for you, when changes began, and any related concerns. Be ready to explain why you suspect low estrogen and whether your periods or signs of ovulation have changed.

Estrogen naturally varies during the menstrual cycle, so test results need to be interpreted in relation to cycle timing.

Semen testing

Some over-the-counter kits only indicate whether sperm are present; they may not assess count, movement (motility), or shape. A more complete semen analysis may be available through a mail-in service, such as Fellow, or through a fertility clinic.

Discuss testing options with a clinician, especially after prolonged difficulty conceiving.

CoQ10

The discussion describes CoQ10 as an antioxidant involved in mitochondrial function. The presenters say there is limited research on pregnancy outcomes—not that CoQ10 is known to be harmful—and they generally don’t recommend stopping it during the two-week wait.

They suggest stopping additional, higher-dose CoQ10 once pregnant, while noting that some prenatal vitamins contain it. They mention 200 mg as a common amount in a prenatal and 600 mg as a fertility dose. Ask a clinician what is appropriate for you.

Low sperm motility and timing

The presenters say sperm are produced daily and that more frequent ejaculation may be helpful with low motility. They suggest intercourse daily if feasible, especially the day before and the day of ovulation. If intercourse isn’t possible, ejaculation at another time may help avoid longer abstinence intervals.

They also acknowledge that pressure or scheduling can make frequent intercourse difficult.

Emotional support

One questioner shared grief and reduced confidence after a pregnancy loss. The response focused on timing and sperm motility; the episode offered sympathy but did not provide specific grief-support strategies.

Presenters and source

• Dr. Natalie Crawford — Host, OB-GYN, and reproductive endocrinology and infertility specialist
• Emily Whitlock — Guest
• Fellow — Cited as an at-home mail-in semen-analysis service