Alcohol and fertility

In recent years, it has become increasingly apparent that lifestyle factors – including stress, lack of exercise, illegal drug use, cigarette smoking and alcohol consumption, can also all play a role. This factsheet provides a summary of the relationship specifically between fertility and alcohol, examining the possible impact on both women and men.

According to the NHS, around 1 in 7 couples may have difficulty conceiving (that is, getting pregnant).[1] Given that significant numbers of adults of reproductive age drink alcohol in the UK, it is important to examine how drinking may negatively impact fertility.

Research studies have shown that consuming alcohol can harm the fertility of both men and women.[2] The relationship between alcohol and fertility is thought to be dose-dependent, which means that the greater amounts of alcohol we drink, the higher the risk of developing fertility problems. It’s therefore likely that whilst any amount of alcohol can adversely impact fertility, drinking heavily significantly increases the chances of that happening.

There is strong evidence that alcohol can decrease fertility amongst people assigned female-at-birth. The precise cause isn’t clear, but one of the reasons may be due to how alcohol can raise levels of oestrogen, one of the main female sex hormones, which can then disrupt the implantation of the embryo (the unborn child) into the endometrium (the inner lining of the uterus), thereby making it more difficult to become pregnant.[3]

Alcohol can also disrupt the functioning of other hormones, namely the Follicle Stimulating Hormone (FSH) and Luteinising Hormone (LH), which control the menstrual cycle and the ability to ovulate (that is, release an egg from one of a female’s ovaries).[4]

Therefore, if you are a woman who is trying to become pregnant, the best advice is to minimise your alcohol intake or, ideally, not drink any alcohol at all.[5] This is also the case for women undergoing In Vitro Fertilisation (IVF) treatment.[6]

For women who are already pregnant, again the best advice is not to drink alcohol. There is clear evidence that shows that heavy drinking in pregnancy is extremely risky and can lead to devastating impacts on the child which last for their lifetime.[7] There is less certainty about just how much alcohol a pregnant woman has to drink before the risk becomes significant, and so doctors advise the safest option for mothers-to-be is to avoid alcohol completely.[8]

Men’s fertility can also be adversely affected by alcohol, by reducing testosterone in the body, a sex hormone for which one of the functions includes regulating libido (that is, our sex drive). Evidence has also shown an association between men who drink heavily and poor semen quality,[9] and therefore the sperm’s ability to fertilise an egg (although this is quickly reversed once consumption is reduced). Other issues resulting from heavy drinking, and which affects fertility, include shrinkage of the testes[10] and premature ejaculation.[11]

Therefore, although alcohol consumption in men is unlikely to harm any resultant pregnancy, for the above reasons it is advisable for men trying to conceive to limit their alcohol intake or avoid it altogether. And importantly, stopping drinking alcohol or cutting back can be a really positive way to support your partner during their pregnancy and help make not drinking feel a little easier and more normal for you both.

As a general guideline, the UK’s Chief Medical Officers (top doctors) recommend not drinking more than 14 units a week;[12] that means about six pints of normal strength beer or a bottle and a half of wine per week. It’s also recommended to have at least a few alcohol-free days each week.

Some top tips for cutting down or cutting out alcohol include:

• Recording what you drink over a few weeks to help you understand your drinking pattern, so you can decide if you want to make a change.
• Identifying which feelings or situations trigger the desire to start drinking.
• Switching to lower strength drinks or alcohol-free alternatives. Alcohol-free beers, ciders, wines, and spirits are now widely available.

[1] NHS website. Overview: Infertility. [Accessed 9 February 2024]. Available at: https://www.nhs.uk/conditions/infertility

[2] Gude, D. (2012). Alcohol and fertility. Journal of human reproductive sciences, 5(2), 226.

[3] Özdemir, A. Z., Karli, P., & Gülümser, Ç. (2022). Does high estrogen level negatively affect pregnancy success in frozen embryo transfer?. Archives of Medical Science: AMS, 18(3), 647.

[4] Emanuele, M. A., Wezeman, F., & Emanuele, N. V. (2002). Alcohol’s effects on female reproductive function. Alcohol Research & Health, 26(4), 274.

[5] NHS website. Planning your pregnancy. [Accessed 12 February 2024]. Available at: https://www.nhs.uk/pregnancy/trying-for-a-baby/planning-your-pregnancy/

[6] Nicolau, P., Miralpeix, E., Sola, I., Carreras, R., & Checa, M. A. (2014). Alcohol consumption and in vitro fertilization: a review of the literature. Gynecological Endocrinology, 30(11), 759-763.

[7] Schölin, L. (2016). Prevention of harm caused by alcohol exposure in pregnancy: Rapid review and case studies from Member States. World Health Organization. Regional Office for Europe.

[8] Ibid. NHS website. Planning your pregnancy.

[9] Finelli, R., Mottola, F., & Agarwal, A. (2021). Impact of alcohol consumption on male fertility potential: a narrative review. International Journal of Environmental Research and Public Health, 19(1), 328.

[10] Adler R. A., Clinically important effects of alcohol on endocrine function. Journal of Clinical Endocrinology and Metabolism. 1992;74:957–960

[11] NHS website. Can premature ejaculation be controlled? Accessed 12 February 2024]. Available at: https://www.nhs.uk/common-health-questions/sexual-health/can-premature-ejaculation-be-controlled/

[12] UK Chief Medical Officers’ Low Risk Drinking Guidelines 2016. See: https://www.gov.uk/government/publications/alcohol-consumption-advice-on-low-risk-drinking