So this question, ‘is drinking while trying to conceive ok?‘ was a big deal to me when I was in the throws of TTC. I was beyond frustrated by how hard it is to get clear answers on this question. Can I enjoy my last few weeks of evening wine or not?!
If you’re trying to get pregnant, no doubt, someone has smothered you in unsolicited advice about how you “shouldn’t” be drinking.
If you’re wondering what the science says about drinking while trying to get pregnant, and how much alcohol actually impacts your fertility, you’re in the right place. I’m going to give you everything you need to know to make an informed decision for yourself.
Does Alcohol Affect Fertility?
The perhaps disappointing spoiler alert is that we don’t really know. The research just isn’t there to make definitive statements like, “drinking a glass of wine will prevent you from getting pregnant or cause a miscarriage“.
If this were the case, we would have discovered long ago this delightful form of birth control, rather than the opposite reality of babies born after just one rowdy night.
We can, however, glean enough insight from the science, and from common sense, to make educated recommendations about drinking while trying to conceive. We can say that:
- Alcohol doesn’t have the same impact on everyone. Deciding whether or not to drink while TTC should be based on your overall health, hormone balance, menstrual regularity, blood sugar control, adrenal & liver function, and reproductive history; and
- It’s not all or nothing. The speed at which you drink, and how much, can make all the difference. In other words, sipping a glass of wine over dinner, European-style, is not the same as chasing a jello-shot with an Irish car bomb, frat boy-style.
But first: Why is there so much conflicting advice around drinking while trying to conceive? Why isn’t there a simple answer?
Here’s the problem: it’s not exactly ethical to ask one group of people to binge drink so that the researchers can compare the effects to a control group abstaining from alcohol. Thus, for almost every controversial topic in fertility and preconception nutrition, from caffeine to alcohol, we don’t have the caliber of research needed for definitive, universal guidelines.
We do, however, have enough observational research to make reasonably well-supported recommendations.
Researchers can ask people to report on what they ate + drank while trying to conceive (TTC) and glean a reasonable understanding of what behaviors do / do not support a healthy pregnancy. These observations are what we have to inform the recommendations to follow👇.
All right, now that we’re on the same page, let’s dig into the science around drinking while trying to conceive a little bit more.
Alcohol & fertility while trying to get pregnant: How much is too much?
You don’t need me to tell you that too much alcohol is bad for you. Excessive drinking causes weight gain, disrupts your hormone balance, throws off your blood sugar, taxes your liver, impairs your sleep, causes anxiety & depression… need I go on?
Once pregnant, we know that heavy drinking can cause fetal alcohol syndrome, which can include mental and physical disabilities in baby.
So, we know that too much drinking (> 5 drinks at once) is bad news. The question is, does that mean any amount of alcohol is unsafe? This is where we enter the gray area about drinking while trying to conceive. Research findings on the effects of light to moderate drinking while TTC are all over the map.
(We don’t even have universal definitions for “light” “moderate” or “heavy” drinking. Generally, light to moderate drinking is </= one drink per day for women and </= two drinks per day for men.)
When TTC, here are the primary questions to consider:
- Does any amount of drinking make it harder to conceive?
- After conception, can drinking cause a miscarriage or pose a health risk to baby?
Since we know heavy drinking is no bueno, going forward, as we consider these questions, let’s assume we’re talking about light drinking (< one drink per day for women and < two drinks per day for men). Let’s dive right in.
Does light drinking while trying to conceive reduce your fertility?
Maybe, but not necessarily. Annoyingly vague answer, I know. Let me explain.
First, the research shows no clear risk associated with drinking while trying to conceive:
Results from research on the impact of alcohol on female fertility are conflicting, but most studies actually show no association between light drinking and infertility.
There are several studies showing that drinking alcohol can reduce fertility in all genders, while just as many studies, if not more, found no association between light drinking (one drink per day) and ability to maintain a healthy pregnancy.
