Alcohol and fertility: what all women’s health professionals should know

In the review article “Alcohol and fertility: how much is too much” published in Fertility Research and Practice, Dr. Kristin Van Heertum and Dr. Brooke Rossi discuss what we really need to know about alcohol and fertility. The authors review a wide variety of data and provide a summary of the most salient points.

Both alcohol use and infertility are very common in the United States. It is estimated that approximately 1 in 8 couples in the U.S. will experience difficulty conceiving. Furthermore, more than 50% of people in the U.S. report usage of alcohol in the past month. Given the prevalence of both of these conditions, we believed it was important to explore their relationship by reviewing the current evidence.

In our recently published review article, we outline the prevalence of various levels of alcohol use in the U.S. as well as some of the non-reproductive sequelae of alcohol consumption. We then review the effects of alcohol on pregnancy outcomes, female and male reproduction, and on fertility treatments.

For patients undergoing fertility treatments, there is data to conclude that even moderate quantities of alcohol negatively affect IVF outcomes for both men and women.

The association between drinking alcohol and Fetal Alcohol Spectrum Disorders (FASD) has been well documented. Our review of the literature confirms that there has, as yet, been no “safe” exposure dose or duration identified at which there is no increased risk of FASD or growth defect.

Alcohol also appears to increase the risk of early miscarriage, second trimester loss and stillbirth. Given these findings, it is our recommendation that pregnant women abstain from any alcohol consumption for the duration of their pregnancy.

In terms of female reproduction, some studies showed no effect of various levels of alcohol consumption on fertility. However, several other studies did document a significantly decreased pregnancy rate and increased risk of infertility. For men, there appears to be no consistent effect on semen quality with any level of alcohol consumption.

For patients undergoing fertility treatments, there is data to conclude that even moderate quantities of alcohol (up to one drink per day for women, two drinks per day for men) negatively affect IVF (in vitro fertilization) outcomes for both men and women, particularly in the days and weeks leading up to treatment.

In our practice, we recommend that all women who are pregnant eliminate alcohol consumption, and those who are attempting to conceive should minimize their intake. We also encourage their male partners to moderate their alcohol consumption in order to optimize their chances of successfully conceiving.

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