Fertility Drugs and Exercise

Often when women go off the birth control pill after having taken it for years, it can take longer than they’d like to get pregnant, and the delay can lead to worry and stress about fertility. Even for women with no fertility issues, it can sometimes take up to 12 months—or longer—to get pregnant. The causes of such fertility struggles are enigmatic to many women and their doctors, so people sometimes point to exercise as an obstacle to pregnancy. Although exercise in and of itself truly has no role in fertility, it can take longer to get pregnant after you go off the pill if you’re burning a lot of fat through workouts.

jogger, running, runner, female runner, female athlete, running and pregnancy, fit and healthy pregnancy, healthy pregnancy, fitness and pregnancyIf you find you need to turn to fertility meds, your provider will probably suggest that you approach exercise with caution. Many specialists advise women to restrict running to fewer than 10 miles per week when they’re trying to conceive, but again, no research exists to support the idea that exercise threatens fertility. That said, fertility drugs may not mix well with aggressive workouts because they enlarge the ovaries from the size of a walnut to the size of, well, a much larger fruit. As they grow, the ovaries get heavier and can twist from the weight, which can be quite painful. Exercise increases the risk of that torsion. At the same time, exercise also increases blood flow throughout your body, and the uterus and ovaries want a good blood flow to assist fertility. As with keeping a healthy balance of calories and exercise, it’s key to balance your body’s desire for activity with its need for moderation.

Many women choose to scale back on running and exercise when struggling with fertility because it gives some measure of control. Some IVF research suggests that highly active women on IVF treatments have more trouble conceiving. A 2006 study found that women with 1 to 9 years of exercise history who worked out at least 4 hours per week were 40 percent less likely to conceive after the first IVF treatment than women who exercised less. Cardio workouts, in particular, lowered the odds of conception after the first IVF treatment for that group. Interestingly, though, women with years of high activity since childhood were just as likely to get pregnant as those who didn’t exercise. Despite these findings, many specialists still insist that there is no relationship between running and the success of IVF. Clearly, there is some ambiguity, and much more research is needed.

hiker, hiking, female hiking, female athlete, hiking and pregnancy, fit pregnancy, healthy pregnancy, fit and healthy pregnancyWhen you make your exercise choices during conception, keep this in mind and focus on what feels right for you. If you’re pursuing IVF, you might want to scale back the intensity and volume of your workouts as you try to get pregnant in the months following treatment while not cutting out activity altogether. If training causes you stress over whether or nor you’ll conceive, give yourself permission to rest, and look for stress-relieving physical outlets, such as Pilates, hiking, and yoga, that you can substitute for intense training.

Fit and Healthy Pregnancy by Dr. Kristina Pinto and Rachel Kramer, MDFit & Healthy Pregnancy is a friendly, comprehensive guide to exercising during pregnancy from athlete-moms Kristina Pinto and Rachel Kramer, MD.

Find Fit and Healthy Pregnancy in your local bookstore or online and learn safe ways to exercise for two!

Please consult your doctor before embarking on an exercise program during pregnancy.

How Exercise Affects Fertility

cycling, cyclist, endurance sports, exercise, exercise and fertility, fit pregnancy, fit and healthy pregnancyOf course you won’t exercise while pregnant until you first get pregnant! Athletic women can have particular concerns about conception and fertility because the reproductive system responds to how much energy we expend by working out. We’re not talking about how you get through a triathlon during your period or the nuances of core work with severe menstrual cramps. And we’re not talking about the tricky business of using up so much energy at the gym that you have zero interest in sex.

