It is well known that drinking alcohol while pregnant can lead to certain types of birth defects, developmental delays, and learning issues in children. What is less known is how or if alcohol consumption affects in vitro fertilization (IVF).1 Because of the high costs of IVF, it is important to understand the risks of drinking alcohol in order to optimize each treatment cycle.
What is IVF?
IVF is a type of fertility treatment for people who are unable to conceive naturally. A typical course of treatment involves collecting a woman’s eggs, fertilizing them outside of the womb, and transferring the resultant embryos back to the womb in hopes of a successful birth.2 The number of embryos that are transferred generally depends on the age of the woman but may be additionally influenced by the level of ovarian response to the fertility hormone known as FSH (which is administered as part of the IVF protocol).2
Partner or donor sperm are then washed and spun to allow for the healthiest, most-active sperm to be selected.2 If there are suitable embryos left over, they may be frozen and used during future IVF attempts.2
How Much Does It Cost?
As part of the Access to Care Summit (ASRM) in 2015, it was reported that the average cost of one IVF cycle was a little more than $12,400.3 Additional fees for chromosomal or genetic testing of embryos ranged from $2,000 to $5,000 and to store healthy eggs and embryos yearly, it costs an extra $1,000.3 And, since many patients have to undergo multiple treatment cycles to achieve a pregnancy, those costs can double and triple before couples are able to successfully conceive.12
Across the nation, only 16 states have passed laws that require insurers to cover or offer coverage for infertility diagnosis and treatment.4 As of 2018, those states are:4
- New Jersey
- New York
- Rhode Island
- West Virginia
Of those, California and Texas are the only two where insurers only need to offer coverage for infertility treatment.4
Alcohol and Fertility: Does Alcohol Increase Risk?
Although men are more likely to drink larger amounts of alcohol, alcohol is absorbed and distributed in body tissues differently than men. A given amount of drinking equates to relatively higher blood alcohol levels in women, which means that same amount takes relatively longer to metabolize.5 As a result, consuming alcohol is more likely to cause long-term health problems more in women than in men.5 These include cognitive and physical issues such as memory loss, liver disease, and cancer, excessive alcohol use may disrupt the menstrual cycle and increase the risk of infertility.5
In men, the reproductive system consists of the anterior pituitary gland, hypothalamus, and the testes.6 Alcohol can interfere with the function of each of them, thus leading to reproductive issues such as impotence and infertility.6 In one study, men with chronic alcohol use produced significantly lower semen volume, sperm count, sperm mobility and number of normally-shaped sperm cells.7 Like women, men are advised to refrain from excessive alcohol consumption if they want to increase their chances of procreating.7
Stats & Information on Infertility
Infertility affects millions of people across the globe. According to the World Health Organization, 1 in every 4 couples in developing countries are affected by infertility.8
In the U.S., a recent study reported that around 7.3 million women aged 15 to 44 have used infertility services.3 The same survey reported that 6.7% of married women are infertile and 12.1% of women have an impaired ability to conceive biologically.3 In that same age group, men have a 9.4% infertility rate and 15.8% of married men aged 25 to 44 are infertile or subfertile (i.e. having a reduced chance of conceiving naturally).3
Age also plays a role in infertility with women in the their 30s being about half as fertile as they were in their early 20s.9 Their chances of natural conception decline significantly after age 35. While male fertility also declines with age, it happens more gradually.9
Can Consuming Alcohol Affect IVF?
There is a limited amount of research on alcohol use in the IVF population; however, studies suggest that alcohol use in women at the time of IVF cycle start can have a negative effect on cycle outcomes.1 The U.S. Surgeon General also advises that woman who are considering becoming pregnant or are already pregnant should abstain from drinking alcohol.10
Even a moderate amount of alcohol consumption by men or women at the time of IVF cycle start has shown a negative effect on cycle outcomes, specifically failure of fertilization and live birth.1 One study found that women who drank the month before attempting IVF were at an increased risk of not becoming pregnant.11 Also, those who drank 1 alcoholic beverage a day were associated with fewer egg cells retrieved, while those who drank 1 week before IVF were at an increased risk of miscarriage.11 Other studies suggest that women who drank 4 alcoholic drinks per week saw a decrease in IVF live birth rates.1,11
Based on the high cost of IVF—money, time, and emotional stress—it is important to optimize each cycle. Therefore, any lifestyle or environmental factors that may have a detrimental effect on the process should be identified and avoided.1
. U.S. National Library of Medicine. (2011). Effect of Alcohol Consumption on In Vitro Fertilization.
. National Health Services (U.K.). (2018). What happens, IVF.
. Iris G. Insogna, MD, MBE and Elizabeth S. Ginsburg, MD. (2018). Infertility, Inequality, and How Lack of Insurance Coverage Compromises Reproductive Autonomy. AMA J Ethics, 20(12), E1152-1159.
. National Conference of State Legislatures. (2018). State Laws Related to Insurance Coverage for Infertility Treatment.
. Centers for Disease Control and Prevention. (2016). Fact Sheets – Excessive Alcohol Use and Risks to Women’s Health.
. Mary Ann Emanuele, M.D., and Nicholas V. Emanuele, M.D. (1998). Alcohol’s Effects on Male Reproduction. Alcohol Health & Research World, 22(30); 195-201).
. Borges E., Pasqualotto F.F. (2014). The Effect of Alcohol Consumption on Male Infertility. In: du Plessis S., Agarwal A., Sabanegh, Jr. E.
. World Health Organization. (n.d.). Global Prevalence of Infertility, Infecundity And Childlessness.
 U.S. Department of Health and Human Services. (2018). How Common is Infertility?
. The American College of Obstetricians and Gynecologists. (2011). At-Risk Drinking and Alcohol Dependence: Obstetric and Gynecologic Implications.
. U.S. National Library of Medicine. (2013). In Vitro Fertilization Outcomes and Alcohol Consumption in At-Risk Drinkers: The Effects of a Randomized Intervention.
. Centers for Disease Control and Prevention. (2018). 2016 Assisted Reproductive Technology Fertility Clinic Success Rates Report.