Should you be avoiding alcohol when trying to conceive?

We should have all heard the warnings about drinking during pregnancy – no amount is a safe amount.

Now of course there are caveats to this. That glass of wine you had at 5 weeks before you even realised you were pregnant – most probably not going to make a jot of difference. Let's not feel unnecessarily guilty!

However research has shown us that we simply can’t predict safe amounts as it is so variable from woman to woman. Thus the safe recommendation is zero, zilch, nada whilst pregnant.

 

But what about when you’re trying to conceive? Particularly if the process is taking months or even years? Do you seriously have to abstain from drinking for that long?!

What if you have your best friend’s wedding, the work Christmas party, or your mum’s 50th?

 

Well let’s explore what the science has to say

It seems the greatest focus on alcohol and fertility issues is focused around the effect on men.

YAS finally!! It is not all about me!! I hear you saying.

There are a few studies showing that alcohol can negatively impact the hypothalamus–pituitary–gonadal (HPG) axis.

The HPG axis is something you will become very familiar with if you are finding it challenging to conceive. Many of the unexplained fertility challenges may be connected to the shutdown of the communication through this pathway.

Two major hormones are produced via this pathway –

  • luteinizing hormone (LH) and
  • follicle-stimulating hormone (FSH)

When the production of these hormones are decreased it can cause issues with sperm production and quality.

Thankfully this seems to be the case only in ‘moderate to heavy’ alcohol use. Most indications are that alcohol and semen damage have a dose and time dependent relationship. Meaning the heavier the drinking and the longer the period of time that drinking continues the worse the outcomes.

The good news, is that reducing alcohol or even withdrawing it completely, saw a dramatic improvement within 3 months. Again, with the dose and time dependent response, it is probable that moderate drinkers and occasional binge drinkers would have seen an improvement sooner when compared with heavy long term drinkers.

 

Okay, so it’s not great for men. What about us women? Sure we can’t drink in pregnancy, but did we just get a ‘get out of jail free’ pass during conception?!

Well, sorry ladies but no. There are some studies which suggest that alcohol intake in women increases the time it took for them to conceive.

Intakes of 2 alcoholic drinks or more per day showed significantly increased risk of infertility, when compared with women who had 1 or less drinks per day. Again it was a dose dependent relationships, with moderate drinkers – more than 1 but less than 2 alcoholic drinks per day – showing a slight increased risk when compared with those drinking 1 or less.

Obviously these numbers were averaged out over a period time. So don’t get pulled into thinking ‘oh I only have more than 2 drinks on 2 nights of the week…the rest of the nights I only have 1 wohoo!

Yes those 3 wines on Friday with the girls, and the two G & T’s plus wine at the dinner on Saturday get averaged out across the week.

Also note this is a standard drink…not whatever-you-can-fit in a wine glass amount.

One study also pointed to an age-dependent relationship. Where the older we got, the more alcohol affects our chances of conception.

So women trying to get pregnant in their 20s who are moderate to heavy drinkers only had a 40% decreased chance of pregnancy. This is compared with women in their 30s, who had a 73% decreased likelihood of becoming pregnant.

The University of Michigan carried out a study which showed that women who binge drink 2 or more times per week – that is 4 or more standard drinks at one time – had significantly less AM hormone and follicle count. This signals that heavy drinking may diminish ovarian reserve.

Given that women are born with all the eggs they will ever have, this result is somewhat disturbing – particularly being mindful of the increased rates of drinking amongst university / college age women.

 

However there are yet other studies which show no relationship to alcohol and chances of conception. They hypothesize a correlation at best – saying that men and women who drink moderately to heavily are at a higher risk of also partaking in other activities which decrease their chance of pregnancy e.g. smoking, not exercising, being overweight, or having a nutrient-inadequate diet. Not that alcohol itself is the cause of the infertility.

All of the above studies did account for these correlating factors, however there is still a margin of error with these things.

 

So given all the above what are my recommendations?

It is very difficult to give recommendations for the conception period given the varying evidence out there.

My thoughts are;

  • It is feasible that alcohol affects semen quality. For this reason men should avoid binge drinking episodes whilst trying for a baby. In addition they could limit or abstain from alcohol in the 1 – 2 weeks prior to their partner’s fertile ‘window’.
  • With the disastrous consequences of fetal alcohol syndrome, potential miscarriage risk, and possible conception issues, I would urge women to refrain from alcohol consumption whilst trying to conceive and during pregnancy. Having minimal alcohol during conception does not seem to provide any harm (1 – 2 glasses of wine or beer once or twice per week). However this consumption once pregnant is not advised – and as there is always a ‘risk’ you will be pregnant if you are TRYING to be pregnant – I would suggest abstaining or consuming in small quantities as infrequently as possible.

Basically if you have to have a glass of wine at the Friday after work drinks, to stop those increasingly frustrating comments of “ooo are you pregnant?”, then you should be okay doing so...but maybe not in the 2 weeks post ovulation.

 

 

Resources

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3739141/

https://www.ncbi.nlm.nih.gov/pubmed/14967377

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4555117/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5504800/

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