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Fertility is a complex and often fraught issue for many people.

The only thing more upsetting and frustrating than being unable to conceive is coming to understand that our own behaviour is part of the problem.

For those still in their 20’s fertility is not often a problem, but as we age conceiving (and successfully carrying) a child becomes progressively more difficult.

The lives we lead can either alleviate or magnify the difficulties that age brings to us all. New research has shown that alcohol consumption and abuse is a large factor in many problems with pregnancy and conception.

Of course, while alcohol abuse has long-term effects, studies have found that even casual, moderate consumption can be detrimental to both male and female fertility rates as well as libido.

This has serious implications for anyone struggling with alcohol addiction as studies suggest that even moderate alcohol consumption can damage your chances of conceiving.

How Much Alcohol Does it Take to Damage Fertility?

Surprisingly, not much alcohol at all is needed to damage your chances of conception in the short-term (and the long-term).

A study published in Fertility and Sterility found that any amount of alcohol consumed in a menstrual cycle reduces the likelihood of conception and that these effects are exacerbated by caffeine [1].

While caffeine alone had no effect at all on a woman’s chances of conception, it actually exacerbates the effect that alcohol has on both male and female chances of reproduction.

Dr’s Rosemarie Hakim, Ronald Gray, and Howard Zacur found that the consumption of alcohol even within the limit suggested by the NHS could reduce the likelihood of conception by 50%, especially when combined with a cup of coffee a day [2].

This study focussed on female fertility, however, a study undertaken by the National Institutes of Health found that drinking even within guidance limits lowers testosterone levels and sperm count and cause either early or decreased ejaculation [3].

So, even a small amount of alcohol can negatively impact fertility and chances of conception in both men and women, but the long-term effects of drinking regularly in even moderate amounts can have real and lasting repercussions for a couples ability to conceive a healthy child.

Of course, the effects are different for men and women.

How Alcohol Abuse Affects Fertility

Likewise, long-term alcohol abuse, or even regular ‘heavy’ drinking (classed as 15 drinks or more per week for men, and 8 or more per week for women), also has serious and lasting effects in terms of fertility for men and women.

Once again, the effects and thresholds differ for men and women and increase in severity with age and increased alcohol consumption.

One shared side-effect, however, is a decreased libido (which has an obvious effect on the likelihood of conception).

1. Male Fertility

Alcohol consumption generally affects male fertility rates in four main ways: by reducing the shape, size, number, and motility of healthy sperm, by lowering testosterone levels, by shrinking the size of the testes, and by impeding (or speeding) ejaculation.

The latter two effects, of course, require substantial and consistent alcohol abuse over a period of time and are longer lasting than the first two.

Changes to the size and shape of the testes or the onset of erectile dysfunction may take years, or even decades, of consistent heavy drinking, and are difficult to reverse or mitigate.

The first two effects, by contrast often begin during intoxication, and begin to recede during alcohol withdrawal; studies have shown that even the damage caused by excessive binge drinking is reversed after 3 months of sobriety [4].

There are cases where prolonged alcohol abuse can cause permanent damage to sperm count and mobility, too, but some research suggests that this can be mitigated, if not fully healed, by adherence to a Mediterranean diet and healthy lifestyle [5].

2. Female Fertility

For women, alcohol and fertility are intricately linked in a very complex way and can have serious impacts upon fertility and the body as a whole.

For example, those who drink regularly tend to be heavier than those who drink little or not at all, and while this affects male fertility, it seems to have a stronger effect upon female fertility because of the way in which visceral fat builds up around the organs.

A higher proportion of visceral fat limits libido and fertility in women.

Furthermore, excessive and regular alcohol consumption can lead to irregular or non-existant periods, disrupt ovulation, excess estrogen (as a result of excess weight), and lowered libido.

A study conducted by the American Public Health Association found that moderate to heavy alcohol consumption increased the risk of endometriosis and other conditions which contribute to generally lower rates of conception as well as total infertility in otherwise healthy women [6].

Of course, not every study has produced adhering results.