Yes, conception is closely tied to energy, to the extent that your body needs enough nutrition, particularly fat, to compensate for your activity and stay in a healthy zone for conceiving and supporting the growth of a fetus. But while exercise intensity and volume are often held responsible for how easily an athletic woman conceives, there are several factors in menstrual regularity that can play out in fertility issues:

  • Balance of energy use and fuel intake (calories)
  • Body weight and composition
  • Disordered eating habits
  • Psychological stress
  • Individual variation among women

swimmer, swimming, female swimmer, female athlete, exercise, exercise and fertility, pregnancy, healthy pregnancy, fit and healthy pregnancyWhen you have missing, infrequent, or irregular periods as a result of any of those factors, you might experience trouble conceiving, which is known as ovulatory infertility. It’s like trying to make an omelet without eggs. Although working out is something of a scapegoat, exercise at high levels of training volume, particularly in endurance sports, can change the frequency and regularity of menstruation, making it hard to predict your ovulation. For example, one study of distance runners found that an increase in mileage from 30 to 42 miles per week was associated with the rate of amenorrhea (missing a period for at least 3 months in a row) going from 2 percent to 31 percent.

The thing is, statistics like this can create the false belief that exercise causes ovulatory infertility, which isn’t the case. Amenorrhea associated with exercise has to do with food intake and energy use and maintaining the balance between them. Exercise simply affects that balance, which wobbles when a woman isn’t getting enough calories from fat to support her energy use. The result is a disruption in the hormones that direct her ability to conceive and may change her body mass index (BMI), which influences menstrual regularity.

For more on BMI and getting pregnant, check out our other articles: Exercise BMI and Getting Pregnant and More on Exercise, BMI, and Getting Pregnant.

Fit and Healthy Pregnancy by Dr. Kristina Pinto and Rachel Kramer, MDFit & Healthy Pregnancy is a friendly, comprehensive guide to exercising during pregnancy from athlete-moms Kristina Pinto and Rachel Kramer, MD.

Find Fit and Healthy Pregnancy in your local bookstore or online and learn safe ways to exercise for two!

Please consult your doctor before embarking on an exercise program during pregnancy.

More on Exercise, BMI, and Getting Pregnant

Pregnancy, Healthy Pregnancy, Fit & Healthy PregnancyWith many women having babies later in life, fertility struggles aren’t uncommon, and many women who are frustrated and emotionally spent from trying to conceive say they cut back on exercise as a way to feel some control over a situation that even doctors have trouble explaining with certainty. This is a normal coping response to a stressful and difficult experience. Ultimately, though, fitness activity is your ally because it relieves stress and helps you maintain a healthy body that can support the growth of a baby. When you think about your workouts, strive to find the mental space between exercise as a stress-buster and workouts that cause anxiety about your fertility. Whether you’re a recreational athlete or an elite competitor, exercise jeopardizes your fertility only when it is the reason that your body doesn’t have enough fat to ovulate and, therefore, conceive.

Most women likely will not have fertility trouble that is exercise-induced. Fertility might become more difficult for those who train at the elite level because their bodies have so little fat, but you can safely maintain a moderate to vigorous fitness program of 4 to 7 days of cardio and strength building exercise per week without concern about conceiving as long as you get enough calories from fat to menstruate. Such a program includes 30- to 45-minute workouts and longer sessions of up to a few hours for endurance athletes. It’s all about fueling to replenish what is burned. However, as mentioned previously, new exercisers should always begin a program gradually, particularly if they’re trying to conceive. As you think about planning your 9-month ultra-event, try to establish a realistic sense of your fitness habits and physical baseline, whether you’re concerned about fertility or looking to determine your pregnancy fitness goals. Print out a calendar and write down your physical activity for the month before conception to get a real idea of your workout baseline.Biking, Bike Riding, Woman Bike Riding, Fitness, Healthy, Exercise, Cardio, Fit & Healthy Pregnancy

Establishing your BMI is another good frame of reference for understanding your fitness and health baseline, but keep in mind that the formula and results rely on your height and weight without taking into account your aerobic capacity, genetics, bone mass, or ratio of fat to muscle. Nonetheless, your bodyfat percentage is important information to consider. A healthy woman is 20 to 25 percent body fat, and a specialist can give you a reliable measurement and analysis of your particular case using skinfold calipers, which might look like a torture device but are actually more like tongs.