So how does alcohol affect ovulation? One Danish study including nearly 30,000 women actually found that light drinking >/= 3 glasses of wine per week, reduced the time to conception.
Data from the Nurses’ Health Study, which followed 18,000+ women for nearly a decade, and laid the foundation for the Fertility Diet, found that women who had a drink per day had the same risk of irregular ovulation as women who didn’t drink at all.
However, your unique physiology might say differently than the research:
Before you throw your party pants on, remember that drinking impacts each of us differently. You have to understand your unique physiology to fully weigh the pros & cons of sipping an adult beverage.
Some of the ways that alcohol can impair fertility & your reproductive health include:
Drinking can increase estrogen levels by:
- Slowing down the rate of estrogen break down in your liver, resulting in more estrogen circulating in your system; and
- Increasing the enzymatic conversion of testosterone to estrogen (a.k.a. aromatization).
Drinking can disrupt ovulation by:
- Throwing off blood sugar balance and increasing insulin resistance;
- Increasing cortisol levels; and
- Blocking LH (luteinizing hormone) receptors on the granulosa cells of your ovaries.
Drinking can prevent conception by:
- Reducing smooth muscle contraction in fallopian tube, so the egg can’t travel to the uterus;
- Disrupting the health of uterine lining, preventing the fertilized egg from implanting.
Let’s put these scary impacts from drinking in context of the medical literature. Review of the research (👆) shows us that we cannot make definitive, universal claims like, ‘if you drink, you can’t get pregnant’.
However, we know that alcohol is far from benign. When deciding whether or not to drink while TTC, it’s important to ask yourself some key questions.
Questions to Ask Before Drinking While Trying to Conceive
Thinking about girls’ night out while TTC? Before you go out drinking while trying to get pregnant, ask yourself a few questions:
- Do you already have high estrogen? (See signs & symptoms of estrogen excess) The best way to know if your estrogen balance is off is through DUTCH testing, which will look at overall estrogen, as well as metabolism of hormones. As described above, drinking alcohol can increase estrogen levels, so you don’t want to make the issue worse in the name of a yummy cocktail;
- Do you have high or low cortisol? Again, I recommend DUTCH testing to understand if your liver and adrenals are already overly-burdened, and thus may be more sensitive to the impacts of drinking. Alcohol stresses your system, which in turn can exacerbate cortisol dysregulation;
- Do you have regular cycles? Are you ovulating? If not, this indicates an underlying issue, like insulin resistance, that needs to get in check before your body can be resilient to the impacts of drinking;
- Have you suffered multiple miscarriages? If so, we know that alcohol can cause oxidative stress that can increase the risk of pregnancy loss (more on that below 👇); and
- Do you have an underlying condition? (Like PCOS, adenomyosis or endometriosis) If so, your hormone balance is likely more sensitive to the impacts of alcohol. In this case, drinking while trying to conceive is probably not a great idea.
Other signs you should be extra cautious with drinking when trying to conceive:
- If alcohol disrupts your sleep / if you wake up feeling more tired or groggy the next day, even if you only have one drink;
- If alcohol disrupts your gut health. For example, if you feel bloated or get loose stools the day of or the day after having a drink; or
- If you are struggling with anxiety or depression.
Does drinking alcohol affect egg quality?
In short, yes.
Poor egg quality is caused by chromosomal abnormalities in the oocytes (egg cells). Excessive alcohol causes oxidative stress that damages chromosomes (a.k.a. chromosomal abnormalities), and thus worsens egg quality and increases risk of miscarriage (more on pregnancy loss below 👇).
Can I drink alcohol during IUI or IVF?
Once again, research in this area is scant. The preponderance of research we do have suggests that it’s best to refrain from alcohol leading up to and during artificial reproductive technology (ART), including IUI and IVF.
