Should I drink alcohol while trying to get pregnant?

Each fertility clinic and doctor has different advice about whether you should allow yourself to drink alcohol at various steps toward pregnancy, including before and leading up to IUI, egg retrieval, embryo transfer or a monitored cycle.

To help, I’ve summarized a review of the latest research published in the British Columbia Medical Journal (BCMJ).

Let me say this first. Cutting out some or all alcohol can be hard for some of us. It was for me. I enjoyed having a half a glass wine or a full one ceremoniously at the end of a long day. But it’s such a personal decision whether you decide to cut down or out alcohol. If you do plan to cut down, scroll down for some tips to make it a smoother habit change and more likely to keep on track – aka, get you closer to having a baby in your arms.

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Latest research on alcohol and fertility

For men’s sperm health, abstaining from heavy drinking is the only definitive advice in the article. The cited studies indicate the following.

• There’s no clear evidence that alcohol affects sperm quantity or quality according to a 2004 study that analyses 10 years of data.
• However, there is evidence to avoid excessive drinking to keep in overall good health.
• Low-risk drinking guidelines across Canada and including the Canadian Centre on Substance Use and Addiction, recommend that men should keep alcohol consumption to a maximum of 15 servings per week and have 2 days a week without drinking any alcohol. This would be considered a healthy choice for overall health and a way to monitor excessive drinking.

For women’s overall fertility and egg quality, the verdict isn’t clear except that heavy drinking, which is drinking more than 10 drinks a week, is inadvisable. This aligns with the low- risk drinking guidelines across Canada. The guidelines also recommend women have 2 days a week without any alcohol consumption.

1. For women’s overall fertility. Some the studies demonstrate that you should keep to moderate or low consumption, if at all.
   • A Swedish 2004 study finds chances of conception decreases if a woman drinks more than 10 drinks a week and that having less than 3.5 drinks per week has a significantly lower chance of infertility than those who drink 10 per week (aka, heavy drinkers).
   • A 2016 Danish study found no difference on fertility between women who drank a moderate amount of alcohol versus those who drank no alcohol.
   • However, a 1998 study reveals that even having less than 5 drinks a week may have a negative impact on getting pregnant. This would mean none or close to none is best. This is where the confusion lies for making the decision.
   • In terms of type of alcohol, you might conclude from a 2003 study to choose wine if you do drink. The results suggest that women who drank wine had a shorter wait time to get pregnant than non-wine drinkers. In the same study they found that those who drank more than 10 drinks a week had the longest wait time to pregnancy. Again, this reinforces the low-risk healthy drinking guidelines.
2. For women undergoing IVF or other medically assisted pregnancy such as IUI. A 2019 study found that for women undergoing IVF or IUI and analyzing those who drank any amount in the month leading up to the the treatment, that the consumption level did not affect the outcome. The study found that ‘the chance of achieving a live birth in the first IUI or IVF/ICSI treatment cycle was unrelated to the number of binge drinking episodes in the month preceding baseline” (Lyngsø, 2019).
3. For seemingly pregnant women. The evidence is more clear (but not 100%). No amount of alcohol is considered safe in pregnancy according to a 2016 article published in Fertility and Sterility by of the American Society for Reproductive Medicine, Society for Reproductive Endocrinology and Infertility and among other authors. The Public Health Agency of Canada makes the same declaration and so will probably any healthcare professional you ask. If you follow the low risk drinking guidelines and if you’ve had an IUI, embryo transfer, or whenever you could be pregnant, do not drink alcohol.

Is cutting down or out alcohol the right choice

To factor in your decision on whether to cut down on alcohol, speak with your doctor (and your naturopath, if applicable). There may be other health factors to tip the scale. Here are some other considerations.

• If you keep drinking and you still aren’t successful with getting pregnant or with embryo quality, would you regret your choice?
• Have you had 2 or more early losses? Failed Frozen Embryos Transfers (FET)?
• Are you very concerned about egg quality?
• Do you have unexplained infertility?
• Think about other areas of your health that are impacted by alcohol consumption.
• If you’re considering whether to have a small amount versus no alcohol, reflect on whether you’re a Moderator or an Abstainer. I’m referring to this article in Psychology Today by Gretchen Rubin, whereby you usually are one or the other:
  1. A Moderator. For these people, it’s better to have a little bit rather than nothing. If this is you, an occasional indulgence…heightens your pleasure and strengthens your resolve. When you give yourself permission to have alcohol you don’t crave it and therefore don’t overdo it. So you might keep a small amount of alcohol in your diet.
  2. An Abstainer. If this is you, then it’s better to have nothing than a little bit. You “exhaust [yourself] arguing ‘How much can I have?’…’If I had it yesterday, can I have it today?’ …whereas abstaining ends those draining debates. [You] don’t feel deprived at all.’ If this is you, you might be choosing cutting out alcohol all together.

Tips on how to cut down or out alcohol.

You’ve made the decision to cut down or out caffeine. No judgment from me! Now it’s time to plan for making this new habit or to strengthen this intention you’ve already made.

For starters, if you’ve been using alcohol to bring down your stress, then consider other stress reduction exercises.

Sometimes we drink for the very act of having a sip in an almost ceremonious way to tell ourselves it’s time to turn off our brains and let down for the evening. If that’s you, then try something else that you do daily to mark the end of the day. Here are a couple of ideas.

• Drink a non alcoholic drink like an alcohol-free beer or a mocktail.
• Take a shower or bath.
• Go for a quick walk or a more intense workout.
• What else sounds appealing, is easy and you’d look forward to?

I’m not going to lie and say it’s necessarily easy. It’s also not for everyone. Remember that you also don’t have to do this perfectly. If you want to but can’t follow through, give yourself self love and grace to fall down and pick yourself up when you need to. And if you need a bit more help when you fall or to get started, book a judgement-free call with me.

References:

Eggert J, Theobald H, Engfeldt P. Effects of alcohol consumption on female fertility during an 18-year period. Fertil Steril 2004;81:379-383.

Jensen TK, Hjollund NHI, Henriksen TB, et al. Does moderate alcohol consumption affect fertility? Follow up study among couples planning first pregnancy. BMJ 1998;317:505-510.

Juhl M, Olsen J, Andersen A-MN, Grùnbñk M. Intake of wine, beer and spirits and waiting time to pregnancy. Hum Reprod 2003;18:1967-1971.

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, Ramlau-Hansen CH, Bay B, et al. Low-to-moderate alcohol consumption and success in fertility treatment: A Danish cohort study. Hum Reprod 2019;34:1334-1344.

Martini AC, Molina RI, Estofán D, et al. Effects of alcohol and cigarette consumption on human seminal quality. Fertil Steril 2004;82:374-377.

Mikkelsen EM, Riis AH, Wise LA, et al. Alcohol consumption and fecundability: Prospective Danish cohort study. BMJ 2016;354:i4262.

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.

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