Research on Alcohol and Fertility

In recent years a wealth of research has been published showing the effects of alcohol consumption on fertility for individuals and in terms of a couples joint prospects of conception.

For example, a study published in Medical News Today showed that those women who recorded the highest rates of alcohol consumption were 18% less likely to conceive than those who did not drink [7].

Likewise, a study published in Obstetrics and Gynecology found that women who drank four or more drinks per week while undergoing IVF were 16% less likely to find success or have a live birth than those who less than this (or not at all) [8].

If both partners were drinking more than four drinks per week, the couple was 21% less likely to conceive or achieve a live birth [9].

Despite all this, The New York Times reported on studies which suggested that moderate alcohol consumption has little to no effect on female fertility but rather affects men more than women [10].

With results being non-conclusive it is hard to know just how much of an effect alcohol has upon fertility in real terms, nonetheless, most medical professionals recommend against drinking, even in moderation, when you are trying to conceive.

Some research has suggested a link between the consumption of alcohol around conception with an increased risk of early-term miscarriage, though this is far from proven.

Alcohol Consumption and Pregnancy

Drinking while pregnant is something that medical professionals, and common sense, have argued against for many years but as medical science advances, there are more complex concerns as well.

Recent studies have raised questions around the possibility of how excessive alcohol consumption around the period of conception might affect the viability of any pregnancy that follows as well as the health of the infant should they survive.

Though results are far from conclusive, studies into early pregnancy suggest that heavy alcohol consumption around the time of conception may increase the risks of a first-trimester miscarriage [11].

Two studies in Denmark, however, have produced contradictory results; one suggests that the mother of a child drinking heavily (10 drinks or more per week) around the time of conception increases the risk of miscarriage in the first trimester by 2 – 3 times [12].

The second, however, found no link whatsoever between drinking at the time of conception and a woman’s chances of miscarrying [13].

Unsurprisingly neither study found a link between rates of drinking in fathers at the time of conception and early state miscarriages, though of course, it does lower the chances of conception.

A woman drinking during pregnancy is another matter entirely and carries its own variety of associated risks.

Some people suggest that very small measures of alcohol will not have an effect on pregnancy.

Nonetheless, medical professionals recommend avoiding alcohol altogether when trying to become pregnant, and most certainly after becoming pregnant.

This is because of the various risks that alcohol poses to foetal development and the viability of a pregnancy.

The Risks to Pregnancy

The risks that alcohol poses to the development of an unborn child are many, and they have much to do with the fact that babies livers are the last organs to develop in the womb.

This means that they cannot process any alcohol that passes from your blood into the placenta, and as a result, they face a number of developmental risks up to and including death.

These are [14]:

  • Increased possibility of miscarriage (especially in the first three months).
  • Increased risk of premature birth.
  • Increased risk of low birth weight.
  • Learning difficulties
  • Behavioural problems
  • Foetal Alcohol Syndrome (FAS)

Of course, the risks associated with alcohol increase exponentially with the amount of alcohol drunk, and the regularity of consumption.

Furthermore, a history of alcohol abuse in the recent past will exacerbate any underlying issues and increase the risks greatly as well as limiting the chances of attaining a viable pregnancy in the first place.

Drinking Recommendations

Despite all of the research to hand, it can be hard for the average person to know what to do.

The most obvious answer is to avoid all when pregnant, but, of course, unless you are actively trying to conceive it can be hard to know just when you do become pregnant, With that in mind, the best advice anyone can give is to strive to stay within the alcohol limits recommended by medical professionals.

That means sticking to an upper limit of 14 units per week, for both men and women, though 12 or less is preferable [15].

Calculating Units

If you want to manage and track your alcohol content accurately, you should be measuring units as these are based on the standard measure of alcohol by volume (otherwise known as ABV).

The ABV of any drink can be found on the labels of cans and bottles, or you can ask the staff of the bar or pub you are drinking in [16].

You can work out how many units any drink contains by multiplying the amount of liquid (in ml) by its ABV (measured as a percentage) and then dividing that number by 1,000.

This is easy even in pubs! In fact, it is often easier in pubs as drinks are sold in a consistent measure.

