Can I Drink Alcohol When Trying to Get Pregnant?

We all know you should never drink alcohol while pregnant. But what about before getting pregnant, while you're trying to conceive? Let's take a deep dive into what the research actually shows.

Alcohol and pregnancy

It's been known for a long time that alcohol consumption during pregnancy is to be avoided: it negatively impacts embryo growth and development.¹ Moderate to heavy alcohol consumption in early pregnancy can lead to increased rates of spontaneous abortion, decreased length and weight of the baby, and growth or neurobehavioral effects.^1,2 The CDC puts it plainly: there is no known safe amount of alcohol use during pregnancy or while trying to get pregnant. And yet, even with that warning, more than 10% of women don't quit drinking after finding out they're pregnant.^4,5 If alcohol can affect embryo growth once you're pregnant, does it also affect your fertility beforehand — say, by messing with egg quality?

Alcohol and fertility

It may come as a surprise, but large population studies don't fully agree on whether alcohol consumption before pregnancy hurts your ability to conceive in the first place. One study found a link between moderate alcohol use and both endometriosis and anovulatory infertility — meaning alcohol could be tied to irregular cycles or cycles without ovulation at all.⁶ Other studies found a decline in the ability to conceive even in women who only had a few drinks per week.^7,8 But some studies, including ones covering tens of thousands of women, find no or very weak associations.^9,10,11 The Nurses' Health Study, for example, found that low to moderate alcohol consumption in the years preceding conception did not increase miscarriage risk.^11,12 Taken together: most evidence suggests low alcohol use well before pregnancy doesn't meaningfully affect fertility or early pregnancy loss — but not every study agrees.

Enter IVF studies

Here's where it gets more useful: IVF studies. Researchers looking at IVF success rates have a real advantage over population studies — a controlled environment, a much shorter recall window (no trying to remember what you drank three years ago), consistent medical procedures, and an early look at the developing embryo. These studies are smaller in scale, but the conclusions they support are stronger because the data quality is so much higher.

Does timing matter?

Just like the population studies, IVF studies consistently show that low to moderate alcohol consumption in general doesn't influence the ability to conceive. But alcohol in the weeks right before an IVF cycle is a different story. One of the first studies on this, from California in 2003, found that women who had 1+ drinks per day in the year before an IVF attempt had 13% fewer eggs retrieved than women who drank little to none.¹³ Other IVF studies have found similar results: drinking in the year before treatment doesn't move the needle much.¹⁴ But the closer you get to the actual procedure, the more it matters:

• 1+ drinks per day in the month before IVF: 2.9x lower odds of a successful attempt¹³
• 1+ drinks in the same week as the IVF attempt: 4x higher risk of not becoming pregnant¹³
• Even among women who did get pregnant, miscarriage rates were higher with alcohol use in the week before the attempt¹³

So: drinking a year before trying doesn't seem to matter much. Drinking within a month of trying starts to matter a lot. If you know you're ovulating soon, this is a good time to find out exactly when — and then stop drinking.

Not convinced yet?

More recent IVF studies find similar effects. A Harvard study grouped women by alcohol consumption right before their first IVF cycle and found daily drinkers had twice the risk of miscarriage after becoming pregnant.¹⁵ A large study at Boston-area IVF clinics found higher alcohol consumption at the start of treatment was associated with lower estrogen levels, 48% lower odds of egg fertilization, and 21% lower live birth rates.¹⁶ This evidence comes mostly from IVF settings, which can be hard to extrapolate to natural conception — but the overall picture is pretty consistent.

What about male partners?

This isn't just on the woman trying to conceive. In an IVF setting, the odds of a live birth were 35% lower when the male partner drank one alcoholic beverage per day.¹⁶ If all of this feels discouraging, here's the reassuring part: you should already be avoiding alcohol once pregnant, and the fertility-related effects of drinking beforehand appear to reverse once you stop and give your body time to reset.

References

1. Hanson, Streissguth & Smith (1978). J Pediatrics, 92(3), 457–460. 2. Floyd, Decouflé & Hungerford (1999). Am J Prev Med, 17(2), 101–107. 4. McCormack et al. (2017). Alcoholism, 41(2), 369–378. 5. Tan et al. (2015). MMWR, 64(37), 1042–1046. 6. Grodstein, Goldman & Cramer (1994). Am J Public Health, 84(9), 1429–1432. 7. Greenlee, Arbuckle & Chyou (2003). Epidemiology, 14(4), 429–436. 8. Jensen et al. (1998). BMJ, 317(7157), 505–510. 9. Curtis, Savitz & Arbuckle (1997). Am J Epidemiol, 146(1), 32–41. 10. Olsen et al. (1997). Alcoholism, 21(2), 206–212. 11. Juhl et al. (2001). Human Reproduction, 16(12), 2705–2709. 12. Gaskins et al. (2015). J Nutrition, 146(4), 799–805. 13. Klonoff-Cohen, Lam-Kruglick & Gonzalez (2003). Fertility and Sterility, 79(2), 330–339. 14. Abadia et al. (2017). Human Reproduction, 32(9), 1846–1854. 15. Dodge et al. (2017). J Assist Reprod Genet, 34(7), 877–883. 16. Rossi et al. (2011). Obstetrics and Gynecology, 117(1), 136–142.