We considered posting this episode on New Year's Eve, when toasting in the New Year is likely to happen, rather than New Year's Day, when many celebrants are waking up to a sore head, a fuzzy tongue, and second thoughts about that third round of shots. It's OK to celebrate — but alcohol is a tricky question when it comes to fertility. How much is too much?   In this episode you’ll hear: [00:00] Intro [2:20] Stopping alcohol in pregnancy message is out but what about while trying [4:28] Research of female fertility and alcohol intake – studies resources listed below [8:30] Research of male fertility and alcohol – studies and resources listed below [10:44] Recap of the evidence for reproductive health [11:23] What I tell my patients about alcohol and fertility  [14:23] Fertility Story – alcohol and fertility   Resources mentioned:  Female reproductive health research: Eggert, J et al. Effects of alcohol consumption on female fertility during an 18-year period Fert Ster 2004;81:379-383 https://www.sciencedirect.com/science/article/pii/S0015028203027171 A cohort study of 7,393 women in Stockholm observed that the risk of infertility was significantly increased (relative risk [RR], 1.59; 95% CI, 1.09–2.31) among women who consumed two alcoholic drinks per day and decreased (RR, 0.64; 95% CI, 0.46–0.90) in those who consumed less than one drink per day.   Anwar MY, et al. The association between alcohol intake and fecundability during menstrual cycle phases. Hum Reprod 2021;36:2538-2538. https://academic.oup.com/humrep/article/36/9/2538/6294415?login=false Moderate drinking, especially in the luteal phase associated with lower fertility   Mikkelsen EM, et al. Alcohol consumption and fecundability: prospective Danish cohort study. BMJ 2016;354:i4262  https://www.bmj.com/content/354/bmj.i4262.long Consumption of less than 14 servings of alcohol per week seemed to have no discernible effect on fertility. No appreciable difference in fecundability was observed by level of consumption of beer and wine.    Tolsrup JS, et al. Alcohol use as predictor for infertility in a representative population of Danish women. Acta Obstet Gynecol Scand. 2003 Aug;82(8):744-9. doi: 10.1034/j.1600-0412.2003.00164.x. https://pubmed.ncbi.nlm.nih.gov/12848646/ Data obtained by self-report from 29,844 pregnant Danish women suggested that time to conception was shorter for women who drank wine than for women who consumed no alcohol.    What does ASRM say? In their Optimizing Natural Fertility Practice Committee Guideline: https://www.asrm.org/globalassets/asrm/asrm-content/news-and-publications/practice-guidelines/for-non-members/optimizing_natural_fertility.pdf “Higher levels of alcohol consumption by women (more than two drinks per day, with one drink containing 10 g of ethanol) probably are best avoided when attempting pregnancy, but there is limited evidence to indicate that more moderate alcohol consumption adversely affects fertility.  Of course, alcohol consumption should cease altogether during pregnancy, because alcohol has well-documented detrimental effects on fetal development, and no ‘‘safe’’ level of alcohol consumption has been established.”   Male reproductive health research: Finelli R, et al. Impact of Alcohol Consumption on Male Fertility Potential: A Narrative Review. Int J Environ Res Public Health. 2022 Jan; 19(1): 328. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8751073/ Excellent review of alcohol metabolism and effects on cellular function with a focus on the detrimental effects on sperm    Hassan M, et al. Negative lifestyle is associated with a significant reduction in fecundity. Fert Ster 2004; 384-392. https://www.sciencedirect.com/science/article/pii/S0015028203028462 Survey study, partners of men with heavy alcohol consumption had a longer time to pregnancy than partners of mild drinkers and nondrinkers.    What does ASRM say? In their Optimizing Natural Fertility Practice Committee Guideline: https://www.asrm.org/globalas