Doctors advise women to completely abstain from alcohol when pregnant, to support brain development of the baby and prevent pregnancy complications. But what about the preconception period? Should you stop drinking when trying to conceive? Does alcohol reduce your fertility? Scientific literature is a bit confusing, so let’s break things down.
Does drinking alcohol reduce my chance of pregnancy?
Even in healthy, normally fertile men and women, doctors agree that heavy and/or binge drinking can harm pregnancy chances. (That’s defined as more than 1 drink a day for women and more than 2 drinks a day for men; or more than 4 drinks within a 2-hour window for women and more than 5 drinks for men.)
As we’ll see below, studies have also shown that alcohol alters the reproductive processes in multiple, measurable ways, which can negatively impact your fertility. For both men and women who do drink more than a moderate amount of alcohol, it’s likely a good idea to cut back while trying.
Study findings are more mixed on whether light to moderate alcohol consumption benefits or harms fertility.
You may have seen some research showing that moderate amount of red wine might increase pregnancy chances, possibly because of the antioxidant in red wine. A prospective cohort study of over 6,000 women found no relationship, positive or negative, between alcohol consumption and pregnancy rates. Other studies have shown that even occasional drinking may be linked to lower ovarian reserve, a known factor for fertility struggles for women.
Why do studies find different effects of alcohol on fertility?
Why do studies show such different results on alcohol and fertility? Quite a few differences in the study designs and participants all make it difficult to come to a uniform conclusion:
- The amount of alcohol consumed
- Participants’ drinking history
- Participants’ age
- Health and fertility status of participants
- Genetic differences in alcohol metabolism
- Time between alcohol consumption and pregnancy attempts
- Endpoints measured
- Other lifestyle factors that may not have been controlled for
- Biases inherent in self-reporting
Should you avoid alcohol when receiving fertility treatments?
Interestingly, for people receiving fertility treatments, studies examining the effects of alcohol consumption on pregnancy chances are more conclusive: Even moderate amount of alcohol appears to negatively impact the outcomes of fertility treatments.
For example, a study of 221 couples found a 13% decrease in the number of eggs retrieved when women consumed one more alcoholic drink per day. (It also found a lower pregnancy rate and higher miscarriage rate among women who drank alcohol, but these should be taken with a grain of salt because the treatment method is an outdated one.) The same study also found a negative correlation between men’s alcohol consumption and live birth rates.
Another study of over 4,700 IVF cycles found that drinking more than 4 alcoholic drinks per week negatively impacted pregnancy rates. The effects were observed in both men and women, and appeared to compound when both partners drank alcohol.
Why alcohol consumption appears to have a clearly negative effect in the fertility treatment setting is unknown. However, given the results of these and other studies, it’s a good idea to stop drinking or reduce the amount when you are undergoing fertility treatments. This is the advice many reproductive endocrinologists give their patients, too. It’s a simple thing you can do to increase your chance of success.
How alcohol interacts with the reproductive system
There are several pathways alcohol and its metabolites interact with the reproductive system. These alcohol-induced changes in hormonal regulation, oxidative stress levels and other facets of reproduction may affect your chances of conception:
- Increase in estrogen levels, which in turn increases FSH levels in women, possibly impacting egg maturation and ovarian reserve
- Increase in LH levels and disruption of menstrual cycle regularity in women
- Increase in oxidative stress, which can affect egg and sperm health, embryo quality and ovulation
- Potential negative effects from other compounds in alcoholic beverages for both sexes
- Disruptions in circadian rhythm, which has been linked to fertility struggles
- Higher risk of erectile and ejaculatory dysfunction in men
- Decrease in the structural health of sperm (what sperm should look like under a microscope - called morphology)
How much alcohol is too much when trying to get pregnant?
Dose-response studies tend to show that the more you drink, the larger is the negative impact on your fertility. For example, a meta-analysis that aggregated data on nearly 100,000 women found that the more alcohol women consumed, the less likely they were to conceive. When women drank one more alcoholic drink, researchers found, it reduced these women’s pregnancy chances by 2%.
How much alcohol is okay to drink when trying to get pregnant? The short answer is to try to cut back as much as you can, as alcohol and its metabolites are a cellular toxin, after all. But as we saw, you may want to take into account where you are on your fertility journey, when making this decision.
Alcohol when trying naturally
For couples who are healthy, under 35 and trying naturally, low to moderate drinking is unlikely to affect pregnancy chances significantly. That means, according to the CDC’s definition, fewer than 1 drink per day for women; 2 for men. Here, one drink is equivalent to 0.6 oz of pure alcohol. This translates to:
- 12 oz of beer (at 5% ABV – note this is less than a pint!)
- 5 oz of wine (at 12% ABV)
- 5 oz distilled spirits like gin or whisky (at 40% ABV)
Alcohol when undergoing fertility treatments
For people who are struggling, older (over 35, but especially if you are 40+) or trying to conceive with the help of a fertility specialist, it may be better to abstain from alcohol completely. Of course, this may be a balancing act for some of us; if you find that having a drink at the end of the day helps you and your partner unwind and de-stress on this difficult journey, reducing the amount to less than 3-4 drinks a week can still help.
Alcohol and fertility: What to do
The effects of alcohol on fertility depends on multiple factors, including your sex, age, where you are on your TTC journey and more. Here’s a quick guide on what to do.
If you don’t drink much alcohol
- Stay the course. While a few studies suggested occasional wine or beer may support fertility, there is no consensus, so it’s likely not worth testing the hypothesis with your own journey!
If you do drink alcohol – lightly to moderately
- If you are healthy, have no fertility issues and under 35, you can probably stay the course. Cutting back to under 3-4 drinks a week (for women – for men, up to double the amount may be okay) can help, if you drink more than this much. If you can abstain completely, that may be the best.
- If you are over 35, have been trying for a while or are trying with the help of a fertility specialist, consider cutting back to under 3-4 drinks per week. Your doctor may advise you to completely abstain, too, to up your chances.
If you drink more than moderately
- Definitely try to cut back to under 3-4 drinks per week. Too much alcohol negatively impacts not just your reproductive health but your overall health. Consult your doctor if you find it difficult to cut back on your alcohol consumption.
Please reach out if any questions come up for you about alcohol and fertility. We are with you.
Ovaterra provides reproductive health resources for general, educational purposes only. This content is not intended to replace medical advice from a qualified healthcare professional. Similarly, when making your financial decisions, please consult qualified financial professionals who can make individual recommendations.
