Do Fertility Lubricants Like Pre-Seed Cause Miscarriage?
Does the use of Pre-Seed, or any other ‘fertility friendly’ lubricants, cause miscarriage? It’s a question I’ve seen on various fertility forums, rarely posted with a reliable answer. I decided to find out the truth.
A bit about cervical mucus
When ovulation time approaches, a woman’s natural cervical mucus increases in quantity. At the same time, this mucus takes on the consistency of raw egg-white; clear, wet, slippery and stretchy.
This ‘fertile’ type of cervical mucus makes the vagina sperm-friendly. Fertile cervical mucus is thought to protect and nourish any visiting sperm, and encourage their passage towards the egg.
However, even during ovulation time the sperm’s journey towards the egg is treacherous. In 1992, a study by Williams and colleagues found that of the thousands of sperm ejaculated in to the vagina, only hundreds or perhaps even tens of sperm make it up to the egg. Obstacles in the great sperm race include:
- the acidic nature of the vagina
- the narrow entrance to the cervix
- the narrow junctions where the fallopian tubes meet the uterus
- the body’s immune system
- cervical mucus
It is believed that cervical mucus is partly responsible for a ‘survival of the fittest’ sperm-screening process. Abnormal sperm; those with defects to their tail or midpiece, or those with poor motility, are less likely to make it through the mucus to the egg. This was shown in a 1994 study by Mortimer, who retrieved and evaluated sperm that had ‘fallen by the wayside’ in the cervical canal. Of the sperm that was retrieved, a larger proportion than usual was found to be abnormal.
Do fertility lubricants like Pre-Seed cause miscarriage?
When this question is asked on fertility forums, the post usually boils down to one specific question. This is the question that I set out to answer.
- Do fertility lubricants such as Pre-Seed interfere with the important sperm-screening role of cervical mucus, making the vagina so welcoming that abnormal sperm can flourish and fertilise the egg?
We also wondered:
- Do fertility lubricants such as Pre-Seed damage sperm, affecting their DNA before they fertilise the egg?
- Has anyone ever investigated miscarriage rates in women using fertility lubricants such as Pre-Seed?
We posed these questions to several fertility lubricant makers, and received the following responses:
Does Pre-Seed cause miscarriage?
I contacted Babystart, the makers of Pre-Seed fertility-friendly personal lubricant. Here’s what they said:
Testing for the use of fertility friendly lubricants focuses on the fact that they do not damage healthy sperm. There are many factors that contribute to miscarriage other than unhealthy sperm. Furthermore, unhealthy sperm would as likely fail to achieve conception than to be “weeded out” by vaginal fluid interaction. We do not know of any research indicating whether the use of fertility lubricants increases miscarriage rates. We have seen no research or clinical opinion that would lead us to believe that such a study should be conducted.
Does Conceive Plus cause miscarriage?
I contacted SASMAR, the makers of Conceive Plus fertility lubricant. Here’s what they said:
In every ejaculate there will be sperm that are healthier than others. The chromatin (DNA) of the sperm will vary naturally due to the lifestyle and health of the man. Through natural selection the healthiest sperm (those with no or reduced chromatin damage caused by oxidative stress) will reach and fertilise the egg. The principle of helping to create an environment that is friendly for sperm by using a fertility friendly lubricant would apply to all sperm, including the healthiest.
During the natural process the healthiest sperm are more likely to reach and penetrate the egg. Using a lubricant that helps provide an environment safe for sperm, egg, embryos and the process of fertilisation can only have a positive effect.
Sperm chromatin assay tests have demonstrated that Conceive Plus does not cause damage to the DNA of human sperm, compared to other brands of lubricant including KY gel. Other tests included embryo testing, which showed no negative effect on embryos exposed to Conceive Plus. The FDA in the United States has cleared Conceive Plus as ‘gamete, fertilization, and embryo compatible.’ Only Conceive Plus has this categorisation.
Does Balance Activ Conceive cause miscarriage?
I contacted BBI Healthcare, the makers of Balance Activ Conceive fertility lubricant. Here’s what they said:
Balance Activ Conceive contains a mix of highly purified hyaluronic acids. These have a chemical structure identical to that of the hyaluronic acid in cervical mucus.
During fertile periods, hyaluronic acid in cervical mucus promotes the passage of healthy sperm, favouring those with high DNA integrity and a normal nucleus, and as such good fertilisation potential. While the hyaluronic acid component of Balance Activ Conceive supports the motility of all sperm and so allows greater numbers to reach the egg, it also plays a role in the selection of quality sperm for fertilisation.
Sperm-preparation assays have shown that Balance Activ Conceive does not cause damage to the DNA of sperm. Nor does it interfere with fertilisation by inducing a premature fusing of the sperm with the egg.
No specific research has been undertaken relating to the use of Balance Activ Conceive and miscarriage rates. Because of hyaluronic acid’s regular use in laboratory sperm function studies and IVF treatment, and because of its known high purity and innate properties, no additional research was deemed necessary or appropriate.
So… Do fertility lubricants such as Pre-Seed cause miscarriage?
The fertility lubricant makers’ responses are extremely informative, and do well in attempting to answer our question. Firstly, they each talk of the rigorous testing that has shown that Pre-Seed, Conceive Plus, and Balance Activ Conceive does not damage sperm or embryos or interfere with the fertilisation process.
Secondly, they state that providing an environment that is ‘sperm friendly’ will likely have a uniform benefit to all sperm, including the healthiest. As such, it is supposed that the healthiest sperm will still win the great sperm race whilst any unhealthy sperm will still ‘fall by the wayside’. This seems a fair clinical assumption.
BBI Healthcare, the makers of Balance Activ Conceive, go on to say that when a fertility lubricant’s key ingredient is hyaluronic acid, the lubricant’s action on sperm should be identical to the natural interaction of cervical mucus with sperm. They therefore assume that any sperm-screening role that cervical mucus performs will be replicated by hyaluronic acid in fertility lubricants.
All three fertility lubricant manufacturers admit that no research has been done in to use of fertility lubricants and miscarriage rates. They feel that what is known about the clinical safety of their lubricants, and the lubricants’ ingredients, pre-empts the need for such research.
Perhaps the many anecdotal reports of women using fertility lubricants and suffering miscarriage are a result of a different phenomenon. When women have complex gynaecological conditions they may struggle to conceive and may turn to fertility lubricants to help. These same women may then suffer miscarriages due to their gynaecological conditions rather than their use of fertility lubricant.
Whilst this suggestion is a reasonable one, it seems wrong to assume anything when so much about fertility and conception remains a mystery. Without the appropriate clinical research, which is yet to be undertaken, no one can say for sure whether or not fertility lubricants cause miscarriage.
American Pregnancy Association (2016) Cervical mucus and your fertility [Online]. Available at: http://americanpregnancy.org/getting-pregnant/cervical-mucus/ (Last accessed 05th October 2017).
Mortimer (1994) Sperm recovery techniques to maximize fertilizing capacity. Reproduction, Fertility and Development. 1994 (6), pp.25–31. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pubmed/8066218 (Last accessed 05th October 2017).
Sakkas D, Ramalingam M, Garrido N, and Barratt CLR (2015) ‘Sperm selection in natural conception: What can we learn from Mother Nature to improve assisted reproduction outcomes?’ Human Reproduction Update. 21 (6), pp. 711–726. [Online]. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4594619/