Does moderate alcohol consumption affect fertility? Follow up study among couples planning first pregnancy

BMJ 1998;317:505-510 ( 22 August )

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Does moderate alcohol consumption affect fertility? Follow up study among couples planning first pregnancy

Tina Kold Jensen, postdoctoral fellow, ^a Niels Henrik I Hjollund, physician, ^b Tine Brink Henriksen, physician, ^c Thomas Scheike, associate professor of biostatistics, ^d Henrik Kolstad, physician, ^b Aleksander Giwercman, physician, ^a Erik Ernst, physician, ^c Jens Peter Bonde, chief doctor, ^b Niels E Skakkebæk, professor, ^a Jørn Olsen, professor. ^e

^a Department of Growth and Reproduction, National University Hospital, Rigshospitalet, Section GR 5064, 9-Blegdamsvej, DK-2100 Copenhagen, Denmark, ^b Department of Occupational Medicine, Aarhus University Hospital, Nørrebrogade, 8000 Aarhus C, Denmark, ^c Perinatal Epidemiological Research Unit, Department of Obstetrics and Gynaecology, Aarhus University Hospital, ^d Department of Biostatistics, University of Copenhagen, 2200 Copenhagen N, ^e Danish Epidemiology Sciences Centre, Aarhus University, Hoegh-Guldbergs Gade 10, 8000 Aarhus C

Correspondence to: Dr Kold Jensen tk.jensen{at}winsloew.ou.dk

Objective: To examine the effect of alcohol consumption on the probability ofconception.
Design: A follow up study over six menstrual cycles or until a clinically recognised pregnancy occurred after discontinuationofcontraception.
Subjects: 430 Danish couples aged 20-35 years trying to conceive for the firsttime.
Main outcome measures: Clinically recognised pregnancy. Fecundability odds ratio: odds of conception among exposedcouples divided by odds among those notexposed.
Results: In the six cycles of follow up 64% (179) of women with a weekly alcohol intake of less than five drinks and55% (75) of women with a higher intake conceived. After adjustmentfor cycle number, smoking in either partner or smoking exposurein utero, centre of enrolment, diseases in female reproductiveorgans, woman's body mass index, sperm concentration, and durationof menstrual cycle, the odds ratio decreased with increasing alcoholintake from 0.61 (95% confidence interval 0.40 to 0.93) amongwomen consuming 1-5 drinks a week to 0.34 (0.22 to 0.52) amongwomen consuming more than 10 drinks a week (P=0.03 for trend)compared with women with no alcohol intake. Among men no dose-responseassociation was found after control for confounders includingwomen's alcoholintake.
Conclusion: A woman's alcohol intake is associated with decreased fecundability even among women with a weekly alcoholintake corresponding to five or fewer drinks. This finding needsfurther corroboration, but it seems reasonable to encourage womento avoid intake of alcohol when they are trying to becomepregnant.

Key messages

As alcohol consumption is widespread and increasing in many countries, even a minor effect on fertility is of public health interest
Some studies have found that women with high alcohol intake take longer to become pregnant, but none have found that moderate intake has an effect
The probability of conception in a menstrual cycle decreased with increasing alcohol intake in women, even among those drinking five or fewer drinks a week
Women who are trying to conceive should be encouraged to avoid intake of alcohol

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