I recently read a very interesting article by Rossi et al. “Effect of Alcohol Consumption on In vitro Fertilization,” published in the prestigious journal of Obstetrics and Gynecology in January 2011, volume 117, pages 136 to 142. The authors looked at more than 4,700 in vitro fertilization (IVF) cycles in more than 2,500 couples. Couples were given questionnaires to fill out regarding their alcohol consumption at the time of the IVF cycle start, not during the IVF cycle or pregnancy. The primary outcome that the authors were interested in was the live birth rate after IVF. They found that for men or women undergoing IVF, drinking four or more drinks per week prior to an IVF cycle is associated with a 48 percent higher risk for failed fertilization and a 21 percent lower chance for a live birth.
On the one hand, it seems obvious that alcohol might have a negative impact upon fertility. However, as the authors point out, while there is an enormous amount of evidence published on the adverse effects of alcohol consumption upon the fetus during pregnancy, there is not much data on the effect of alcohol consumption upon fertility. In addition, they theorize that perhaps couples undergoing IVF are not expecting to conceive without assistance and therefore they may not limit alcohol consumption prior to an IVF cycle, thinking that they will stop once they start their fertility drugs.
In general, infertile couples in this study reported less drinking than the general population – 45 percent to 66 percent reported consuming any alcohol at all, while 62 percent to 74 percent of the general population reports that they are current drinkers.
After I read this article, I started paying more attention to whether or not my patients were drinking. We tell all of our female patients not to drink at all during the IVF cycle, but we do not really say anything about drinking prior to the IVF cycle. We do not pay much attention to the guys at all, unless the wife brings up a concern about too much alcohol. But how much is too much? Until this study, there really was not much data out there.
To my surprise a lot of women and men are consuming significant amounts of alcohol. They have some idea that maybe they are drinking too much, but without their doctor saying something very specific, they really did not think about it too much. I found that many men and women — men more so than women — were drinking four or more drinks per week. Although many of my patients enjoy having a drink, most responded very positively to the recommendation to cut back to fewer than four drinks per week. For my female patients, I also asked them to abstain completely after ovulation (usually around day 14 if you have 28-day cycles). Yes, even the guys were happy that there was something they could do to help with the baby-making plan!
So, bottom line — no alcohol at all during the IVF cycle — definitely for women, and not a bad idea for the guys. Before the IVF cycle, alcohol seems to be OK in moderation. And moderation — at least according to this recent, large study — seems to be less than four drinks per week.
Written By: Serena H. Chen, M.D., IRMS Reproductive Medicine at Saint Barnabas, October 16, 2011