Should You Exercise When Trying to Get Pregnant?

Social media is awash with #fitpreggo moms-to-be weightlifting and dancing their way to parenthood. But when you’re still trying to get pregnant, how does fitness fit in?

Although you should always consult your doctor about what activity level is right for you, here are some considerations.

Are You Already Exercising?
Exercise is an important part of a healthy lifestyle so if you have a regular menstrual cycle and have been working out, experts say, continue. If you’re not, consider starting.

Dr. Max Ezzati, of the Palo Alto Medical Foundation, Fertility Physicians of Northern California, says that when you are dealing with infertility, exercise can help alleviate some of the anxiety and tension of such a stressful process — for women and men. He adds, “Exercise, especially aerobic exercise, can also help make antioxidants more available in the body, which may help improve the quality of the egg and sperm.”

Dr. Daniel Christie, at IVF Florida, says, “If a patient trying to get pregnant tells me ‘I’m thinking of training for the Ironman,’ I would say: ‘Not now.’ But if you have been running regularly and want to continue, that’s fine.”

“Yoga is the overall favorite, for me, as a doctor recommending exercise, and for my patients,” he says. “It helps in so many ways—with stress management, but also particularly to prepare you for pregnancy; it helps develop or maintain core strength, prevent or reduce leg/back pain, and improve flexibility and joint health.”

Yoga is the overall favorite — for me, as a doctor recommending exercise, and for my patients. It helps in so many ways.Does Exercise Rule Your Routine?
If you are a high-intensity, “can’t stop, won’t stop” athlete, but your periods have stopped or are irregular, you’ll have to make some changes, because this complicates ovulation, fertilization, and implantation.

Ovulatory dysfunction is a common cause of infertility, especially for women who are underweight due to intensive exercise and/or calorie restriction. They have hypothalamic amenorrhea, meaning their period stops and they may not produce and release eggs.

If there’s enough energy in the body, Ezzati says, the brain, the “command center” for conception, releases hormones that send a green light to the ovaries. (The hypothalamus secretes GNRH which signals the pituitary gland to release FSH and LH).
If there’s too much stress or not enough energy in the body, such as if a woman has a low body mass index or weight — often seen with marathon runners — the brain sends a red light to the ovaries not to produce and release eggs.

Stopping or reducing workouts for hard-core athletes may be difficult, but consider it a temporary “pregnancy training” requirement.

Is It Time to Get Moving?
On the flip side, some ovulatory dysfunction may be from PCOS (polycystic ovary syndrome), often seen in obese women with infrequent or prolonged menstrual periods. Ezzati says that if a woman is significantly overweight or obese (and may also have PCOS), she could have too much estrogen in the blood, which could send a signal to the brain to suppress FSH and LH.

Exercise can help here, too. A key Australian study of obese women seeking fertility intervention showed a 25% increase in the rate of live births for those who made lifestyle changes like exercising and dieting for weight loss versus the comp group that sought immediate intervention. In fact, some patients no longer needed fertility assistance after the weight loss helped regulate their hormonal function.

Are You Undergoing IVF?

You can exercise when trying to get pregnant via IVF, but there’s one point when you’ll want to slow down.

“At the most aggressive stage of IVF,” Christie says, “toward the end of the stimulation period, women are getting the most hormones. The ovaries are two to four times their normal size due to follicle growth. This could cause some discomfort, so women going through it may not want to exercise.”

On rare occasions, jarring motions at this point have led to ovarian torsion (or twisting, with reduced blood flow from the ovaries). For patients who do want to move, Christie recommends walking, gentle yoga, or swimming.

The protocol for what happens on and after embryo transfer day, is evolving.

Christie says: “In the past, post embryo transfer we used to (and some doctors still) keep the patient on the bed at a slight decline for 30 to 40 minutes, but a Fertility and Sterility study showed that there was a statistical difference in the pregnancy rates of an active group versus a rest group, with the active group being higher. Now, after transfer, patients are [essentially] off the table and out the door.”

Ezzati agrees that they used to have patients lay still for a time, but now they have patients wait no longer than 5 to 10 minutes because the study showed that “almost immediate ambulation after transfer improves success.”

There are different recommendations for embryo transfer day; guidance is more informed opinion than evidence based; check with your doctor. Exercise concerns are about avoiding an excessively elevated heart rate leading to abnormal blood flow and physical stress interfering with normal hormone activity.

On the day of embryo transfer, many doctors believe you should feel free to move around, but don’t swim (or bathe), to be cautious about possible infection.

If you want to exercise during the two weeks from transfer day until the beta (hCG) pregnancy test, Ezzati and Christie advise moderate exercise (according to your target heart rate), but avoid demanding, vigorous routines. (Figure out your target heart rate here).