Can I exercise after my IVF embryo transfer?

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Q:

Is it safe to exercise after an IVF embryo transfer?

A:

Exercising before your in vitro fertilization (IVF) treatment can help to improve your chance of conception. During your treatment though, there may be times you need to modify your physical activity to give yourself the best chance of success. For some women, this will mean doing less, but for other women, this will mean increasing their physical activity levels.

So can you exercise during the two week wait? The answer is yes, but there are a few things to consider including:

  1. How active you have been before your treatment commenced
  2. What type of treatment preceded your embryo transfer

While it is not the time to run a marathon, you do want to avoid (if you are healthy) prolonged bed rest (24 hours) following a transfer as this is associated with a 40% reduction in clinical pregnancy rate. One reason behind this may be that by resting you are reducing blood flow to the uterus and research has linked an increased risk of miscarriage to reduced uterine blood flow. Interestingly, abdominal temperatures in infertile women are lower than that of fertile women, suggesting reduced blood flow to the uterus. Increased fertility stress has also been associated with reduced endometrial blood flow. Anytime muscles contract they generate heat. Repeated muscle contraction, which happens during exercise, will also lead to greater blood flow. With increased blood flow comes an increase in the delivery of oxygen to tissues – an essential fuel for our cells to function and grow. Indeed, women who are physically active during treatment are more likely to have increased implantation rates and live birth results.

Embryo transfers can take place immediately following a stimulation protocol (conventional or minimal) or natural cycle for egg retrieval (fresh transfer), or following the thawing of an embryo (frozen transfer). With conventional stimulation cycles comes a greater risk of over-stimulating the ovaries and developing a condition known as ovarian hyperstimulation syndrome (OHSS) that results in abdominal bloating and discomfort. OHSS typically occurs 7-10 days following the trigger shot and while everyone responds differently to stimulation protocols, collecting a large number of eggs, having PCOS or high AMH levels >6.95 (high egg reserves) places you at greater risk of OHSS. Your physical activity would need to be highly modified if suffering from OHSS but if you have an egg retrieval and transfer without any side effects, engaging in light to moderate aerobic activity will have benefits for your outcome.

If you are undergoing a frozen cycle, your ovary size and hormones are far more reflective of usual conditions so moderate aerobic activity and moderate resistance training can be undertaken. For women and men that have never exercised regularly, a gradual progression in your exercise prescription is most beneficial and for heavy exercisers it is important to get the balance right between your frequency of high-intensity exercise sessions, recovery, and energy intake. The amount and type or activity will be different for each individual depending on their background and medical history so ensure you consult an Exercise Physiologist to get the right program for you.

For many women reducing physical activity often increases stress which is associated with negative outcomes for conception and early pregnancy. Engaging in regular physical activity brings with it feelings of confidence and resilience that translate to feeling less stressed, and adopting a more positive outlook. This can be so beneficial during the two week wait! Pessimism has been shown to predict IVF failure so engaging in light to moderate exercise following your transfer will keep stress levels down and increase your chance of success.

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Written by Dr. Cecilia Kitic
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Dr Kitic runs The IVF Project, a world first online exercise prescription service for women and men undergoing fertility treatments. Having experienced infertility and multiple cycles of IVF, Dr Kitic wanted everyone to have access to evidence based clinical exercise prescription to improve their chance of conception.

Dr Kitic is an Exercise Physiologist with a PhD in Exercise Immunology and over 20 years research experience in understanding how exercise affects the body. She is also a Senior University Lecturer in Exercise Prescription.

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