Alcohol and TTC: Navigating drinking over the holiday period

It’s been a long year. You’re ready to kick back and have some fun at last. Office parties, Christmas markets, putting up the tree…fuelled by mulled wine in a ridiculous mug…

Then the thought hits you. Could a tipple or two hurt your chances of a healthy pregnancy in future?

There are some official recommendations. There are also some grey areas in the research. Today we’ll be looking at both, so you can decide for yourself.

The Relationship Between Fertility And Alcohol

Experts all agree that long-term heavy drinking is not good for your health. This includes your reproductive health.

We know, that’s hardly a newsflash. What you’re really wondering is: what’s a “sensible” amount?

Interpreting The Official Recommendations

It depends how far ahead you’re planning.

For women and birthing parents who are actively trying to get pregnant, you’ll find a limit of 1-2 units of alcohol once or twice a week in the NICE guidelines. For men, they say 3-4 units a day. This is also what doctors tend to recommend.

(Not sure how much you’re drinking? Try this calculator.)

Here’s the thing. Sometimes conception takes ages after pressing go, but sometimes it happens unexpectedly quickly. You might want to bear this in mind if you’ve been envisaging a gentle transition away from old habits.

To get yourself in the optimal position in either case, most experts advise making lifestyle changes 3-6 months in advance. Yes, this applies to men as well as women. It’s a team effort!

The Grey Areas In The Medical Research

It might surprise you to hear that there’s a lack of conclusive evidence on the link between low to moderate alcohol consumption and fertility health. This is because it’s so difficult to study.

There are 3 big reasons for this:

Results are often skewed by recall bias. Our memory isn’t 100% reliable, so self-reported behaviour (which a lot of today’s research is based on) isn’t 100% accurate.
There’s often social desirability bias. People fear being judged for their drinking habits, which doesn’t exactly encourage accurate answers. So in theory, the amount of alcohol that impacts fertility could be higher than numbers suggest.
It’s an ethical minefield. The gold standard in science is to run statistically watertight randomised controlled trials, but you can’t really do that here. It would mean asking one group of people to engage in behaviour that could harm another life, then comparing that group to a control group. So until new research methods are developed, there’s no way to conduct ethical studies that prove the impact of alcohol on fertility.

Better Safe Than Sorry?

This 2017 review by the National Library of Medicine writes that “the physiologic effects of alcohol consumption on female reproductive physiology have not been well delineated due to a paucity of high quality studies”.

In other words, the jury’s still out, and there are lots of low-quality studies fogging up the picture.

Drink Aware say that alcohol could affect ovulation and sperm quality. They’re just not definitive about the findings.

For Example…
This 2021 study found that “heavy drinking in the ovulatory window could disturb the delicate sequence of hormonal events”.

Why are they hedging their bets? Among other things, the authors point to small sample sizes and the potential for “confounding factors” (correlating information about the participants that wasn’t assessed).

All of this explains the unhelpful differences in opinion out there. And the resulting confusion for everyone else. For instance, in contrast to NICE, this NHS website tells those who are actively trying to get pregnant to quit alcohol altogether. Argh!

Basically, It’s Your Judgement Call

Worried about the possible link between alcohol and fertility? Staying off the sauce is a direction you could go in. Just remember that it’s easy to over-obsess about restrictions, creating extra stress that doesn’t serve you or your health. It’s all about finding a balance.

Enjoy having a glass of wine to wind down? Go for it. Based on the medical knowledge we have so far, it needn’t become a stick to beat yourself over the head with. Just try to leave the rest of the bottle intact…

One Idea To Try

Invest in a fabulous crystal glass to drink from. Whether you’re aiming to cut down or quit the booze, this helps you get the most out of whatever you do drink.

Dress up your beverage with fresh mint or a maraschino cherry or a cocktail umbrella. Play around with it. Let your inner teenager have fun! You can still enjoy the ceremony and social ritual of drinking while looking out for your health.