The most common question I get in my practice – “Will alcohol make my fertility worse?” There’s so much conflicting information about drinking and fertility. Recently I had a client ask me if it was ok to have a glass of wine once a week (the client and her husband love to go out to dinner once a week. My client so enjoys a glass of wine during this special dinner.). I told her to go for it. She looked at me in shock – “really????”.
Now, I’ve been watching the research and was aware there’s little clinical evidence that minor/light drinking has an impact on fertility and conception. When I was poking around the journal articles recently, I came across a current research article on the topic.
The research article is long and I’m going to break it down into consumable information tidbits.
First: The article mentions women undergoing fertility treatments are less likely to share the truth about their drinking habits. I have noticed with my clients, there is a lot of shame and guilty around any type of alcohol consumption. Please, ladies be truthful with your practitioner. It’s our job to help you figure out if it’s impacting your fertility.
The article mentions:
- Acute heavy drinking can cause hormonal imbalances.
- Heavy drinking causes a decrease in fertility and can result in earlier onset of menopause.
- There’s conflicting evidence for light to moderate drinking impacting fertility in women.
- One study found no correlation between drinking and ovulatory dysfunction.
- One study found earlier conception rates with women who drank.
- One study found women who drank 1 to 5 drinks a week had fertility issues.
- Women consuming 10 drinks a week had decreased conception rates.
- Women over 30 who drank 1 to 5 drinks a week had a higher rate of infertility compared to women who drank or less drinks per week.
As a practitioner, I see an added element to “drinking” alcohol – how a woman is using the alcohol to cope.
There are women who enjoy a beautiful glass of wine – it’s part of a meal, part of an experience – an experience that bring the woman joy and happiness. Most of these women don’t experience a strong desire to have alcohol all the time. Their drinking is mostly very light – about once a week or every other week.
Other women use alcohol to cope with sadness, depression, stress and insomnia. Alcohol becomes a life line to deal with emotional overwhelm and the struggle to “relax”. I believe it’s the combination of stress and alcohol that can lead to infertility. Clinically stress, anxiety and depression have a strong correlation to infertility. Maybe it’s not the light to moderate drinking causing conception issues?
Other clients who base basal temperature chart, will experience a major spike in their chart after drinking alcohol. With these clients, I believe it’s a benefit to avoid alcohol as it has the potential to impact hormones.
I don’t doubt heavy drinking causing fertility issues. Seen it in my practice often combined with earlier menopause.
I think the alcohol question has more facets to it beside the alcohol in the glass. Thus, the research is conflicting. If you are dealing with the heavy emotional part of infertlity and have the craving to drink alcohol, mixing modalities for physical and emotional support is important.
Trying to conceive? Try acupuncture and Chinese herbs to improve your fertility. Acupuncture can decrease stress hormones, improve pelvic blood flow and balance reproductive hormones.
Alcohol and fertility: how much is too much?
Fertility Research and Practice, December 2017
Kristin Van Heertum , Brooke Rossi
Approximately 12% of couples in the U.S. experience difficulty conceiving or impaired fecundity, defined as the ability to achieve a live birth in a single menstrual cycle. As alcohol is the most widely used recreational substance, it is important to understand any deleterious effects it has on human reproduction. In this review, we will discuss the prevalence of alcohol use in the U.S.; the health risks and benefits associated with alcohol consumption outside of reproduction; the effects of alcohol on fertility in both women and men, such as alcohol’s impact on ovarian reserve, steroid hormone production, sperm quality and fecundability; and finally, the impact of alcohol consumption on fertility treatments.
Prevalence of alcohol use and abuse
Alcohol use is common in the United States. The 2015 National Survey on Drug Use and Health (NSDUH) found that 86.4% of people age 18 or older reported alcohol consumption at some point in their lives, and 56% reported drinking in the past month. The survey reported a prevalence of binge drinking, defined as drinking a quantity of alcohol to raise the blood alcohol concentration (BAC) to 0.08 g/dL (typically 4 drinks for women and 5 drinks for men in 2 h), of 26.9%.
Studying alcohol consumption in a group of women who are attempting conception presents significant challenges. While recall bias can occur in any population, these women may be less likely to accurately report their level of alcohol consumption as they may be embarrassed by, or feel guilty about, their alcohol use.
Effects of alcohol on female reproduction
The physiologic effects of alcohol consumption on female reproductive physiology have not been well delineated due to a paucity of high quality studies in this area. Studies in humans and animal models have found alterations in ovulation and menstrual cycle regularity with chronic/prolonged alcohol intake, though amount consumed is often not specified. Schliep et al. found that acute alcohol uses increased estradiol, testosterone and LH levels, with greater increases seen in women who reported recent binge drinking, though with no associated menstrual cycle dysfunction.
Heavy alcohol use may diminish ovarian reserve and fecundability in women. Ovarian reserve, a measure of a woman’s reproductive potential determined by her remaining oocytes, can be measured in a variety of ways, including serum follicle stimulating hormone (FSH) and anti-Müllerian hormone (AMH) levels as well as antral follicle count. A study of African American women in Michigan found that women who regularly binge drink two or more times a week had a 26% lower AMH level than current drinkers who do not binge after age-adjustment. There is also evidence that women who suffer from alcoholism may experience menopause at an earlier age than their non-alcoholic counterparts.
On the other hand, the relationship between light to moderate alcohol use and female infertility has yet to be fully characterized. An 8-year cohort study of 18,555 women without a history of infertility who were attempting to conceive found no relationship between alcohol consumption and ovulatory dysfunction. Multiple other studies have found no relationship between moderate alcohol consumption and fecundability. A retrospective study of almost 40,000 pregnant women actually reported a shortened time to pregnancy in women who consumed a moderate amount of alcohol compared with those who did not drink at all. However, a Danish cohort study found that, compared with women who drank no alcohol, women who reported consuming 1–5 drinks per week, in addition to those who consumed more than 10 drinks per week, had a decreased chance of achieving a clinical pregnancy. A cohort survey-based study of 7,393 Swedish women also found a dose-response relationship of the amount of alcohol consumed to the risk of seeking treatment for infertility, with high alcohol consumers being more likely to seek treatment than moderate drinkers, while low consumers had a significantly lower risk of pursuing fertility treatment. Another study from Denmark found that alcohol intake of 1–6 drinks per week in women over the age of 30 may be associated with an increased incidence of infertility when compared to women of the same age who consume less than one drink per week.