Several studies have linked alcohol and infertility. Although the exact amount of alcohol consumption associated with infertility in uncertain, it is true that heavy drinking can lead to impotence, decreased libido, and reduced sperm count in men. High alcohol consumption by females can lead to menstrual irregularities, altered blood levels of estrogen and progesterone, and in pregnant women, may have deleterious effects on the unborn child including stillbirth. Therefore, our habits are an essential factor for both male and female fertility.
What do studies show?
The following are some studies that have been performed to demonstrate the effect of alcohol on male and female fertility.
- In a case-control study of 3,833 women in the United States and Canada, a rise in infertility due to ovulation disorders or endometriosis was found in women who consumed alcohol.
- An analysis including 430 Danish couples of 20 to 35 years of age trying to conceive for the first time showed that alcohol intake in women reduced their fertility. This was also seen in women who drank five or fewer drinks a week.
- In another European study including 7,760 Danish women, infertility problems were reported in women older than 30 years and those who consumed seven drinks or more of alcohol per week.
- In a long-term random study of 7,393 Swedish women, it was found that high alcohol consumption of more than six fluid ounces per week was significantly associated with infertility.
- In a multi-centre study in Europe, women who consumed eight drinks or more of alcohol per week were less likely to become pregnant in one attempt.
- Another study focused on couples undergoing assisted reproductive therapy (ART) and reviewed charts of couples’ alcohol consumption during and the year before treatment. It was found that both male and female alcohol consumption profoundly reduced the probability of live birth and increased the risk of miscarriage.
The T-ACE questionnaire
It is essential that all patients be screened for alcohol consumption during their first prenatal visit. Although the goal of infertility treatment is pregnancy, the use of a screening method to identify the risk is practical. The T-ACE questionnaire is a four-item survey including the following questions:
- Tolerance: How many drinks does it take to make you feel high?
- Annoyance: Have people annoyed you by criticising your drinking?
- Cut Down: Have you felt you ought to cut down on your drinking?
- Eye Opener: Have you ever had a drink first thing in the morning to steady your nerve or to get rid of a hangover?
In a study, 350 women were surveyed by the T-ACE questionnaire. The questionnaire was able to screen women who had more than two drinks per day before and while they were pregnant. The T-ACE questionnaire has been validated to work well in socially and ethnically diverse women and is superior to the SMAST and AUDIT questionnaires.
In conclusion, while there is a controversial link between the amount of alcohol and infertility, studies conclusively show that couples trying to conceive should be screened for alcohol consumption. Infertile couples that seek medical interventions should be asked to modify their alcohol consumption and lifestyle factors to increase their probability of conceiving.