Are Artificial Sweeteners
Safe for Fertility?

Written & Edited by: Dr. William Haas MD, MBA & Dr. Ashley Eskew, MD, MSCI

Last updated: July 29th, 2020

Artificial sweeteners when trying to get pregnant

Feeling good about that diet soda swap, right? 

It has zero added sugar, no calories, and it tastes good. Sweet!

But then the voice in the back of your head kicks in and you begin to wonder whether the artificial sweetener in your diet soda is harming your fertility. 

Do the benefits of consuming fewer sugar calories outweigh the risk of artificial ingredients?

Let’s find out and take a look at whether artificial sweeteners are safe for your fertility. 

Why Is Real Sugar A Problem

The USDA estimates that the average American consumes almost 60 pounds of added sugar per year — that translates to 13 teaspoons of extra sugar per day, which is equivalent to FIVE glazed donuts. 

Notice we called out ADDED sugar. 

We aren’t as concerned about the naturally occurring sugars found in antioxidant-rich foods like blueberries and your other favorite fruits – assuming you don’t a pound of them each day. 

When it comes to added sugar, one of the biggest sources in the standard American diet is high-fructose corn syrup, which is commonly found in soda and juice drinks as well as ketchup, salad dressings, and other unexpected places. If you haven’t stumbled upon any of the work by Dr. Robert Lusting on evils of high-fructose corn syrup, make sure to check it out. 

As we discussed in our post on carbohydrates and fertility, sugar is a simple carbohydrate that creates a quick and momentary spike in blood sugar and insulin levels. Over time, this pattern can lead to: 

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    Hormonal imbalance

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    Fatigue / Mental fogginess

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    Anxiety / Depression

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    Weight gain

And when it comes to your reproductive health, persistently elevated insulin levels have been associated with:

On top of all this, sugar is also addicting… Ever have a sugar craving? Especially when you’re stressed? That’s because sugar provides your body with an immediate source of energy and serotonin (one of the feel-good chemicals in your brain). 

Okay, we think you get it – extra sugar in your diet is not such a good thing.

Now let’s turn our attention to artificial sweeteners… 

Types of Artificial Sweeteners

When it comes to artificial sweeteners, you have a lot of choices. 

Just take a look at the dish of multi-colored packets on the table next time you go out to eat…

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    Blue (aspartame) – Nutrasweet / Equal

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    Pink (saccharin) – Sweet’N Low

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    Yellow (sucralose) – Splenda

The reason that there are so many different artificial sweeteners is that the food industry has tried to appeal to our desire to enjoy sweet foods and drinks without the extra calories of sugar. 

Unfortunately, cutting the calories from sweeteners may not provide us with the free pass that we were hoping to enjoy.  

General Health Concerns With Artificial Sweeteners

For quite some time, artificial sweeteners have gotten a bad wrap.

Initial scrutiny dates back to the 1970s when studies linked the artificial sweetener saccharin to bladder cancer in laboratory rats. This resulted in a somewhat frightening warning label to be applied to artificial sweetener packets for quite some time. 

Even though the Food and Drug Administration has declared many artificial sweeteners to be “generally recognized as safe” (GRAS), there is still some concern about what impact they may have on our health. 

Other potential health concerns with artificial sweeteners include an increased risk for:

As with most things in the scientific literature, there are other studies that would suggest no clear differences exist between people who use artificial sweeteners and those who do not. Of course, they also come with the disclaimer that “potential harm could not be excluded”. 

If you’re not starting to take pause over artificial sweeteners, let’s switch gears slightly and look at their impact on reproductive health.

Fertility Health Concerns With Artificial Sweeteners

We should be upfront in saying that there are not a significant number of clinical studies evaluating the impact of artificial sweeteners on reproductive health and fertility outcomes.  

As with many areas of emerging research, our initial knowledge has emerged from animal studies. Some of the outcomes of artificial sweetener exposure in animal models include:

These findings must be interpreted with caution given the small numbers, and often dosing in animals can be much higher than human levels, however, the findings are still worth noting.

Moving our attention away from animal studies, there have been a handful of human clinical trials that have evaluated the impact of artificial sweeteners on reproductive outcomes. 

One preliminary study published in Fertility & Sterility has received some attention over the past few years. This study looked at the impact of artificial sweeteners on oocyte quality in 524 women undergoing intracytoplasmic sperm injection (ICSI). Researchers found that consumption of beverages with artificial sweeteners was associated with : 

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    Decreased oocyte quality

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    Decreased day 2 & 3 embryo quality

There was also an inverse association with implantation and pregnancy rate, although this wasn’t statistically significant.

Admittedly, there are some limitations to this particular study including the lack of information on the amount of artificial sweeteners consumed by the women, their overall diet quality, or other factors impacting their fertility (e.g., PCOS, endometriosis, etc.).

In contrast, the PRESTO study, which we discussed in our Decoding the Fertility Diet series, actually found little association with diet soda and time to pregnancy. 

Looking beyond fertility outcomes, artificial sweetener consumption has also been evaluated with respect to preterm birth risk in 2 large studies. 

The Danish National Birth Control investigated artificial sweeteners and preterm birth intake in more than 59,000 women. Compared to no intake, consumption of 1-4 drinks with artificial sweeteners increased the risk of preterm delivery, regardless of body weight, smoking status or education level (other factors that are associated with preterm birth). 

Similarly, the Norwegian Mother and Child Cohort Study involving more than 60,000 women found that consuming 4 artificial sweetened beverages per day was associated with a significantly higher risk of preterm delivery after controlling for similar confounding factors.

As with most things in medicine, more research is needed on this topic, but there is certainly some information out there to suggest that artificial sweeteners might not be completely harmless when it comes to your efforts to conceive.

How to Naturally Satisfy Your Sweet Tooth

Scientific studies aside, there’s no need to get confused or overwhelmed when it comes to satisfying your sweet tooth. 

Your safest bet when it comes to sweeteners is to choose a natural sweetener in moderation… 

Yes, that pesky, at times not so fun word – moderation!

In all seriousness, why risk your reproductive health by using artificial sweeteners when you can enjoy natural alternatives instead? 

Next time you’re in the kitchen, give one of these natural sweeteners a try:

Natural Sweeteners

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    Dates – A great addition to granola bars, yet the application for dates are endless. Medjool dates are an OvulifeMD favorite.

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    Maple syrup – A woodsy alternative to honey with complex flavor notes of cinnamon, hazelnut, and vanilla. Try drizzling on top of roasted brussel sprouts or chickpeas.

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    Raw honey – Perfect topper for your morning breakfast bowl or mixed into a homemade sauce. Purchase local, unprocessed variety, and in a glass jar if at all possible.

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    Ripe bananas – Thicken up your next smoothie with this natural sweetener. Also great to use when baking.

Final Thoughts

After reading this post, you might not be ready to completely eliminate artificial sweeteners from your diet – we totally get it. 

With that said, we encourage you to minimize your intake, the same as you would with added sugar. And even if future research does not demonstrate definitive harm, artificial sweeteners certainly aren’t helping your fertility. 

Whatever you decide, be mindful and enjoy what you eat!

With Love & Empowerment,
Dr. Ashley Eskew and Dr. Will Haas
Whenever you’re ready, we're here to help you remove fertility-threatening foods from your diet so you too can increase your chances of getting pregnant.

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