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Is it safe to exercise during IVF? Here’s what the science tells us

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If you’re about to start your first IVF cycle then you may be wondering: “Is it safe to exercise during IVF?”

IVF (in-vitro fertilization) is a complex process – the amount of information you have to navigate and the conflicting advice you are given is frankly overwhelming! 

It can even be more confusing as a patient to know whether or not you should exercise during IVF. 

“Is there any such thing as too much exercise during IVF?”

“What about exercise before and after an embryo transfer?”

“What about exercise during the two week wait?”

If you have asked yourself these questions, then read on as we’ll explain all you need to know about exercise during IVF.

In this guide we’ll explore:

  • Can you exercise during IVF?
  • What are the benefits of exercise during IVF?
  • Exercise at each stage of the IVF cycle
  • What are the risks of exercise during IVF?
  • What are the best exercises to do during IVF?
  • Exercises to avoid during IVF

Ready?

Let’s get started!

exercise during ivf

Can you exercise during IVF?

You may be wondering: “Is it safe to exercise during IVF?”

Whether or not you work out during your IVF cycle is down to the exercise you’re currently doing, personal preference as well as the guidance you receive from your doctor and medical team.

Advice from the Fertility Institute is to “always make sure you work closely with your doctor. They’ll know your unique case and can suggest the best approach to exercise during IVF for you.” 

Some women choose to stop high impact exercise and focus on doctor-approved, low impact exercises like walking and yoga.

While other women choose to stop exercising altogether because they either don’t want to take any risks, or it just feels too uncomfortable with all the IVF medication. 

Whether or not you exercise during IVF will also depend on the stage that you’re at in the IVF cycle.

After the embryo transfer and during the two week wait, for example, you may be advised to just stick with gentle walking.

If you are worried that exercise will impact your chances of success, then consult with your doctor and IVF medical team.

Related: Running while pregnant: Is it safe? 7 exercise tips during pregnancy

What are the benefits of exercise during IVF?

We all know the benefits of regular exercise for your physical and mental health.

Lack of exercise is often associated with diseases like obesity, type 2 diabetes, certain cancers and cardiovascular disease.

Obesity is often a cause of irregularities in the menstrual cycle, reproductive issues and poor IVF outcomes. 

There is evidence that shows that maintaining a healthy body weight is linked to successful fertility outcomes. 

One 2018 study showed that physical activity before an IVF or ICSI cycle is associated with increased rates of clinical pregnancy and live births.

The study added that only a small increase was found in implantation rate, and no effect was shown on miscarriage rate. 

Other studies have shown that regular exercise (4 hours or more per week) before IVF may actually negatively affect outcomes.

So you can see why women are often confused when it comes to exercise during IVF.

There seems to be so much contradictory evidence!

What we can take away from this evidence is that exercise remains important for all women, regardless of their age and weight. 

The research tells us that leading a sedentary lifestyle (i.e. not exercising at all) can lead to lower fertility rates. 

But doing too much exercise can have a negative effect on your menstrual cycle, ovulation and fertility. 

The bottom line? While it is generally considered safe to exercise during an IVF cycle, the type, intensity and amount of exercise that you do and at each stage of your IVF cycle matters. 

The general advice is to stick within your comfort zone and do exercise that you’re familiar with.

In other words don’t suddenly start a new, demanding fitness routine!

Related: Should you work out on your period? 6 best exercises to do on your period

exercise during ivf

Exercise at each stage of the IVF cycle

The IVF cycle is split into the following seven stages:

  1. Ovarian stimulation
  2. Egg retrieval
  3. Sperm retrieval
  4. Fertilization
  5. Embryo transfer
  6. Two week wait
  7. Pregnancy test

An average IVF cycle takes between 2 to 3 weeks, and typically more than one IVF cycle is needed.

Exercise during ovarian stimulation

During ovarian stimulation, hormone medications are used to stimulate the ovaries to produce multiple eggs.

Various studies caution against strenuous activity during this stage of the IVF cycle because there is a higher risk of ovarian torsion. 

Torsion is the process in which the ovary twists itself, meaning the blood supply to the ovary gets cut off in the twisting process. 

One 2003 study concluded that ovarian torsion is a potential complication of ovarian stimulation.

Adding that patients undergoing ovarian stimulation are often instructed to forego exercise or strenuous activity. 

This doesn’t mean you need to stop exercising altogether.

Instead adapt your exercise routine so that you focus on gentle and low impact exercises that do not involve a lot of intensity. 

If in doubt, speak to your doctor or IVF medical team.

Exercise before and after egg retrieval

During the egg retrieval process, mature eggs are collected (retrieved) from the ovaries and fertilized by sperm in a lab. 

Before egg retrieval, patients should still be cautious with strenuous exercise as the ovaries will still be enlarged following ovarian stimulation. 

According to the same 2003 study, the risk of ovarian torsion persists even beyond the treatment cycle, adding that patients should limit strenuous activity if the ovaries have not returned to normal ovarian size. 

After egg retrieval, patients should approach strenuous exercise with the same caution.  

Related: What is an endometriosis flare up? Exercising with endometriosis 

exercise during ivf

Exercise before sperm retrieval

Once the eggs have been collected, they are fertilized by sperm in a lab.

If you’re using your partner’s sperm, a semen sample will need to be provided on the morning of egg retrieval.

It has been suggested that physical inactivity and obesity may be associated with reduced semen quality and lower sperm count. 

According to a 2017 study, physically active men have been reported to have higher numbers of mobile sperm with normal morphology compared with sedentary men. 

The study adds that sperm concentration was reported to be 43% higher in men who engaged in moderate to vigorous exercise among a population of 231 men seeking infertility treatment. 

