Should I exercise when trying for a baby?

Trying for a baby can be an overwhelming time, navigating conflicting advice from the internet, friends, and family; it can often feel like the process takes over every inch of your existence.

You may have heard that too much—or too little—exercise while you’re trying for a baby can make it harder to conceive.

So, when it comes to exercise and getting pregnant, what should you be doing?

The benefits of exercise whilst trying to conceive

We’re all aware of the health benefits that physical activity has for our overall health; reducing the risk of developing certain diseases and conditions including cardiovascular disease, type 2 diabetes, some cancers and improved mental wellbeing (1). There is some evidence to suggest that physical activity can benefit your fertility; with pregnancy rates being twice as high in women maintaining regular exercise compared to no exercise when trying to conceive (2). 

Pregnancy marks a time of huge change within your body, both physically and emotionally with increased demand on your organs. Mental health conditions such as anxiety and depression are also more common during and after pregnancy. 

Practicing regular exercise can make it easier to cope with the demands of pregnancy and labour by improving your strength and flexibility. Childbirth can also be an intense physical challenge that requires stamina and endurance. It has been shown that labour can be shorter during all stages for women who have been active during their pregnancy; emphasising the importance of creating healthy habits when trying to conceive (3). 

Ultimately, developing healthy exercise habits when trying for a baby should mean that you can use them throughout your pregnancy. This can lead to a healthier pregnancy with research showing that being active before and during early pregnancy can reduce your risk of having complications, such as gestational diabetes and pre-eclampsia (4,5).

Fertility Treatment 

When you are doing everything you can in your quest to have a baby, you want to maximise your chances, so it’s normal to wonder if exercise should be a part of your routine during fertility treatment. There is usually no reason for complete restriction of exercise during fertility treatment.

However, the best way to determine if and what exercise you should be doing during any fertility treatment is talk to the team overseeing your care. They will know your full medical history as well as what treatments you are having and will be in the best position to advise you on whether you should alter your exercise routine.  

There will be certain parts of your fertility treatment where exercise can be more difficult. Fertility medications as well as the side effects of some parts of your treatment like egg retrieval can cause bloating, fatigue and mild discomfort. During this you may not feel like doing much exercise – and that’s ok your body is already working extremely hard!  During treatment, it’s really important to listen to your body and not push anything.

During certain parts of your treatment you may also want to take a break from exercise. If you are going through IVF, you will be taking hormonal injections to grow multiple follicles in your ovaries in preparation for an egg retrieval.

At the time of hormonal stimulation, the ovaries will be growing, in some women becoming the size of grapefruits! The ovaries are connected to your pelvis by structures called ligaments which also contain their blood supply. When the ovaries enlarge they have an increased risk of twisting on themselves, potentially cutting off their blood supply which can become an emergency called ovarian torsion (6). 

The risk of ovarian torsion from IVF is small but many doctors will advise you to avoid strenuous or jarring exercise that causes the ovaries to shift around in your pelvis. Examples of these exercises include:-

• running
• yoga inversions
• high-impact exercise

If you’re worried about exercise before or during your fertility treatments, it’s best to talk to the team that’s looking after you and their recommended guidelines. They will have the best information on how to care for yourself during treatment.  

Male Fertility

We all know it takes two to make a baby and you and your partner may both find it helpful to support each other to lead a healthier lifestyle as you prepare to have a baby together. In men, being overweight can impact the quality and quantity of their sperm and anybody who isn’t active is more likely to be overweight.

There isn’t enough evidence to show that lots of exercise causes male infertility.

If your partner is extremely active and you have concerns about fertility, he may be advised to do less exercise. However, there are other factors that are more likely to be behind the problem (7). 

PCOS

For women living with PCOS it can be more difficult to get pregnant. One of the first-line treatments for PCOS is exercise as it can help the cells in your body become more receptive to a hormone called insulin. Exercise in PCOS can help to regulate ovulation (the monthly release of an egg from your ovary), and can allow any medication you may be taking to be more effective (8). 

