Should I drink caffeine while trying to get pregnant?

Are you scratching your head wondering whether to cut out or down on coffee or any caffeine while you’re trying to get pregnant? How about before egg retrieval or embryo transfer?

For the answer, it depends on what your doctor recommends, your interpretation of the latest research, your health and fertility journey so far, and ultimately what risks you’re willing to take. Here’s the latest research published in the British Columbia Medical Journal (BCMJ) in November 2020, but I’ll provide the article’s main findings below. I’m here to make this smoother because I know it’s overwhelming.

After you review all the facts and do some inward reflection, and finally make your decision, I recognize that it’s not always that simple to move on. It’s an ongoing process. I coach clients to find clarity on these kinds of decisions and to keep them, but for some people it’s clear from the start and easy all the way (lucky them). For me, cutting out my daily cup of coffee was never worth it on any part of my fertility journey or beyond. That was my personal choice. To help with your decision for where you’re at now, scroll on.

Research on caffeine and fertility

For women’s fertility and egg quality, the research on the effects of caffeine isn’t concrete according to this BCMJ article authored by Canadian fertility doctor, Dr. Dunne.

• A 1997 study finds that consuming more than 500mg of caffeine a day is associated with increased time to achieve pregnancy.
• A 2008 study concludes that drinking more than 200mg a day is associated with increased risk of miscarriage.
• However, a 2019 study finds that
  1. women undergoing IVF and ICSI have no difference in outcomes between those who drink 1 to 5 cups of coffee versus those who had no coffee, and
  2. women undergoing IUI who drank 1 to 5 cups of coffee per day were 1.5 times more likely to achieve clinical pregnancy and a live birth than those who drank zero cups.
• To add to the confusion, a randomized controlled trial study published in 2017 found no difference in select birth outcomes between women who drank caffeinated coffee versus women who drank decaf.

• Health Canada, a Canadian federal department, states that pregnant women or women who are planning to become pregnant should limit their caffeine intake to no more than 300 mg of caffeine per day.

• The American Society for Reproductive Medicine states that moderate caffeine consumption of 1 to 2 cups of coffee per day before or during pregnancy does not have any apparent adverse effects on fertility or pregnancy outcomes.

For men / sperm quality and quantity, the effects of alcohol aren’t clear.

• A 2017 study found that caffeine did not affect sperm or affect the amount of time to get pregnant, though there were previous studies that contradicted this.
• This same study also refuted a previous study that claimed caffeine in soft drinks may have negative effects on sperm volume.

How to make the decision

You’ll have access to all the references in the article and at this end of this post to do as much homework as you need. But when it comes to making the decision, keep in mind the trade-off between what you need to do to be emotionally well and what may affect your ability to have everything that you’re working so hard to achieve – a healthy baby.

Would you regret it if you had any amount and your next cycle failed? What about if you didn’t cut down to 1 or 2 cups a day?

Have you had multiple miscarriages or failed FETs?

Does your naturopathic doctor have advice (if applicable)?

Are you confident that this risk is worth it?

How to cut out or down on caffeine

If cutting down or out is the right decision for you, then it’s time to prepare yourself for success. Don’t forget that you don’t need to do this perfectly.

1. Phase out caffeine instead of dropping it cold turkey. Most people get withdrawal headaches when they cut down caffeine too quickly. Instead, use a phased approach.
   • Cut down caffeine little-by-little over a few days or weeks.
   • For example, if you usually have 4 cups of coffee a day, start with 3 cups and a green tea. Then down to 2 cups and a green tea after 3 days. Then 1 cup and a green tea. Then just one cup. (Then down to half a cup, and then none).
2. Switch to decaf.
   • If you normally have a ton of green tea, switch to decaf green tea. If you usually have coffee with milk, switch to decaf coffee with milk.
   • Here’s a fun tip. Think about drinking coffee while you drink your decaffeinated beverage. Seriously. Your brain is good at being tricked, so give it a try.
3. Maintain healthy sleeping habits if you can.
   • When you reduce your daily caffeine intake, you may notice you’re more tired. Over time it will get easier, but maintaining health sleeping habits in the meantime will make this transition easier.
4. Find accountability. This is an option to help keep you on track.
   • An example of maintaining accountability could be telling someone or or posting on social media that you’re cutting down caffeine. Just telling them might help you stay on track if you know they know. They might check in with you about it. Or you can ask them to.
5. Reward yourself! What could your reward be?
6. Consider where you get your caffeine. One cup versus two cups of caffeine is meaningless when you don’t know how much caffeine is in your bevy. Here’s some help below. Maybe you can have more than you thought!

Starbucks’ full list of their drinks and nutrition information is here. There’s a lot of variability across the franchises.

That’s the quick and dirty outline of caffeine and fertility. If you need a bit more help as you go or to get started, book a call with me. It won’t even cost you a cup of coffee.

References:

Beach BJ, Obel C, Henriksen TB, Olsen J. Effect of reducing caffeine intake on birth weight and length of gestation: Randomised controlled trial. BMJ 2007;334:409-412.

Bolúmar F, Olsen J, Rebagliato M, Bisanti L. Caffeine intake and delayed conception: A European multicenter study on infertility and subfecundity. Am J Epidemiol 1997;145:324-334.

Lisa J. Zhang, Jeffrey Roberts, MD, FRCSC, Caitlin Dunne, MD, FRCSC. Optimizing fertility Part 2: Environmental toxins. BCMJ, Vol. 62, No. 9, November, 2020, Page(s) 323-327 – Clinical Articles.

Lyngsø J, Kesmodel US, Bay B, et al. Impact of female daily coffee consumption on successful fertility treatment: A Danish cohort study. Fertil Steril 2019;112:120-129.e2.

Practice Committee of the American Society for Reproductive Medicine, Society for Reproductive Endocrinology and Infertility, et al. Optimizing natural fertility: A committee opinion. Fertil Steril 2017;107:52-58.

Ricci E, Viganò P, Cipriani S, et al. Coffee and caffeine intake and male infertility: A systematic review. Nutr J 2017;16:37.

Weng X, Odouli R, Li DK. Maternal caffeine consumption during pregnancy and the risk of miscarriage: A prospective cohort study. Am J Obstet Gynecol 2008;198:279.e1-279.e8.