Optimal Fertility: Cocktails or Mocktails?
Infertility is stressful, no question about it! So the question is: to drink or not to drink?
In this blog, I talk about the research on alcohol and fertility and offer some mocktail and “lower alcohol” cocktail recipes if you are going to have a drink. It’s helpful to have some facts and recipes to make a good decision.
There are so many non-alcoholic drinks for pregnant women (also known as “preggatinis“), but you don’t see “fertilatinnis” (I totally made that up) on the menu because there is no set rule about not drinking when TTC.
Clients often ask, “Is it OK to drink while trying to get pregnant?” Most natural health fertility practitioners, myself included, generally advise clients not to drink. But if you’re going to have a drink and you are not pregnant, what would some healthier options be when TTC?
First, let’s look at the science behind how alcohol affects women’s fertility and how alcohol affects men’s fertility. How does alcohol affect ovulation? Does alcohol affect egg quality? How long does alcohol affect sperm? All good questions so you can make an informed decision on what to do.
Fertility 101
To start with the basics: we want the body working optimally for fertility. That means nourishing food, moderate exercise, good blood sugar control,lots of antioxidants, and reduced inflammation.
When we can’t get pregnant, especially if it is “unexplained infertility,” there is often a reason lurking somewhere in our health. This is why functional medicine is important in looking for “root causes” instead of treating the symptom. When infertility is “unexplained” there is no symptom to treat. Getting your body as healthy as possible is the key and alcohol is not a necessary item and can inhibit optimum health (although it can have some health benefits).
What’s up with alcohol?
Alcohol is processed by the body differently than food. It is a toxin and the liver breaks down alcohol from a toxic substance to water and carbon dioxide, with the rest excreted through the lungs which is why you can smell someone when they have been drinking a lot (and why we use breath tests). The rest goes through the kidneys that we excrete out as pee and is released in sweat.
Alcohol impacts how the brain communicates with the body and that’s why too much can lead to a change in “normal” behavior. Regular drinking and excessive drinking come with some side effects other than the buzz. The impact alcohol has on you depends on your body weight, your muscle mass and your tolerance.
How alcohol impacts female fertility
Heavy alcohol use may diminished ovarian reserve and fertility in women. Ovarian reserve is a measure of a woman’s reproductive potential determined by how many eggs she has in her body. It can be measured in a variety of ways, including serum follicle stimulating hormone (FSH) and anti-Müllerian hormone (AMH) levels as well as antral follicle count.
Although the decline comes with age, you can accelerate the decline with an unhealthy diet, extra stress, over exercising, and drinking. You want as many eggs as possible when TTC.
How drinking can impact females
Additional ways drinking can interfere with fertility:
interrupting menstrual cycle and ovulation causing changes to ovarian function, known as amenorrhea and anovulation, respectively
changing hormone levels of testosterone, estradiol and luteinizing hormone
causing hyperprolactinemia or high prolactin in the blood
(Source: Healthline)
Does alcohol reduce female fertility?
There is more research to show the negative impacts of alcohol on fertility.
For example, a study of African American women in Michigan found that women who regularly binge drink two or more times a week had a 26% lower AMH level than drinkers who don’t binge, after age-adjustment.
Another study published in the journal Obstetrics and Gynecology found that women beginning an in vitro fertilization (IVF) treatment who drank four or more drinks per week were 16 percent less likely to have a live birth than those who drank less than that or not at all.
When both partners drank at least four drinks a week, the rate of live birth was reduced even further, down to a 21 percent less chance of having a live birth when compared to couples who didn’t drink or drank less than four drinks per week.
However, moderate drinking may not impact fertility.
The New York Times referenced a large study in Denmark indicating that moderate alcohol consumption does not seem to impact a woman’s fertility, although it is known to decrease sperm count in a man.
Danish researchers studied 6,120 women trying to conceive in stable relationships with male partners. The women reported their drinking habits in questionnaires. By the end of the study, 4,210 of the women had gotten pregnant.
Women who drank the alcoholic equivalent of one to 13 four-ounce glasses of wine a week were no less likely to conceive than those who abstained completely. A typical bottle contains about 25 ounces of wine, and people often drink glasses containing five or more ounces in a sitting, so with two to three restaurant glasses of wine you would easily be over the line.
Note that the same study found that heavier drinking — the equivalent of two bottles of wine or more a week — was associated with an 18 percent decrease in ability to conceive. That’s a big drop and two bottles of wine is totally possible if you are drinking several days a week.
