Should I exercise through IVF?
IVF and Exercise: Should You Keep Working Out During Treatment?
Written by Dr. Fiona Callender, Naturopathic Doctor with a focus in Perinatal Care
If you've started on your journey with assisted reproductive technology (ART), you probably have a lot of questions. One of the most common questions I get asked is, “Can I keep exercising when I’m going through IVF?”. This isn’t necessarily a question with the most straightforward answer.
The answer may even differ depending on which practitioner you are talking to. Some clinics recommend stopping almost all physical activity. Others may suggest you "listen to your body." Friends, social media, and online forums often add even more confusion.
So what's actually supported by research?
When we talk about it more broadly, exercise is one of the best things we can do for our overall health and there is little evidence to suggest that exercise harms IVF outcomes. That said, fertility treatments can have a significant physical (and emotional) effect on your body and this deserves some additional consideration.
Rather than thinking about an exercise as "safe" versus "unsafe," I think it’s more helpful to think about how your exercise might adapt throughout treatment, depending on your individual circumstances and how you are feeling.
Exercise is generally good for fertility and pregnancy
Before we even dive into the details on ART/IVF, it's worth remembering what we already know: Regular physical activity is beneficial for fertility outcomes, as well as pregnancy. We even have newer research showing benefits for baby’s physical and cognitive development.
Regular physical activity is associated with:
improved cardiovascular health
lower risk of diabetes
improved sleep
reduced stress and anxiety
lower rates of hypertension
From a fertility and conception stand-point, there are several studies that have found that women participating in moderate intensity activity have higher clinical pregnancy rates and improved live birth rates following ART. In some studies, they even show improved ovarian stimulation outcomes.
So why are patients still told to stop exercising?
The concern probably isn't exercise itself, but rather the ovarian changes that happen with IVF.
During controlled ovarian stimulation, which can occur in a number of ART protocols, multiple follicles grow at the same time, causing the ovaries to increase substantially in size and weight. This creates a true but relatively rare concern.
A larger, heavier ovary has more mobility within the pelvis. If it twists on its supporting blood vessels (ovarian torsion), blood flow can become compromised. Ovarian torsion is uncommon, but it is considered a surgical emergency. The possibility of this rare complication is the main reason fertility clinics often recommend temporarily avoiding vigorous exercise during stimulation.
That said, it is important to note that there is no direct evidence showing that exercise itself increases torsion rates. The recommendation is largely based on biological plausibility and a small number of case reports, not studies demonstrating that exercise causes torsion.
So what actually increases the risk of ovarian torsion?
The biggest driver of torsion risk is ovarian enlargement, not movement itself.
Risk is highest when:
the ovaries become significantly enlarged
ovarian hyperstimulation syndrome (OHSS) develops (more common in those with PCOS/PMOS)
pregnancy occurs after embryo transfer (particularly in the first trimester)
there is a history of previous ovarian torsion
Most reported cases of torsion happen without any obvious exercise trigger.
While it's possible that sudden twisting or high-impact movement could be a factor if we already have an enlarged ovary, we simply don't have evidence that exercise meaningfully changes the overall risk.
Because torsion is rare but potentially serious, we generally take a more conservative approach with exercise prescription.
So should you stop exercising?
For most patients, it’s probably not an all-or-nothing situation. I usually counsel patients by taking into account their current routine and adapting based on their risk. Most people don’t need to eliminate movement altogether. We want to balance the benefits of exercise - of which there are many! - with the small but serious risk of torsion.
Remember, exercise offers benefits beyond improving conception rates
When we focus only on implantation or live birth rates, we can sometimes forget about the other ways exercise can be helpful during an assisted reproductive cycle. This period of time can take an emotional and physical toll on my patients. For many, exercise is an important part of maintaining routine, supporting mood and stress relief, and improving sleep quality.
For many people, suggesting we take exercise out of their routine would do far more harm than good. Maintaining a sense of normalcy and routine has it’s own inherent value in fertility care.
When should you call your clinic?
Regardless of your exercise routine, you should seek urgent medical care if you develop:
sudden severe pelvic pain
pain that is worsening rapidly
nausea or vomiting with severe pelvic pain
significant abdominal swelling or shortness of breath
These symptoms deserve prompt evaluation, whether they occur during exercise or while you're sitting on the couch.
TLDR;
Exercise is generally one of the healthiest things you can do for your health, and likely your fertility.
Even in IVF cycles, you don’t likely have to stop exercising completely - especially if exercise is something that helps you cope with stress and feel like yourself. It’s possible to stay active while being cautious around the physical changes that occur with ovarian stimulation.
For many people, that might look like:
Continuing moderate, low-impact activity.
Prioritizing adequate nutrition and recovery.
Temporarily minimizing strenuous, high-impact, heavy lifting, or twisting exercise during ovarian stimulation and while the ovaries remain enlarged (early pregnancy)
Knowing the symptoms of ovarian torsion and seeking urgent care if they occur.
The evidence doesn't support having as much fear around movement as you may have been told. Instead, it supports individualized recommendations that balance the many benefits of exercise with the temporary anatomical/physiological changes that occur during assisted cycles.
If you would like more support through your fertility journey, I approach care with evidence, not restriction. The goal is to support you in feeling your best while making intentional changes to help you grow your family.
The information in this blog is educational and should not be confused with specific medical advice for your unique situation. Please consult your care team for more individualized recommendations.