Exercise and Fertility: Finding the Right Balance

Regular moderate exercise supports fertility in numerous ways:

Weight management:

• Helps maintain healthy BMI (associated with optimal fertility)
• Reduces excess body fat (which can disrupt hormones)
• Supports weight loss for those who need it

Hormone balance:

• Helps regulate insulin (important for ovulation)
• Supports healthy testosterone levels in men
• May help balance reproductive hormones

PCOS benefits:

Exercise is particularly beneficial for women with PCOS:

• Improves insulin sensitivity
• Can help restore ovulation
• Reduces androgen levels
• Supports weight management

Stress reduction:

• Reduces cortisol and stress hormones
• Improves mood and mental health
• Provides distraction from fertility worries

Improved blood flow:

• Better circulation to reproductive organs
• May support uterine lining development
• Improves overall cardiovascular health

For men specifically:

• Supports testosterone production
• Associated with better sperm quality
• Reduces oxidative stress
• Supports healthy weight

General health:

• Reduces inflammation
• Improves sleep quality
• Boosts energy and wellbeing
• Supports immune function

The sweet spot for fertility appears to be regular moderate exercise:

Guidelines for women:

Amount:

• 150 minutes of moderate activity per week
• Or 75 minutes of vigorous activity
• Spread across most days

Types of beneficial exercise:

• Walking (brisk)
• Swimming
• Cycling (moderate)
• Yoga
• Pilates
• Light jogging
• Dancing
• Strength training

Characteristics of "moderate" intensity:

• Slightly breathless but can still talk
• Heart rate elevated but not maximal
• Breaking a sweat
• RPE (Rate of Perceived Exertion) of 5-6 out of 10

Guidelines for men:

• Similar amounts: 150 minutes moderate per week
• Include both cardio and strength training
• Avoid excessive heat (saunas, hot yoga)
• Consider shorts over tight clothing
• Cycling: moderate amounts are fine, but extreme long-distance cycling may affect sperm

Strength training:

For both partners:

• 2-3 sessions per week
• Full body or split routines
• Moderate weights
• Supports metabolism and hormone health

Flexibility and relaxation:

• Yoga supports stress reduction
• Stretching maintains mobility
• Mind-body practices may help with fertility stress

While exercise is beneficial, excessive intense exercise can sometimes impair fertility:

For women:

How too much exercise affects fertility:

Hypothalamic amenorrhea:

• Intense exercise can suppress the hypothalamus
• This stops signals to the ovaries
• Ovulation ceases and periods stop
• Common in elite athletes, dancers, and intensive exercisers

Risk factors:

• Very low body fat (below 17-22%)
• Energy deficit (not eating enough for exercise level)
• High training volume
• Psychological stress
• History of eating disorders

Warning signs:

• Irregular or absent periods
• Reduced libido
• Fatigue and poor recovery
• Stress fractures or bone issues
• Hair loss

Research findings:

• Studies show women exercising vigorously for >60 minutes daily have higher infertility rates
• The effect is more pronounced when combined with low body weight
• Moderate exercise does not have this effect

For men:

Excessive exercise may:

• Temporarily reduce sperm count (recovers with rest)
• Increase oxidative stress
• Raise testicular temperature during exercise
• Affect hormone levels short-term

Particularly concerning:

• Marathon training or extreme endurance sports
• Heavy steroid use (common in bodybuilding)
• Cycling very long distances regularly

The good news:

These effects are generally reversible when exercise is reduced to moderate levels.

If you're undergoing fertility treatment, exercise recommendations may change:

During IVF stimulation:

As the ovaries enlarge during stimulation:

• Reduce high-impact activities
• Avoid jumping, running, or bouncing
• Risk of ovarian torsion (twisted ovary)
• Light walking and gentle stretching are fine
• Follow your clinic's specific guidance

After egg retrieval:

• Rest for a day or two
• Avoid strenuous activity for 1-2 weeks
• Light walking is encouraged
• Let your body recover

After embryo transfer:

• Continue normal light activities
• No bed rest is required (studies show it doesn't help)
• Avoid intense exercise for a few days
• Walking is beneficial
• Resume normal moderate exercise after a few days

During the two-week wait:

• Continue gentle exercise
• Avoid extremes (too much or complete inactivity)
• Don't do anything you wouldn't do if pregnant
• Listen to your body

Early pregnancy:

• Continue moderate exercise if you were exercising before
• Avoid starting intense new regimens
• Stay hydrated
• Don't overheat

Your clinic's advice takes priority:

Every situation is different. Follow the guidance of your fertility team.

Practical tips for incorporating healthy exercise:

If you currently don't exercise:

• Start slowly
• Walking is excellent and accessible
• Build up gradually over weeks
• Find activities you enjoy
• Any movement is better than none

If you're a moderate exerciser:

• You're likely in a good place
• Maintain consistency
• Ensure adequate recovery
• Focus on enjoyment

If you're a heavy exerciser:

Consider whether you're overdoing it:

• Are your periods regular?
• Are you maintaining a healthy weight?
• Do you have enough energy?
• Are you obsessive about exercise?

If concerns arise:

• Reduce intensity and volume
• Ensure you're eating enough to fuel activity
• Take rest days
• Consult a doctor if periods are irregular

Building a sustainable routine:

Weekly structure example:

• 3 days: 30-minute moderate cardio (walking, swimming)
• 2 days: 20-30 minute strength training
• 2 days: Rest or gentle yoga
• Total: approximately 150 minutes

Making it enjoyable:

• Exercise with a partner
• Try new activities
• Exercise outdoors when possible
• Join classes for social support
• Don't force activities you hate

The bottom line:

Exercise supports fertility when done in moderation. Focus on consistency, enjoyment, and overall wellbeing rather than extreme fitness goals during your conception journey.