Should You Limit Alcohol Before Embryo Transfer?

What is the guidance and/or risk associated with drinking alcohol prior to a frozen embryo transfer? I already have frozen embryos, so I’m just asking about the period from when I start doing the injections again before the transfer up until the transfer date.

—Lizzy

This is unfortunately a tough thing to study, so there isn’t great data or national guidelines to help your decision here.

Most studies on alcohol’s effect on health rely on people self-reporting their alcohol use, which can lead to underestimating alcohol exposure. There’s also the question of who should be used as a reference group to compare alcohol exposure; even studies that follow the same individuals over time ask only about alcohol use at single time points, which overlooks the potential effects of prior heavy alcohol use. Many of the studies looking at alcohol use and fertility specifically do not look at the pattern of drinking (such as binge drinking), nor potentially related behaviors. And because there is some evidence to suggest that alcohol can have a negative effect on IVF outcomes, as well as the ethics of giving alcohol to individuals without their knowledge, we are never going to get a randomized controlled trial on this subject.

The concern with an embryo transfer cycle is the impact of alcohol on the ability of the embryo to successfully implant and establish a pregnancy. Again, as far as I can tell, there have not been any studies looking at this specific question. What we do know is that alcohol has been found to increase levels of estrogen, which can hinder ovulation and prevent successful implantation. But because we do not have data, we do not know how this interacts with and changes with the various protocols for frozen embryo transfers after IVF. For example, theoretically, alcohol-induced elevated estrogen levels could negatively impact follicle development during a natural or modified natural embryo transfer protocol in which the embryo transfer is dependent on the timing of ovulation. But it is still unclear how this would impact a programmed embryo transfer cycle in which natural ovulation is suppressed.

A reasonable approach here is to discuss this with your provider to see if your fertility practice has any internal guidelines to help you. In many practices, it’s recommended to limit alcohol use to one or two drinks a day until the embryo transfer. Good luck!