17 September 2019
Exercise and Fertility Treatment
Including exercise in your routine can be an important step towards one’s journey to conceive. Regular moderate exercise can help maintain stable insulin levels improving glucose homeostasis and insulin sensitivity, as too much insulin can be detrimental to eggs and sperm. Exercise contributes to hormone regulation, optimising the reproductive system while improving metabolism and circulation which may help contribute to improved egg and sperm production. Exercise can promote regular detoxification of excess hormones and toxins from the body important for fertility. Additionally, regular physical activity can help relieve stress and anxiety, which have both been shown to be potential risk factors that can affect the assisted reproductive outcome (1). Moderate exercise should be included in conjunction with a healthy fertility friendly diet when looking at lifestyle factors to improve one’s fertility.
Research has shown that regular workouts could improve reproductive function, as a study in Obstetrics and Gynaecology showed that women who exercised 30 minutes or more day had a reduced risk of infertility due to ovulation disorders (2). Though going the opposite direction with extreme exercise or vigorous exercise has been linked with lowered fertility (3). So balance is key. Incorporating exercise before fertility treatments can be beneficial especially if not active already as female physical activity before IVF/ICSI cycles was associated with increased rates of clinical pregnancy and live births, these results showed that exercise before IVF/ICSI cycles could help physically inactive women to improve their chance of a successful pregnancy (4).
For men and women who are overweight and obese exercise can help maintain weight or achieve a modest weight loss which improves general health and fertility. Extremes in BMI (body mass index) both under and above can affect fertility. Studies have shown, even 10 % of weight loss can be beneficial in improving chances of conception (5). Studies have found that physical activity of any type may improve fertility among overweight women, a subgroup at higher risk of infertility. While women of leaner disposition who substitute vigorous exercise with moderate exercise may also improve their fertility (6).
While obesity in men can reduce sperm quality and therefore fertility. Regular moderate physical activity can help men lose weight or stay in the healthy weight range therefore improve sperm quality. But, large amounts of high intensity exercise can be detrimental for sperm quality and should be avoided while trying to achieve pregnancy (7).
During Fertility Treatment
During fertility treatment including in vitro fertilisation (IVF) and insemination (IUI) it is important for women to scale back on exercise as this is the time you want to protect your ovaries as they become more enlarged and sensitive during treatment. As a general rule during fertility treatment it is advised to avoid high intensity and high impact training, heavy weight lifting and intensive cardiovascular exercise instead opting for more low impact exercise which is less stressful on the body. Even if you are used to vigorous exercise, during treatment it is advised to scale back to low intensity. Women who are undergoing IVF treatment where the ovaries are stimulated to produce a number of follicles can be at risk of medical emergency called ovarian torsion with vigorous exercise being a risk factor especially within the week of egg collection or after. Large body movements may also redirect circulation from the areas we need it directed to during fertility treatment, for example potentially increasing blood flow to muscles instead of to the reproductive system and a women’s eggs (8). As you progress through stimulation treatment you may also feel more bloated, fatigued and mild discomfort as the size of the ovaries increase, therefore the last thing you will want to do is take part in a high intensity work out! It is still important to maintain some physical activity though such as regular walking, swimming, light resistance training, stretching or gentle yoga/Pilates. It is important to adhere to the advice ‘listen to your body’ during this time as it is important to incorporate a sense of self care for oneself. Fertility treatment can be difficult enough with the potentially heightened emotions, medications, and fertility procedures without going hard at the gym! So how to you get the balance between too little or too much exercise? We would recommend 30 minutes 3 – 4 times a week with no more than 4 hours exercise a week during fertility treatment.
With potential pregnancy
Once potentially pregnant, therefore in fertility treatment after insemination or an embryo transfer we would advise our patients to only engage in light to moderate exercise such as walking, swimming (not until at least three days after a transfer) and gentle yoga/Pilates. It is also not recommended to start any new or intensive exercise programme when pregnant.
The two week wait can be very difficult as you are not usually involved in the usual routines of attending for scans/bloods at this stage therefore it is only a case of waiting until test date and trying one’s hardest to stay off Google searching to decipher every possible symptom you may be feeling. If you are normally an avid exerciser then it can be difficult to take it easy during this time and you may miss the beneficial psychological effects of exercise. Instead look at other forms of stress coping strategies such as incorporating acupuncture, meditation, gardening or a walk-in in nature during this time.
If you are having trouble either conceiving naturally or during fertility treatment then always consider your exercise routine, is it too little, or too much and moderate as needed. Always feel free to speak to your Fertility consultant or Nurse if you have any questions. Sims IVF work with Gym Plus who have been trained to work with fertility patients. If you would like more information on our partnership with Gym Plus please email firstname.lastname@example.org
By Anita Foote
References: (1)Barton-Schuster (2019) Accessed at http://www.natural-fertility-info.com; (2) Charvarro JE et al (2007) Obstet Gynecol, 110, 1050-8; (3)Rodino,I et al (2015) Obstet Gynae 56,1 ; 82-87;(4)Rao, M et al (2018). Reprod Biol Endocrinol, 16:11 ;( 5) Clark et al (1995) Hum Reprod, 10 (10) 2705-12 ;( 6) Wise, l et al 92012) Fert Sterl 97 (5) 1136-142; (6) Palomba, S et al (2014) RBMO 29 (1) 72-79; (7) The Fertility Society of Australia, Accessed at http//.www.Yourfertility.org.au;(8) The Fertility Institute (2018), accessed at http//.www.fertilityinstitute.com