If you’ve traveled in Europe, you might be astonished by how small the standard glasses of wine are there. My Grandmother used to drink out of one at home daily and I honestly thought it was more of a sherry glass than a wine glass. It’s easier to be a moderate drinker in Europe.
If you’re drinking out here in the US, stick to one or two glasses, max.
Men’s drinking matters: alcohol does impact sperm.
One of the things that drives me nuts about the modern IVF model is that men don’t seem to matter. I have personally heard it as a patient and had clients tell me they were told, “He’s fine, he doesn’t need to do anything.”
Your man absolutely matters! In more ways than one. He is 50% of the partnership and needs to be there for this journey and his health determines 50% of your chance as a couple of getting pregnant.
The basic semen analysis is not enough information, which is why I advocate for more advanced semen testing to make sure you are not swinging through hoops and going through lots of procedures when it may be that male infertility is a contributing factor.
So, how does alcohol affect the reproductive system in males? The research on men is similar and it all comes down to the “heavy drinking” category. Yet, men are more likely to chug five beers in a sitting than women.
Studies found that heavy alcohol consumption results in reduced testosterone levels in the blood. Alcohol also impairs the function of the testicular Sertoli cells that play an important role in sperm maturation. In the pituitary gland, alcohol can decrease the production, release, and/or activity of two hormones with critical reproductive functions, luteinizing hormone and follicle-stimulating hormone. Finally, alcohol can interfere with hormone production in the hypothalamus.
Heavy, consistent drinking or binge drinking—five or more drinks in a two-hour timeframe—has negative effects on sperm. More than 14 mixed drinks in a week can lower testosterone levels and affect sperm count.
How Drinking impacts Males
lowering testosterone levels, follicle stimulating hormone, and luteinizing hormone, and raising estrogen levels, which reduce sperm production
shrinking the testes, which can cause impotence or infertility
changing gonadotropin Trusted Source release which impacts sperm production
causing early ejaculation or decreased ejaculation
changing the shape, size, and movement of healthy sperm
(Source: healthline)
What to do about drinking when TTC?
If you can go without drinking, my top recommendation for couples TTC is sticking to healthy mocktails for pregnancy.
Avoid sugary sodas! Try my easy mocktail recipe below, Rebecca Katz’s delicious Pomegranate Mock Mojito, or any of the sugar-free mocktails here.
Salted Watermelon Lime fizz
Refreshing and fun for summer!
Ingredients
2 cups of cubed watermelon
5-10 mint leaves
Juice of 2 limes
2 cups sparkling water or ginger kombucha if you want a tangy kick
Instructions
Salt the rim of your glass with celtic sea salt.
Blend watermelon, mint, and lime juice in a blender until combined. Add a bit of crushed ice to the blender to give it a more frozen drink consistency.
Pour over ice and top up with sparkling water or ginger kombucha. Stir very lightly to keep it frozen.
Viola!
On the other hand, I get it. Infertility sucks. It’s stressful, emotionally, financially draining, and hard on your relationship. If you want to have 1-3 glasses (total) of alcohol a week, before and right at the time you are TTC, then go ahead.
If you are going to drink when TTC…
My suggestions are to go with an organic or biodynamic wine. Grapes have lots of pesticides that you’ll want to avoid. My current favorite is this biodynamic syrah and the company was the first european winery to obtain B-Corp status. Good to people and good for the earth. I get mine at Whole Foods Market in DC.
Other options are hard kombucha, another new favorite drink of mine if you like the cold, fizz of beer. It has a nice fermented taste. My two favorites are Flying Embers Grapefruit with a hint of thyme hard kombucha and for a more hoppy taste (and 8% alcohol level), Strainge Beast blood orange & passion fruit hard bucha.
If you want a cocktail, a low sugar cocktail like a vodka tonic or vodka seltzer are good options. Avoid the daiquiris and super sweet cocktails where you are getting lots of sugar in addition to the alcohol—not a good thing for fertility because it promotes inflammation and high blood glucose.
I am not a fan of the gluten in beer and I’d like you to avoid beer along with wheat based drinks. Yeah, that’s bourbon, rye, whiskey, and gin. (You can have lots of old fashioneds after you have a kid!) You can have cider or hard seltzers that are vodka based. Check to see if your vodka is potato-based and avoid the ones that are corn- and wheat-based.
Confused by it all?
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