Can I drink while trying to become pregnant?
‘Tis the season for our team to be asked “how much alcohol is too much”?
Alcohol is deeply woven into the fabric of our culture here in Australia, and with such widespread acceptance it can at times be quite tough to avoid the lure of a drink in the sun, even if you wanted to. With the season of celebration looming the topic of a few social drinks is coming up time and again.
How much alcohol is too much?
The World Health Organisation have recently stated there is no level of alcohol that is truly “safe” when it comes to health. Alcohol, regardless of your drink of choice is processed by the liver, which breaks it down into acetaldehyde— a toxic substance which causes oxidative stress and DNA damage, which are bad news for our cells.
Regular alcohol use also forces the liver to prioritise detoxification, which can interfere with the metabolism of other compounds like hormones.
What about fertility?
Similarly, research has not landed on an exact tipping point where alcohol becomes detrimental to fertility, but the overwhelming consensus is for both partners is:
heavy drinking is out, light is better, nothing is likely to be best.
To be clear, for women or the person carrying the pregnancy, if there is any chance of pregnancy the safe amount is zero. For those trying, preparing to conceive or prepping for egg collection the odd drink on a special occasion is unlikely to significantly affect fertility or preconception efforts but the research strongly indicates the devil is in the dosage. Research certainly indicates that moderate and heavy drinking is more likely to have an impact than light drinking.
For men and those with sperm, these guidelines are similar - moderate drinking has been linked to impaired sperm parameters in some studies but the dose seems to be important.
A look at some of the research
Moderate and heavy alcohol intake appears to have potential to disrupt hormonal balance, ovulation and egg quality - all key factors in fertility. A research review published in 2017 found although there are inconsistencies throughout the research, it is likely that women consuming more than seven standard drinks per week faced a higher risk of sub-fertility. Somewhere between 1 and 4 drinks per week increased the risk of miscarriage compared to people who abstained or drank minimally. Some older research indicated that binge drinking may additionally impact antral follicle count, an important factor in IVF success rates. For those in the IVF space, the authors concluded that abstaining or minimising alcohol was imperative, as even “moderate amounts of alcohol may decrease their chances of a successful live birth”.
More recently, an interesting study published in 2021 looked at alcohol at different points of the cycle, concluding that any level of alcohol consumption throughout the cycle could reduce the probability of conception.
Not dissimilar, findings on the impact of alcohol on sperm are varied, but point toward the fact that sperm health is equally likely to be affected. This study found that somewhere between 5 and 25 units of alcohol per week was associated with reduced sperm count, poor motility, and abnormal morphology. Research from 2022 found that paternal alcohol consumption prior to conception is also linked to increased risks of adverse childhood behavioural problems with a dose-dependent relationship.
Why the inconsistencies?
There are limitations to nearly all research investigations! Self reporting on alcohol intake is fraught – recall and social desirability bias both come in to play, as well as inconsistencies with serving sizes, and day-to-day variability. While some research looked at drinking patterns (binge drinking with period of abstinence or low dose but consistent), not all studies take this in to account. In addition, we also have to remember that conception requires two sets of DNA and even considering both partners alcohol intake, there are huge number of other factors that would have to be considered and adjusted for. Keeping this in mind, looking at the overarching patterns of research as opposed to each individual paper might be a better take.
Actionable steps
Can you have one drink?
Self-awareness : this is fairly critical for anyone planning to conceive. Reflecting on your alcohol habits: How much and why do you drink? Is it a stress-relief tool? Is it a special occasion thing, and what is a special occasion for you? Understanding the role alcohol plays in your life can help you make informed decisions that prioritise your health and fertility.
Standard Drink Awareness: to make better choices, understanding what exactly is a ‘standard drink’ -
30ml of spirits
330ml of 4% beer
170ml of champagne
100ml of wine.
A commitment to the health of your whole family
A final thought from years working with mostly women trying to conceive. The preconception phase can be hard and at times isolating. Approaching this time as a team with a shared commitment to a goal is so deeply beneficial not just for fertility, but for relationships and mental health. Nothing beats a good wingman, or wingwoman when you’re going light for the celebration season.
There is more about alcohol and sperm here and more actionable steps here