Your individual body and fertility will probably have different needs and patterns for metabolizing food depending on the type and intensity of your different activities. If you’d like a specific dietary plan for your fertility and fitness routine, get the input of a nutritionist, fertility expert, and/or exercise specialist who can address the specifics of your lifestyle and health. When it comes to your cycle and fertility, individual variation is as important as the energy intake–use relationship.

See the first article on this topic: Exercise, BMI, and Getting Pregnant

Fit and Healthy Pregnancy by Dr. Kristina Pinto and Rachel Kramer, MDFit & Healthy Pregnancy is a friendly, comprehensive guide to exercising during pregnancy from athlete-moms Kristina Pinto and Rachel Kramer, MD.

Find Fit and Healthy Pregnancy in your local bookstore or online and learn safe ways to exercise for two!

Please consult your doctor before embarking on an exercise program during pregnancy.

Exercise, BMI, and Getting Pregnant

You might be thinking, “Hold up; I thought pregnancy meant the freedom to gain weight. Why measure my body fat?” Body-mass index (BMI), is calculated from a formula based on your height and weight and can be factor into fertility and healthy nutrition for supporting the growth of your fetus.

fertility, pregnancy, pregnant, healthy pregnancy, fit and healthy pregnancyIf your BMI is either too high or too low, your periods can be disrupted, affecting conception. Specifically, a BMI that is below the 10th percentile, meaning your body fat is less than 22 percent of the total, means you could experience irregular periods or amenorrhea. Eating fewer calories than you use during the day can disrupt your body’s ability to produce estrogen and progesterone, which regulate your menstrual cycle and by extension your ovulation and fertility. However, when your diet includes enough fuel to support your exercise routine and energy use, there will be no change in the hormones responsible for fertility.

If you’re having house guests, you buy more groceries. If you’re going to house a baby in your body, you need enough nutrition for both of you. Your kids won’t just raid the fridge as teenagers—they’ll do it in the womb, too.

On the whole, medical experts agree that there is no real evidence that exercise intensity threatens fertility—as long as you get balanced nutrition to maintain a healthy fat store. In fact, research shows that overweight women experience a higher rate of infertility than those who have lower BMIs, with 12 percent of cases attributable to being underweight and 25 percent to obesity.

What’s more, vigorous exercise actually lowers your risk for ovulatory infertility, as long as you maintain a healthy BMI. Every hour that you exercise each week is associated with a 5 to 7 percent lower risk of infertility related to ovulation.

If your doctor or midwife is concerned about your BMI being too low, you might be advised to decrease your workout intensity or training volume temporarily while you boost your calorie intake to meet your body’s demands (based on what you’re burning). If that’s the case, don’t fret about lost workouts. Consider replacing one calorie-sucking cardio workout per week with a yoga or dance class. You might not tap into your aerobic endorphins, but you can still achieve the delicious feel of a sweaty workout.

archery, low-impact exercise, exercise during pregnancy, fit and healthy pregnancyThis is a great time to try a new fitness activity you haven’t been able to fit into your regular routine or specific training regimen. It could be your chance to try belly dancing and archery—just don’t do them together. Fitness isn’t a threat to pregnancy; it’s an asset. As long as your training or exercise program increases gradually in intensity and volume, it will be less likely to jeopardize your menstruation because the reproductive system adapts to changes in exertion and metabolism. Older studies that linked exercise and infertility sampled women who started very intense programs or who had other complicating factors, such as stress or nutritional deficits. More recent research that compares exercisers of various levels of intensity with nonexercisers finds that the rate of conception is similar between groups and that approximately 5 percent of women in both groups experienced infertility.

Check back soon for the next article: More on Exercise, BMI, and Getting Pregnant

Fit and Healthy Pregnancy by Dr. Kristina Pinto and Rachel Kramer, MDFit & Healthy Pregnancy is a friendly, comprehensive guide to exercising during pregnancy from athlete-moms Kristina Pinto and Rachel Kramer, MD.

Find Fit and Healthy Pregnancy in your local bookstore or online and learn safe ways to exercise for two!

Please consult your doctor before embarking on an exercise program during pregnancy.