Alcohol and Fertility
Infertility is the inability to conceive after a year or more of unprotected sex. One potential cause of infertility is alcohol consumption.
To understand fertility, it’s essential to know the steps involved in human reproduction:
- A woman’s body must ovulate (release a mature egg from her ovaries)
- A man’s sperm must fertilize the egg
- The fertilized egg must travel from the fallopian tube to the uterus
- The fertilized egg must implant inside the uterus and develop into an embryo
Infertility may happen if there’s a problem in one or more of the above steps.
Infertility affects almost 15% of couples trying to conceive. Both men and women equally contribute to infertility.1, 2
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Effects on Male Fertility
Alcohol consumption affects male fertility through:2, 3
- Hormonal changes: Successful spermatogenesis (sperm production) results from complex hormonal mechanisms. Alcohol can adversely affect testosterone and various reproductive hormones.
- Sexual dysfunction: Alcohol use can lead to impotence, premature or decreased ejaculation, and loss of libido. Any of these dysfunctions can be a cause of infertility.
- Other health conditions: One example is alcohol-related liver dysfunction, which is linked to lower sperm production.
Sperm Production and Quality
In men, alcohol consumption can adversely affect sperm production and quality.
To be able to conceive, a man must exhibit high-quality sperm:4
- Semen volume: Normal semen volume is between 1.5 to 5.0 milliliters per ejaculation. Semen is composed of sperm, water, and other components.
- Sperm count: Normal sperm concentration ranges from 20 to 150 million per milliliter of semen.
- Sperm motility: At least 60% of sperms should have forward movement.
- Sperm morphology: At least 60% of sperms should have a normal size and shape.
In a study conducted in 1985, 20 alcohol-dependent men showed poor sperm quality and low testosterone levels. This was the first study that looked into the connection between alcohol and male fertility.5
In 2011, 57 studies showed further evidence of alcohol’s adverse effects on semen volume, sperm motility, and sperm morphology.2
In 2017, 15 more studies supported alcohol’s detrimental effects but only among heavy drinkers. Men who drink moderately were unaffected.6
Alcohol’s impact on sperm quality is primarily tied with hormonal changes. In heavy drinkers, alcohol can:2, 6, 7
- Decrease testosterone levels: Sperm production requires this hormone.
- Decrease luteinizing hormone (LH) levels: LH stimulates testosterone production.
- Decrease follicle-stimulating hormone (FSH) levels: FSH stimulates sperm production.
- Disrupts gonadotropin-releasing hormone (GnRH) activity: GnRH stimulates the release of FSH and LH.
- Increase estrogen levels: Estrogen can slow down sperm production in men.
Effects on Female Fertility
Three out of four women drink alcohol while trying to get pregnant.8 Chronic or prolonged alcohol consumption can disrupt women’s ovulation and menstrual cycle.3, 9
A 2017 study showed that moderate and heavy drinking in the post-ovulation phase decreases the odds of pregnancy by nearly half.10
Alcohol’s impact on a woman’s reproductive cycle is also tied to hormonal changes. Alcohol can:3, 9, 11
- Increase estrogen, FSH, and LH levels: These hormones trigger the thickening of the uterine wall. Changes in their concentrations may lower the chances of embryo implantation.
- Increase testosterone levels: Alcohol intake temporarily increases testosterone in women. This mechanism can disrupt a woman’s regular cycle.
Heavy alcohol use may also reduce ovarian reserve and the potential to bear children. Ovarian reserve is determined by a woman’s remaining oocytes (immature egg cells).3
Pregnancy
The effects of alcohol during pregnancy are better understood than the effects it has on women who are trying to conceive (get pregnant).
The fetus (unborn child) is more exposed to higher concentrations of alcohol than the mother due to alcohol build-up in the amniotic fluid.3
Some health risks of drinking during pregnancy include:
- Bearing a child with fetal alcohol spectrum disorders (FASDs): Affected children will have development, learning, behavior, and socialization problems.3, 12
- Increased risk of fetal loss: Two to four alcoholic drinks per week increase the risk of miscarriage, particularly in early pregnancy.3
Alcohol consumption (even moderate drinking) may also decrease in vitro fertilization (IVF) success. This is possibly due to alcohol reducing oocyte yield and live birth rates.3
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Fertility Tips Regarding Alcohol
The good news is that alcohol’s impact on fertility is usually reversible. In men, stopping alcohol use can drastically improve semen quality in just 3 months.1, 13
Here are a few fertility tips regarding alcohol use:
- Stop or minimize alcohol consumption: While this action is an obvious choice, abruptly quitting may trigger withdrawal symptoms, particularly in those with an addiction. Ask your doctor how to quit alcohol safely.
- Be mindful of pregnancy status: Women should avoid alcohol if they’re trying to conceive. They may not know they’re already pregnant and still drink, exposing the unborn baby to various risks.
- Recognize and avoid triggers: Some situations, places, or things may encourage people to drink. To cut down on alcohol, understand these triggers and avoid them.
- Stop drinking together: This is an excellent way for couples to maintain their own and their future child’s health.
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When to See a Medical Professional
Couples trying to conceive should seek professional help in the following situations:1
- No success after trying to conceive after 6 months
- The woman is over 40 years of age
- Recurrent pregnancy losses (having two or more spontaneous miscarriages)
- Health conditions affecting fertility (like hormonal disorders, polycystic ovary syndrome (PCOS) in women, and sexual dysfunction in men)
- High withdrawal risk
Difficulty stopping or controlling drinking habits