For example, a pint of strong larger (568ml) at 5.2% ABV has 2.95 units, as is shown by the following equation:

5.2 x 568 ÷ 1,000 = 2.95 units. [17]

Where as a 35ml shot of vodka at 40% contains 1.4 unites:

40 x 35 ÷ 1,000 = 1.4

Alternatively, you can use an only alcohol unit calculator such as the one offered by alcohol change on their website.

Dealing With Alcohol Addiction During Pregnancy

Drinking during pregnancy is, of course, not recommended by any medical professionals, but for those struggling with alcohol addiction, it is not always as easy as simply abstaining.

These days there are many alcohol treatment programs which specialise in helping women who are struggling with alcoholism, AUD, or alcohol dependency.

While any sobriety focussed program is preferable to no help whatsoever, these specialist programs are the most desirable as they understand intimately the unique situation in which pregnant women struggling with alcoholism finds themself.

As a result, they will help pregnant women to detox and seek sobriety in a way that is the least traumatic and stressful for both mother and child.

Alcohol, Fertility, and Pregnancy

In the end, while there is no conclusive answer to many of the questions which surround alcohol consumption, fertility, and the smooth completion of pregnancy almost all sources agree that it is best to avoid excessive alcohol consumption.

In fact, many recommend total abstinence, especially once a pregnancy has been established.

Studies have shown that alcohol consumption reduces short-term fertility in both men and women, and can have long-lasting effects on long-term fertility when abused consistently.

In fact, alcohol abuse over a long period could cause damage up to and including total impotence in some cases.

Likewise, alcohol consumption on the lead-up to and during pregnancy has been linked to miscarriage, stillbirth, and birth defects as well as more specific ailments like foetal alcohol syndrome.

As a result, sobriety is recommended by all medical associations, and there are resources available to those who feel they may be struggling with alcohol dependency or addiction.

References

[1] https://www.fertstert.org/article/S0015-0282(98)00257-X/fulltext

[2] https://www.fertstert.org/article/S0015-0282(98)00257-X/fulltext

[3] https://www.ncbi.nlm.nih.gov/pubmed/20117050

[4] https://www.rbmojournal.com/article/S1472-6483(09)00273-9/fulltext

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399329/

[6] https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.84.9.1429

[7] https://www.medicalnewstoday.com/articles/312629.php#1

[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4487775/

[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4487775/

[10] https://www.nytimes.com/2016/08/31/well/family/moderate-drinking-does-not-affect-fertility.html

[11] https://books.google.co.uk/books?hl=en&lr=&id=YP9XBvP0xwwC&oi=fnd&pg=PA9&dq=does+drinking+before+conception+cause+miscarriage&ots=CdaCh0z8LN&sig=2xsuUacctB8sd-DzCFy6C6lCAdY&redir_esc=y#v=onepage&q=alcohol&f=false

[12] https://books.google.co.uk/books?hl=en&lr=&id=YP9XBvP0xwwC&oi=fnd&pg=PA9&dq=does+drinking+before+conception+cause+miscarriage&ots=CdaCh0z8LN&sig=2xsuUacctB8sd-DzCFy6C6lCAdY&redir_esc=y#v=onepage&q=alcohol&f=false

[13] https://books.google.co.uk/books?hl=en&lr=&id=YP9XBvP0xwwC&oi=fnd&pg=PA9&dq=does+drinking+before+conception+cause+miscarriage&ots=CdaCh0z8LN&sig=2xsuUacctB8sd-DzCFy6C6lCAdY&redir_esc=y#v=onepage&q=alcohol&f=false

[14] https://www.nhs.uk/conditions/pregnancy-and-baby/alcohol-medicines-drugs-pregnant/

[15] https://www.drinkaware.co.uk/alcohol-facts/alcoholic-drinks-units/latest-uk-alcohol-unit-guidance/

[16] https://www.nhs.uk/live-well/alcohol-support/calculating-alcohol-units/

[17] https://www.nhs.uk/live-well/alcohol-support/calculating-alcohol-units/