Can Too Much Alcohol Cause Infertility?Anna Ciulla
Can too much alcohol cause infertility? That question is one many couples ask when trying to conceive. They wonder whether drinking can affect their chances of achieving pregnancy, and if so, to what degree.
The answer to that question is a qualified “yes.” Heavy drinking and excess alcohol are most certainly linked to decreased fertility. Much of the accumulated research suggests, in fact, that even a moderate weekly alcohol intake can make it more difficult to conceive. But, just how much alcohol is “too much” for couples hoping for a successful pregnancy? And, more specifically, how does problem drinking affect fertility? This article will educate couples on everything they need to know regarding the link between alcohol and infertility, including what to do if a drinking problem may be interfering with your prospects of having a child.
The Link Between Alcohol and Infertility
Strong scientific evidence suggests a link between alcohol and infertility, although the precise nature of this link — especially with respect to what constitutes “too much alcohol” for achieving pregnancy — is not without controversy and can depend on whom you talk to. Generally, there seems to be an inverse relationship between alcohol and fertility: as alcohol intake increases, fertility decreases (for both men and women).
Some of the same research indicates, however, that there may be a threshold at which drinking begins to have a negative impact on fertility, and that, contrary to previous findings, moderate drinking may not be an obstacle to achieving pregnancy. In a more recent study, researchers at Boston University were studying how alcohol affected women’s fertility in particular. Over a period of nine years, and in collaboration with researchers in Denmark, the BU team followed 6,120 Danish women who were trying to conceive. The researchers found that women who drank more than 14 alcohol servings per week (the equivalent of one to 13 four-ounce glasses of wine) experienced a nearly 20 percent decrease in their capacity to achieve pregnancy. (That squares with previous findings showing a link between heavy drinking and impaired fertility.)
Strikingly, though, women whose weekly alcohol intake fell under this rather high threshold (13 alcohol servings or less) reportedly “were no less likely to conceive than those who abstained completely.” This finding was controversial for a couple of reasons, starting with the implication regarding what constitutes “moderate drinking.” Dietary Guidelines for Americans from the U.S. Department of Health and Human Services and U.S. Department of Agriculture define “moderate drinking” much more conservatively—as no more than one drink per day for women. (13 drinks/week obviously far exceeds this recommended guideline for “drinking in moderation.”)
The BU finding also disputed previous studies that did find a link between drinking in moderation and infertility — a link that starts at a much lower weekly consumption threshold, too, for that matter. For example, a study of 430 Danish couples between the ages of 20 to 25 found that for women, even five drinks a week or less were associated with lower fertility.
And a number of other large studies have confirmed similar conclusions — namely, that while fewer than five drinks per week probably are not harmful to fertility, over that amount can adversely impact fertility. Similarly, heavy routine drinking (two or more drinks per day) and binge drinking (five or more drinks at a time) are associated “with increased rates of menstrual abnormality” and “miscarriage,” according to a summary of the research by reproductive specialists.
How Alcohol Affects Fertility in Men and Women
Alcohol can contribute to infertility in both men and women in a number of ways, according to accumulated research.
Drinking can affect fertility in women, by:
- Delaying the onset of conception
- Altering levels of estrogen and progesterone (two hormones that are critical to preparing the uterus for pregnancy)
- Disrupting the monthly menstrual cycle and ovulation
- Increasing the risk of endometriosis (a painful condition involving the uterine lining that directly hinders one’s chances of getting pregnant)
- Increasing the risk of miscarriage, including harm to the fetus
In men (as in women) even moderate drinking can affect fertility, by reducing sperm count and quality, according to recent research published in the British Medical Journal.
Alcohol’s other effects on male fertility can include:
- reduced libido
- erectile dysfunction and/or impotence
- decreased motility of sperm (slower sperm)
- suppression of male hormones associated with reproduction
Dangers of Alcohol Exposure in Pregnancy
Furthermore, the dangers of alcohol exposure in pregnancy — and, in particular, the risks of developing “fetal alcohol syndrome” and/or “fetal alcohol spectrum disorders” — have been well-cataloged and one big reason the American Academy of Pediatrics has said “no amount of alcohol is safe during pregnancy.”
But “no amount of alcohol” may also be best during the pre-conception window when couples are trying to get pregnant, according to the recent recommendation of the Centers for Disease Control and Prevention (CDC). One reason is that alcohol’s risks to the fetus may be higher during this vulnerable window and the very first weeks of pregnancy.
Abstaining From Alcohol to Maximize Fertility
The medical consensus, then, is that total abstinence from alcohol is the ideal for couples looking to conceive. At the very least, for couples hoping to maximize the prospects of a healthy and successful pregnancy, weekly alcohol intake should fall within the recommended guidelines for drinking in moderation (five drinks or less per week). Research also suggests that couples that have been trying to conceive for a year or more without success may benefit from reevaluating their drinking habits.
If you or your partner find it difficult to modify your drinking habits by reigning in alcohol consumption or abstaining entirely, that may be the sign of a diagnosable substance use disorder (SUD) — a known contributor to infertility. If you have reason to believe that problem drinking is reducing your fertility, consulting with the right medical professionals can help.