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Can You Drink When You're Trying?

The short answer: It’s clear as Cristal that you shouldn’t booze it up. Not while you’re pregnant, and not while you’re trying to get pregnant either. Alcohol is the most common known, preventable cause of mental and physical birth defects in the United States. Every year, about 40,000 babies are born with fetal alcohol spectrum disorders (FASDs), according to a report done by the U.S. Department of Health and Human Services. The effects of FASDs vary widely, from mild learning disabilities or physical abnormalities, to the most severe, fetal alcohol syndrome, which causes facial deformities, mental retardation, growth deficiencies, and central nervous system damage. Since most women won’t know they’re pregnant immediately, the safest strategy is to start teetotaling even before you get the positive pregnancy test.

While there are some doctors who are a bit more lenient, and who advise their patients that an occasional glass of wine while pregnant—or trying—is probably okay, the biggest hurdle to safety is that there’s really no data to determine how much is too much. There’s never been a study to conclude what amount of alcohol is safe to drink during pregnancy. (Think about it—how could they ethically study it?) So there’s no real answer to how much alcohol can cause damage. A sip of champagne? Probably won’t harm anything. Two sips of champagne? Again, probably won’t do much damage. A glass of eggnog? Aye, there’s the rub. If there’s no research to tell you where you can draw the line, how can you know for sure?   

What we do know is that the risk of having a baby with FASD is dose-dependent, meaning it increases with the amount of alcohol you consume. And so the recommendation of multiple federal and local health agencies and organizations is that women shouldn’t drink at any time during pregnancy, or beforehand if they’re planning to become pregnant. “The party line is, if you’re trying to conceive you shouldn’t drink,” says Peter Bernstein, M.D., MPH, professor of clinical obstetrics and gynecology and women’s health director of the fellowship program in maternal fetal medicine at Montefiore Medical Center/Albert Einstein College of Medicine and a member of the CDC’s Select Panel on Preconception Care.

So what are the risks if you realize that you had a glass of wine before you knew you were pregnant? That’s actually a very common scenario; according to the CDC, only about 40 percent of pregnant women even realize they’re pregnant at four weeks of gestation.

If that happens, don’t panic. Even Dr. Bernstein says that one drink will probably not be harmful. But if you’re actively trying, or you know you’re pregnant, the consensus is: Don’t drink. And if you’re more than an occasional social drinker and you’re planning to be pregnant soon, talk to your doctor or seek help with quitting before you ditch the contraceptives.

Alcohol and Fertility
Another important question is, does alcohol help or hinder conception? Unfortunately, there’s no easy answer to that question. Although plenty of research has been dedicated to the subject, results have been all over the map. One study found that women who drank moderate amounts of alcohol were at increased risk for infertility, but two others had the opposite results: In one of these, women who were moderate drinkers got pregnant slightly faster than teetotalers. In the other, wine drinkers got pregnant faster than non-wine drinkers, and faster than beer and spirits drinkers. But even the researchers don’t necessarily attribute their results to the alcohol itself. They theorize that perhaps moderate alcohol intake correlates with more frequent sex, or perhaps it provides a degree of stress control which has a positive effect on reproduction.

With in vitro fertilization (IVF), the results have been more conclusive. A recent analysis of study results on 2,500 patients going through IVF found that women who consumed at least four drinks per week at the start of an IVF cycle were 18 percent less likely to have a live birth. “Those results were significant,” says study author Brooke V. Rossi, M.D., clinical fellow in reproductive endocrinology and infertility at Brigham and Women’s Hospital in Boston.

Bottom line? If you’re pregnant or hoping to become pregnant soon, play it safe: Don’t drink. (And tell your partner not to drink while you’re trying, too.)

A version of this story was originally published in the Winter 2009 issue of Conceive Magazine.
 

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