Researchers found that drinking any alcohol in the year leading up to IVF resulted in fewer eggs retrieved, and that those who reduced or completely abstained from alcohol leading up to their treatment had better chances of a successful pregnancy.
Since you want to do everything you possibly can to make your IUI or IVF successful, your best bet is to avoid alcohol completely.
Is it safe to drink alcohol during the two-week wait?
During the two week wait (i.e. two weeks of agony) after ovulation (and hopefully conception 🤞🤞🤞) when you’re waiting to take a pregnancy test, is it safe to have a glass of wine, or even a cocktail on Friday night?
If fertilization occurs, then the egg cell will duplicate and divide into a mass of identical cells. Any of these cells could develop into any part of the baby (pretty crazy!) Drinking during this time could kill one or more of these cells.
However, a minor loss will not cause any harm to baby – at this early stage, another cell can replace the lost one. The risk is if you drink too much and kill too many of these cells, in which case, the embryo will not be viable and you could lose the pregnancy.
To play on the safe side, you don’t necessarily have to abstain all together. Instead, just be sure to drink slowly and in moderation (</= one drink per day). See below to understand why drinking when trying to conceive should be done in moderation 👇.
Can drinking in early pregnancy cause a miscarriage?
When you have a drink, your liver metabolizes the alcohol from acetaldehyde, which is toxic, and then into the benign compound, acetate. When you drink slowly, your liver makes this conversion into acetate, preventing any harm to the fetus.
If you drink faster than your liver can metabolize the alcohol, that’s when problems can occur. This is why sipping wine over the course of a meal is very, very different from taking shots or shotgunning a beer.
Again, the research on drinking while trying to conceive and miscarriage risk during the 1st trimester is varied – one systematic review found no reportable association between light drinking and miscarriage risk, while another large study did find that even light drinking (>2 drinks per week) does increase risk of pregnancy loss.
Given that there’s even a little risk, the safest bet is definitely to abstain from alcohol in the 1st trimester. If you do decide to sip on an adult beverage, we don’t have the evidence to condemn that choice – just sip slowly.
Does drinking alcohol affect male fertility?
Yup. XY chromosomes don’t get out scott free on this one.
If men drink more alcohol, at a faster pace than their liver can detoxify, their swimmers pay the price. Research suggests that excessive drinking can reduce testosterone below desired levels, shrink testicles, make it harder to get and maintain an erection and slow sperm production.
So much of the fertility burden is placed on the woman’s shoulders. When it comes to drinking alcohol, this is one area where both partners may need to exercise some moderation.
Bring it home: is drinking while trying to conceive safe?
We know that excessive, heavy drinking is harmful to you and babe-to-be. You definitely don’t want to have more than one drink per day if you’re actively trying to make a baby.
However, according to the current medical literature, we can’t say that light drinking (</= 1 drink per day for women) is dangerous during the preconception period.
Once you get your positive pregnancy test, the risk of loss from having even just two drinks per week is too high to justify an adult beverage. Opt for a mocktail, at least until you’re safely in the second trimester.
And, if you have any of the following health concerns, you’re likely less resilient to the impact of drinking alcohol, and you’ll do your fertility good by abstaining:
- Poor liver or adrenal function;
- Blood sugar imbalance and risk of insulin resistance;
- Underlying conditions like adenomyosis, endometriosis or PCOS;
- Excessive estrogen and / or low progesterone;
- Anovulatory cycles or irregular cycles;
- A history of recurrent miscarriages; or
- GI, sleep or mood issues made worse by drinking.
We can say for sure that drinking alcohol doesn’t do your fertility (or your health) any favors! If you can live without out, I recommend doing so, at least until you get that beautiful babe in your arms.
If you’re frustrated that you’re still not pregnant and want to make sure you do everything humanly possible to have a healthy pregnancy, I can help.
I offer fertility nutrition coaching to give you custom solutions, designed for your unique physiology, so you can take control of your health & your fertility.
Rooting for you,