Abstract

PIP: This article reviews the effects of alcohol on male and female gonads and hormonal levels; it further discusses the use of ethanol during pregnancy and its teratogenic effect on the fetus. Impotence is a common result of acute alcoholism, and testicular atrophy, infertility, and decreased libido are associated with alcoholism 70-80% of the time. In addition, alcohol consumption produces significant spermatozoal morphological changes involving breakage of the sperm head, distention of the midsection, and curling of its tail. Seminiferous tubules are filled mostly with spermatids that undergo degeneration and result in aspermia. Acute ethanol intoxication is accompanied by decreased plasma testosterone levels and a surge of luteinizing hormone. Ethanol appears to have a dual effect: locally on the gonads and centrally on the hypothalamus-pituitary axis, causing an adverse effect on spermatogenesis. Less is known about the effects of alcohol on the female reproductive function; however, inhibition of ovulation and a significant reduction of plasma estradiol and progesterone levels has been noted in rats following ethanol administration. Alcohol consumption during pregnancy is the most frequent known teratogenic cause of mental retardation. Infants most severely affected by maternal alcohol abuse during gestation possess a number of dysmorphic anomalies termed fetal alcohol syndrome. The abnormalities most typically associated with alcohol teratogenicity can be grouped into 4 categories: growth deficiencies, central nervous system dysfunctions, craniofacial abnormalities, and other major and minor malformations. The effects of maternal alcohol consumption on the fetus are independent of maternal nutritional status and smoking history. Alcohol abuse during pregnancy occurs in 2-13% of US women, and these women have a 50-70% chance of delivering an infant with a serious abnormality.