​​What about exercise during the two-week wait?

The “two-week wait” refers to the luteal phase of your menstrual cycle that begins after ovulation and possible fertilisation of an egg. This lasts until either pregnancy occurs or you get your period. It’s hard to know if exercise affects implantation for a few reasons:-

1. We don’t have a good test to determine exactly if and when implantation occurs. This makes it difficult to study whether exercise may impact implantation
2. There are so many other biological mechanisms that need to happen correctly for successful implantation to occur, so it would be really difficult to pinpoint the exact role exercise may play.

What are the recommendations?

If you are trying to conceive, it is generally a good idea to act as though you are already pregnant, because it can be a few weeks before you know for certain. This means if in doubt, follow the pregnancy guidelines. This applies to avoiding alcohol and reducing your caffeine intake as well as what you should do when it comes to exercise.

You don’t have to join expensive gyms or follow a strict exercise plan. Building exercise into your everyday life can begin at home. For most women, if you have always been active, continuing to exercise at the same level when trying for a baby is safe and healthy. If you haven’t been active before you start trying for a baby and want to get started, start to build up your level of activity. The advice to build up to would be:

or

or

Moderate activity is any exercise that raises your heart rate, makes you breathe faster and feel warmer. You should still be able to talk without pausing for breath and examples include:-

Vigorous activity is any exercise that makes you breathe hard and fast and you won’t be able to say more than a few words without pausing for breath. Examples include:

Examples of muscle-strengthening exercises are:

Can exercise impact my periods?

Most women who are used to vigorous, intense exercise do not struggle to get pregnant and can continue their level of exercise when trying for a baby, throughout pregnancy and into motherhood. 

Some women who have a low or healthy BMI and do vigorous, intense exercise regularly, for example elite athletes, can struggle. This is because the stress that intense physical activity places on the body can affect the hormones responsible for your periods. If you exercise at vigorous intensity and have been struggling to get pregnant or do not have regular periods it may help to bring down your level of activity and ensure you are eating enough to replace the energy used during exercise.

Ultimately, it’s important to remember that there are many reasons why you might be struggling to conceive that may or may not be related to how much or how little physical activity you or your partner is doing. 

If you haven’t conceived after 1 year of trying for a baby or within 6 months if you don’t have regular periods, it’s a good idea to talk with your GP who can investigate this further.

References 

1. Department of Health & Human Services. 2018 Physical Activity Guidelines Advisory Committee. Phys Act Guidel Advis Comm Sci Rep. 2018;
2. Mena GP, Mielke GI, Brown WJ. The effect of physical activity on reproductive health outcomes in young women: A systematic review and meta-analysis. Human Reproduction Update. 2019.
3. Perales M, Calabria I, Lopez C, Franco E, Coteron J, Barakat R. Regular Exercise Throughout Pregnancy is Associated with a Shorter First Stage of Labor. Am J Heal Promot. 2016;30(3).
4. Tobias DK, Zhang C, Van Dam RM, Bowers K, Hu FB. Physical activity before and during pregnancy and risk of gestational diabetes mellitus: A meta-analysis. Diabetes Care. 2011;34(1).
5. ​​Aune D, Saugstad OD, Henriksen T, Tonstad S. Physical activity and the risk of preeclampsia: A systematic review and meta-analysis. Vol. 25, Epidemiology. 2014.
6. ​​Rackow BW, Patrizio P. Successful pregnancy complicated by early and late adnexal torsion after in vitro fertilization. Fertil Steril. 2007;87(3).
7. Ibañez-Perez J, Santos-Zorrozua B, Lopez-Lopez E, Matorras R, Garcia-Orad A. An update on the implication of physical activity on semen quality: a systematic review and meta-analysis. Vol. 299, Archives of Gynecology and Obstetrics. 2019.
8. Royal College of Obstetricians and Gynaecologists. Polycystic ovary syndrome : what it means for your long-term health. Inf you. 2005;100(February 2005)