Exercise before and after embryo transfer

Once the eggs have been fertilized with sperm and have developed into embryos, a fertilized embryo is transferred into the uterus. 

In most cases, one single embryo will be transferred into the uterus. 

There are two types of embryo transfer: fresh and frozen. 

Your IVF medical team will identify the best approach for you depending on your unique situation. 

Both frozen and fresh embryo transfers largely follow the same process, with one key difference:

  • Fresh embryo transfer: a ‘fresh’ embryo is inserted into your uterus between 3 to 7 days after egg retrieval and fertilization. 
  • Frozen embryo transfer: a ‘frozen’ embryo that has been thawed is inserted into your uterus and can occur months or years after the egg retrieval and fertilization. 

Before a fresh embryo transfer, your ovaries will likely still be enlarged following the stimulation process.

The advice is still to avoid strenuous exercise before and after a fresh transfer.

Before a frozen embryo transfer, much of the same advice applies as you want to avoid putting your body under any physical stress. 

Exercise during the two week wait

For many women undergoing IVF, the two week wait is the hardest part of the entire process.

It’s called the two week wait because you will find out approximately 9 to 14 days after the embryo transfer if you’re pregnant. 

The key is to stay relaxed and calm during this window – but that is easier said than done!

Complete bed rest for an extended period of time following an embryo transfer is no longer recommended. 

In fact, several studies in recent decades have explored the impact of shorter bed rest compared with longer bed rest immediately after embryo transfer. 

Interestingly, these studies indicated no difference in pregnancy outcomes, except for one randomized study that found higher implantation rates for women assigned one hour of bedrest compared with 24 hours of bedrest after IVF. 

During the two week wait you’ll want to avoid any activity that could be harmful to a brand new pregnancy. 

Avoid intense forms of exercise and instead focus on gentle movement like walking. 

According to a 2015 study, sports and exercise did not ultimately affect the odds of a live birth following IVF.

Adding that lifestyles that include more active living (walking, cycling, active travel, less television watching) appeared to favor implantation and pregnancy. 

The study also concluded that time spent in sedentary behavior during embryo days 6 to 13 was not associated with pregnancy outcomes. 

Related: What is runner’s face? Causes + 10 prevention tips

exercise during ivf

What are the risks of exercise during IVF?

As with any form of exercise, it’s important to consider the potential risks and side effects.

As we mentioned earlier, it’s always recommended that you consult with your doctor and IVF medical team before exercising during your IVF cycle.

One 2006 study that included 2,232 patients concluded that in general women who exercised for 4 or more hours per week for 1 to 9 years, compared with women who didn’t exercise, were:

  • 40% less likely to have a live birth
  • Three times more likely to experience cycle cancellation
  • Twice as likely to have an implantation failure or pregancy loss.

It’s worth noting that this study was conducted with patients who were undergoing their first cycle of IVF.

The study also doesn’t specify the age of the patients in the study, and we all know that age matters when it comes to fertility treatment and successful outcomes. 

We talked earlier about the risk of exercise-induced ovarian torsion.

Ovarian torsion is a real risk during your IVF cycle, but it’s worth noting that instances of ovarian torsion are rare.

According to a 2017 study, a 10-year review of 128 patients with adnexal torsion found that 2.7% of emergency surgery cases involved ovarian torsion.

Related: Jogger’s nipple: What is it and how to avoid it

What are the best exercises to do during IVF?

Now you know more about exercise during IVF, here are the best exercises to do during IVF.

As with any form of exercise, get guidance from your doctor or IVF medical team before doing these during your IVF cycle. 

#1 Walking

Walking is a great option for exercise during IVF as it improves blood flow and helps you maintain a healthy weight. 

It is recommended you walk at a normal, steady pace so you don’t overdo it. 

#2 Light jogging

If you don’t want to give up running all together during IVF, then light jogging may be a great alternative for you.

Aim to jog at a steady, controlled pace and avoid any sudden jumps or twists in movement. 

If at any point you start to feel uncomfortable, stop all together or stop and continue walking. 

#3 Swimming

Similar to walking, swimming has many benefits.

It is recommended during IVF because it keeps you active without placing too much stress on your body. 

So if you’re worried about not being active during your cycle, swimming can help you maintain your existing fitness levels. 

#4 Gentle yoga

Gentle yoga has benefits for your physical and mental health.

Yoga is a restorative activity so it allows you to keep fit without stressing out your body too much. 

Avoid yoga positions that place pressure on your abdomen.

Strenuous yoga workouts such as ashtanga and power yoga should also be avoided.

#5 Light weight strength training

Light weight strength training is just what it says on the tin – weight training that involves light weights instead of heavy weights. 

When performed properly, light weight strength training can help to improve your muscular endurance. 

Avoid any strength exercises which involve jumping, twisting or flipping your body. 

If you’ve never lifted weights before then it’s best to avoid taking up strength training during your IVF cycle. 

Related: Why do my legs itch when I run? How to prevent runner’s itch

exercise during ivf

Exercises to avoid during IVF

It is recommended you avoid the below exercises and activities during IVF:

  • High impact exercises like long distance running and high intensity interval training.
  • Exercises that require you to jump, twist or flip your body like CrossFit, kickboxing and gymnastics.
  • Exercises that involve direct body impact. 
  • Activities that involve quick changes in body position or quick twisting.
  • Heavy weight lifting.
  • Abdominal exercises like crunches.
  • Inverted poses during yoga or Pilates.
  • Vigorous activities like acrobatics or circus skills. 

Related: What does running do for your body? 10 benefits of running

Caroline Geoghegan
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