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Alcohol and fertility are dangerous bedfellows. “Can’t I give up chocolate and not alcohol?” if I got just $1 for every time I hear this question working with women trying to conceive, I’d be rich! But the reality is it just doesn’t work like that.
The evidence - and research - on the impacts of alcohol on reproductive health is very clear. Let’s take a look and break it down.
Lifestyle factors
Alcohol, booze, grog, liquid courage. Whatever we call it, it’s the most widely used socially sanctioned substance. We use alcohol to toast our friendships, achievements, a new year, a new job, the end of another lockdown … even not having caught the dreaded virus.
We use alcohol to celebrate marriages, divorces, and to cope with messy break-ups. Whether we need to commiserate or celebrate we turn to our old friend alcohol.
Here are some basic facts: data suggests we are taking up drinking at a younger age, now in our younger teens. We are binge drinking more than ever before. In fact, many people start a drinking session with the intention of getting drunk.
You likely don’t think of the long-term implications and dangers of drinking alcohol and how it impacts fertility and fertility treatment. The reality is the impacts start long before you think about being a parent.
Another fact: alcohol decreases your ovarian reserve. I bet no-one has ever told you back when you were a teenager or in your 20s, that all those nights on the booze were decreasing your viable reproductive egg pool. You’ll want those eggs back in later years, that’s for sure!
Pregnancy and alcohol
If you are a medium to heavy drinker you’re more likely to experience alterations in the regularity of your ovulation and menstrual cycle. You may also find it more difficult to get pregnant and/or successfully carry a baby to full-term - often experiencing early and late-term miscarriages.
And for men the news is no better - too much drinking can influence both the quality and motility of their sperm!
Recently researchers have been studying the timing of drinking and menstrual cycles which hasn’t been previously investigated. The research notes that for moderate drinkers - so 3-6 drinks per week - during the luteal phase (days 14-28ish) when the lining of your uterus thickens in preparation for the possible implantation of a fertilised egg, there is a 44% reduction in the chance of conceiving compared with non-drinkers. Each additional day of binge drinking brings a further 19% decrease in your chances of conceiving.
Data also suggests that women who drink heavily pre-pregnancy - so more than 6 drinks per week - are more likely to continue drinking through pregnancy. Drinking through pregnancy risks foetal health and can lead to Foetal Alcohol Spectrum Disorder (FSD), Alcohol-related Neurodevelopmental Disorder (ARND), birth defects, birth weight, and characteristic facial anomalies.
Alcohol readily crosses the placenta into the amniotic fluid. This means that baby is exposed to a higher concentration of alcohol than the mother because of the interaction with amniotic fluid. This is why mothers-to-be are encouraged to completely cut out alcohol during their pregnancy to reduce the risks to the unborn child.
Alcohol and Fertility Treatments don’t mix
The research in the area of the influence of alcohol on fertility treatment outcomes - such as IVF - is still being confirmed. This is partly due to the fact that most women who go through ARTs have already given up alcohol prior to entering treatment. The research that has been conducted has been very consistent in that alcohol and successful fertility treatments don’t mix.
Research has shown a 13% decrease in the number of oocytes (eggs, ova, ovum) retrieved, with a nearly 3% higher chance of not achieving pregnancy. As well there is a more than 2% increase in the chance of miscarriage in women who consumed 1 (yep one!) drink more per day compared to those who had one less.
For men there is a higher risk of not achieving a live birth when men drank in the month leading up to treatment particularly when they drank the week of sperm collection.
A research study of more than 2,500 couples undergoing more than 4,700 IVF cycles showed that couples who drank four or more drinks per week, prior to an IVF cycle, had a 48% chance of failed fertilisation and 21% lower chance for a live birth when both partners drank. Even moderate levels of alcohol intake - so less than 4 drinks per week - can decrease success with IVF and other treatments.
Some fertility treatment providers will advise patients not to drink alcohol at all during the IVF cycle. This also includes male partners to help them to feel they are contributing to their baby-making! Before the cycle it is recommended low to moderate drinking - so less than 4 drinks per week - if any, seems okay.
The science is clear. But, ultimately it comes down to what you are prepared to do to have the best chance. Many women are following un-scientifically researched diets, supplements, exercise routines, and other spiritual ideas. Simply giving up alcohol through an IVF cycle can really make a difference to the chance of having a baby and having a healthy baby and the science supports this.
The reality is that these days there are so many alcohol free alternatives no matter what your usual choice is (wine, spirits etc.). So you can still socialise and have a drink with friends - just make it a mocktail.
Give it everything you’ve got - even if that means giving up alcohol and taking up mocktails. There’s so much to lose and everything to gain. Find more helpful fertility facts you should know here. And remember if you need support on this journey reach out and let’s chat.