Throughout in vitro fertilization (IVF), your patients may have many questions about physical activity. Should I keep exercising? How much can I do? General lifestyle guidance and pregnancy recommendations suggest that women should keep active by working out at least three hours per week. Research has been mixed, however, on the relationship between IVF and exercise. Some studies suggest that it can have a negative effect on assisted reproductive outcomes, but others haven't found the same results. What's the best way to counsel your patients?
IVF and Exercise Patient Outcomes
A large, oft-cited 2006 study in Obstetrics & Gynecology found that women who exercised four hours or more per week for one to nine years before IVF were less likely to have a live birth. However, research since hasn't found the same correlation. A more recent study in Fertility and Sterility found that women who were physically active the year before undergoing IVF had better clinical outcomes. Most women in the study did not continue vigorous physical activity after embryo transfer. A third piece of research published in Women's Health found that regular physical activity at least three times per week increased implantation rates, improved the chance of getting pregnant and reduced miscarriage risk.
Studies related to IVF and exercise still don't provide hard-and-fast rules, instead suggesting that an approach to working out should be tailored to each patient. Their prior exercise history and body mass index (BMI) can affect IVF success and change the recommendations for physical activity. Research in Reproductive BioMedicine Online found that physical activity in the year before starting fertility treatments can have a beneficial influence on IVF outcomes. Much of this effect was noted for women of normal weight, and less so for women who are overweight or obese.
How to Counsel Patients About Exercise
It's still unknown how exercise affects IVF success when continued after implantation. Most studies examined physical activity leading up to fertility treatment, and many women in the studies greatly reduced their activity during IVF cycles. A number of the studies also found that being sedentary during treatment did not negatively affect live birth rates or clinical uterine gestation rates.
Any exercise recommendations will need to be customized for your patients based on their current physical activity level, BMI and other factors. Because obesity and being overweight contribute to infertility, counselling those patients to exercise with a weight-loss focus or consider a fertility diet before IVF may have beneficial effects.
Women of a normal weight may continue with their regular exercise habits or possibly an altered routine under close guidance. Most studies after the one conducted in 2006 did not often cite exercise of more than four hours per week, which had the most detrimental effects among that research population. It may be on the safe side to encourage patients to stick to a shorter duration of moderate or vigorous physical activity while undergoing IVF.
Overall, encouraging your patients to pay attention to exercise and closely monitoring them is important. Ask specific questions about what kind of workout they're doing and the duration of their sessions. Collaborating with your patients to find the right solution could lead to a healthier pregnancy and more favorable results.
