Trying To Conceive and Exercise

 

Should I Exercise When Trying to Conceive? 

One of the most common questions women ask when trying to conceive (TTC) is; ‘Should I exercise or not while trying to conceive?’ It can be confusing trying to navigate the conflicting advice from the internet, friends, and family. Women are told everything from ‘Absolutely no exercise while trying to conceive!’ to ‘Exercising is great, BUT not during a certain time in the cycle’ to ‘It’s okay to exercise, BUT not too much and not this type.’ Women are left confused and often terrified of doing the wrong thing, and they may stop exercising completely losing a healthy way of maintaining fitness and decreasing anxiety – and a source of joy.

Start by talking with your doctor who will look at what type of exercise you are currently doing and walk through ways to maintain or modify your own personal routine for your particular situation. Every woman is unique, but everyone should keep their body moving in ways that are right for them. Instead of broad, general, and dogmatic rules, let’s review the literature and some unique situations to help answer the question: ‘To exercise or not to exercise while trying to conceive.’

General Guidelines

Exercise is good for you. Study after study shows the benefits of regular exercise as a means of preventing chronic illnesses like cardiovascular disease, type 2 diabetes, breast and colon cancers, and more. Lack of exercise is often related to obesity, and many studies find that obesity is directly linked to reproductive issues such as menstrual irregularities, ovulation dysfunction, and higher risk of poor obstetric outcomes. Exercise is important for all women, regardless of weight; interesting research shows lower fertility rates in women with normal weight with a sedentary lifestyle. However, studies in athletes with high levels of vigorous exercise show a negative impact on menstrual cycles, ovulation, and fertility, leading researchers to conclude that too much exercise is not good for fertility. So if you re-read these last few sentences, you can see how confusing the data on exercise for women trying to conceive can be – exercise is ‘good’ for health and fertility in women who are obese or normal weight, BUT women shouldn’t exercise too much, because that’s ‘bad’ for fertility. What should women do?

Exercise While Trying to Conceive

Although there are many studies on exercise and fertility, they all differ in the patients they study, the questions they are trying to answer, and the approach they take to try to answer those questions. Some find exercise improves fertility, and some warn that too much exercise can lead to infertility.

An excellent meta-analysis (a paper designed to compile data from different studies) published in 2019 helped review the data critically and draw together recommendations to help answer the fitness and fertility question. The authors concluded that physical activity (alone or in combination with diet) has beneficial effects on reproductive outcomes and that pregnancy rates can be twice as high in patients maintaining regular exercise compared to no exercise while trying to conceive. The benefits are most helpful in patients with obesity, polycystic ovarian syndrome, and insulin resistance, and moderate physical activity did not significantly improve or harm success with fertility treatment. The authors, while recognizing the many limitations of clinical research, support the general conclusion that exercise is good for women trying to conceive and in fertility treatment – unfortunately, they did not provide specific answers on how much exercise or how intense the exercise should be. 

PCOS

Polycystic ovarian syndrome (PCOS) is a collection of signs and symptoms such as irregular menstrual cycles, high levels of male hormones resulting in acne and excessive hair growth or loss, insulin resistance, difficulty losing weight, and infertility. The diagnosis of PCOS is not black and white, and many patients exhibit some but not all signs and symptoms. The relationship between physical activity, obesity, and insulin resistance associated with PCOS has been studied extensively, and one review of five studies showed improved ovulation, weight loss, and insulin resistance with moderate exercise for 12- to 24-week exercise programs. Patients with PCOS who are ready to conceive can be frustrated by irregular menstrual cycles – it’s difficult to time ovulation and intercourse, and months can go by just trying to figure out whether or not ovulation is occurring. Options for these patients include ovulation induction with medication, but some evidence shows that regular physical activity (with or without weight loss) improves hormonal profiles, regulates menstrual cycles, and is associated with higher chances of ovulation and conception in some PCOS patients. Exercise with weight loss in obese PCOS patients is beneficial, and exercise with or without weight loss is beneficial for all PCOS patients.

Obesity

Higher body mass index (BMI) and weight are associated with infertility, irregular menstrual cycles, and a higher risk of poor obstetric outcomes like miscarriage, and many studies researching the impact of exercise on fertility focus on obese patients. Not surprisingly, improved outcomes with weight loss are shown in many studies and are especially beneficial for obese patients with PCOS. Interestingly, some studies show improved cycle regularity, ovulation, and even live births were not necessarily associated with weight reduction but were improved in obese women changing diet and increasing exercise while trying to conceive. One study showed that natural conceptions can improve with physical activity in obese patients whether or not the number on the bathroom scale changes. The data is encouraging for patients who are frustrated with efforts to lose weight while trying to conceive. Focus on the goal of being healthy – not an arbitrary weight goal. Losing weight will likely eventually happen with consistent healthy lifestyle and physical fitness, but benefits like improved insulin resistance, hormonal balance, and improved mood can happen immediately with regular exercise!

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