First of all, if you’re reading this, congratulations, you are likely already taking great care of yourself!

This is a piece about exercise during In Vitro Fertilization (IVF). The fact you’re here means you’re wondering whether you should start exercising or continue to exercise during your cycle. Either way, asking those questions means you are curious about healthy, natural ways to keep your body and mind operating at their best, which is excellent!

So let’s get to it – can you exercise during your IVF cycle? If you’re not a big athlete, should you start now? How much is too much exercise? And what are the risks?

We’ve got you covered – let’s get moving!

Can you exercise during an IVF cycle?

Yes – but keep it light, or moderate at most. While exercise is a fantastic way to lose weight, increase muscle and bone density, improve sleep, and lower stress (with some studies pointing to an improvement in pregnancy rates for couples pursuing fertility treatment), the middle of your IVF cycle is definitely not the time to take on a new or exceptionally vigorous exercise routine.

How could exercise affect my IVF cycle?

Let’s talk quickly about the different stages of IVF to be more specific about why exercise should be limited during most of the cycle and avoided at one point altogether.

A typical IVF cycle lasts about 2 two weeks, with women taking ovary-stimulating medication for the first ten days. During this time, your ovaries are enlarging due to the growth of follicles (egg-containing sacs). Many patients experience physical symptoms resulting from this phenomenon, noting a bloated, heavy feeling in their pelvis, especially toward the end of the ten days of medications.

After this period, when the follicles are developed enough, the woman will take a trigger shot to free her eggs within her follicles, and egg retrieval (a short surgical procedure) is scheduled for about 36 hours later. Following this procedure, the patient has a 2-6 week waiting period during which her body is allowed to recover before starting a Frozen Embryo Transfer (FET). The frozen embryo transfer cycle can be accomplished either through a “synthetic,” a “natural,” or a “Cryo-stim” approach. In both synthetic and natural frozen embryo transfer cycles, the ovaries remain their normal sizes. However, in the cryo-stimulation approach, the ovaries may enlarge a little as multiple follicles are stimulated to optimize uterine lining development.

Because exercise affects your heart rate, blood flow, and the position of organs and other components of your body inside your physical frame, exercise can affect the very delicate – and powerful – IVF process that relies on everything being in just the right place at the right time. This is why heavy exercise is strongly discouraged during your entire IVF cycle.

How can exercise affect the medication portion of an IVF cycle?

During the ten (10) days of taking injectable hormone medications to grow the follicles inside a woman’s ovaries, the ovaries get heavier and heavier, becoming more prone to twisting around their ligaments if placed in a compromising position (think heavy exercise that contains a lot of sudden or jerky movements or jumps). While this condition, called ovarian torsion, is very rare, it’s also very serious. It could cut off blood supply to the ovary, requiring emergency treatment and an abrupt halt to your IVF cycle.

How can exercise impact egg retrieval?

Now, while heavy exercise is discouraged during your whole cycle, doctors usually discourage any exercise, including light walking! – the day of your egg retrieval procedure. Because the procedure involves both anesthesia and surgery (even though it’s short and most women start to feel better the same day and can even return to work the day after), the entire event takes a significant toll on your body, which needs rest. If you are an exercise junkie, try to take one day off – even your walk around the block can wait 24 hours, can’t it? During this time, it’s best to rest and let your body recover. We’re not talking bed rest here. We’re just talking about taking it easy and maybe going for a nap. Even light to moderate exercise on the day of your procedure could cause you pain, bleeding and may lead to more serious complications.

Can I start exercising after an embryo transfer?

Torsion is the most prominent and serious risk of exercise to your IVF cycle. Heavy exercise is strongly discouraged during your entire IVF cycle, even during the several weeks between your egg retrieval procedure and embryo transfer.

But what about after your transfer? It’s OK after that, right? Technically, no. You still want to take it easy after transfer because you don’t want to disrupt the embryo implantation process.

But you do get a whole lot more wiggle room now – only intense exercise is discouraged in the days following embryo transfer. While it’s fine to take a walk on the day of the transfer itself, try not to do much more than that. You can resume moderate exercise until you have your beta bloodwork to determine pregnancy in the days following. If that bloodwork confirms pregnancy, you’ll probably want to continue on the ‘moderate’ exercise path until your baby’s heartbeat scan. If you are not pregnant, you technically can go for an intense workout session if it will help you relieve some stress, but a walk or swim might do the trick without pushing yourself to exhaustion.

So what are light, moderate, and heavy exercises? I need a recap.

The million-dollar question! There’s a lot of variation here, but let’s keep it simple: light exercise is taking a short 15-minute walk. Moderate exercise is taking a 1-hour walk or a 20-minute swim (give or take!). And intense exercise is doing a 30-minute run, 15-minute HIIT exercise, or anything on top of this.

Think of it this way: light exercise is not strenuous, and you get your heart rate up just a little. Moderate exercise is also not challenging, though it can last longer and raise your heart rate quite a bit. Heavy exercise is challenging, puts you out of breath, and causes a significant spike in heart rate. When in doubt, use your common sense!

In general, light or moderate exercise is fine during your cycle, with the exception of egg retrieval day, which should be all about snoozing and getting a foot massage, with no exercise at all. Heavy exercise is off limits for your entire cycle, including the time between your egg retrieval and transfer and the time until your beta hCG test.

So what exercises are OK?

Walking, walking, walking! Walking is so underrated yet so beneficial. Think of it – you can do it almost anywhere, anytime, with enormous cardiovascular value and little risk (except the risks associated with an accidental fall, of course). Swimming is also fantastic – it’s easy on the joints, burns plenty of calories, and includes a therapeutic benefit. Yoga is another favorite, though take care to avoid inverted positions or ones that require contorted stretches.

Which exercises should I avoid?

Best to avoid running, sprinting, HIIT exercises, skiing, snowboarding, boxing, kickboxing, wrestling, or anything else that requires heavy exercise and could result in a fall, abdominal injury, or intense body movement (like jumping rope).

What about sex?

This is a pretty easy one – don’t do it. Like, at all. Sex is discouraged during your entire IVF cycle and during the period between your embryo transfer and beta blood work. If the blood work confirms pregnancy, some doctors will suggest avoiding sex until at least after your baby’s heartbeat scan. If the beta test shows no pregnancy, you can likely have sex.

In terms of the period between your egg retrieval procedure and Frozen Embryo Transfer (FET), which can be about a month, sex is optional, though some doctors suggest avoiding it. All this sexual avoidance is about erring on the side of caution and not wanting any sudden movements or contractions (caused by orgasm) to interfere with your IVF cycle or future pregnancy.

I’m starting my cycle soon, but I’m not a big athlete – should I start exercising now?

Though exercise is good for everyone, going too hard or too fast isn’t suitable for anyone, especially those whose bodies are unaccustomed to such activity levels. If you’re new to this, start small – like a light walk every day. Don’t try much else – even this little bit of movement will do your body and mind plenty of good.

I’m not starting my cycle for a while – should I start getting in shape by exercising?

As mentioned throughout this piece, and in scientific research in general, exercise does a body good. It is encouraged for everyone to keep a healthy weight, reduce blood sugar, regulate hormonal function, and more.

For these three reasons, exercise has been associated with improved pregnancy rates in fertile and infertile people, especially in those who are obese or struggling with hormone disorders like Polycystic Ovary Syndrome (PCOS).

So, by all means, start moving! Just go slow, don’t engage in intense exercise too often (you could increase your chance of injury), and once it comes to your cycle, remember that less is more!