Thursday, November 16, 2006

Regular Exercise Prior to IVF Treatment Lowers Success Rate

From the American College of Obstetricians and Gynecologists:
"While it may seem counterintuitive, women who regularly exercised for four or more hours per week in the previous nine years or less were 40% less likely to have a live birth after their first cycle of in vitro fertilization (IVF) than women who didn't exercise, according to a new study published in the October issue of Obstetrics & Gynecology. Regular exercisers were also twice as likely to have an implantation failure or pregnancy loss after undergoing IVF than women who did not exercise. Cardiovascular exercise, in particular, was associated with a 30% lower likelihood of successful live birth compared with nonexercisers.

...With a grant from the National Institutes of Health, researchers analyzed prospective data on 2,232 women who underwent IVF treatments at one of three clinics in the Boston area from 1994 to 2003. Of these women, 61.3% reported that they exercised regularly, and 38.5% reported that they didn't exercise. Women exercisers were broken down into three different groups based on their primary type of exercise: walking, cardiovascular (eg, jogging, aerobics, treadmill), and other (eg, swimming, yoga, team sports). These three groups were further broken down into four basic categories based on the number of hours per week and the number of years that they had been exercising.

The study found that, in general, women who reported walking for exercise had essentially the same likelihood of successful live births after their first IVF treatment when compared to nonexercisers. However, the subgroup of women who walked for four or more hours per week for the previous nine years or less were 50% less likely to have a successful live birth after IVF compared with nonexercisers.
More here.

The good Chinese medicine docs all say that at the very least, menstruation is a time to rest, and don't even do much yoga (especially inversion poses) that will interfere with the downward flow.

But pregnancy is even more of a time when you need rest, and less stress. When I had my first miscarriage, at 12 weeks, I was a stress bucket and was jogging all the time. And what did I do the day before I actually miscarried? Went on a bike ride. Heavy cardiovascular exercise IS a stress on your body. I also think in general I don't need to be such a crazy goal-oriented exerciser. That in itself is stressful. Geez.

10 comments:

Third Mom said...

This is interesting Marie, and that was me when we were trying to get pregnant. I wonder now if that had anything to do with our infertility.

And it is counterintuitive, I'd have never expected this was the case.

Happy Thanksgiving!

Green Fertility Marie said...

Margie,

My acupuncture guy was looking at me, like "Chill out, go take a walk!" Plus everyone's been scolding at me to eat more. I would normally poo-poo that kind of stuff, but my menses have really changed materially...I mean they've been icky and PMS-y my whole life!

RE: exercise and infertility: I think there's the stress, and also the body mass index thing...and I think babies are smart, they know when it's okay and when it's not, of when to come into your life some other way :)

Anonymous said...

Very interesting and Wow! It makes sense, but I'm still shocked! I think I'm o.k. now, my exercise is daily walks, yoga 2 or 3 times a week and I usually don't do yoga on the first 3 days of my period. But I just purchased a mini-trampoline to help my circulation. I'll have to ask acu dr. what he thinks!

Yup, I'm very goal oriented as well! I remember when I first started macrobiotics years ago my macro counselor was amazed at how I dove into it and how much I had educated myself on the topic so quickly. I thought it was a compliment at the time, but perhaps more of an observation on my obsessiveness and nervousness?

Ali

Green Fertility Marie said...

The mini-tramp is good for lymph drainage, too...just make sure you have fun!

Anonymous said...

My question is, how would you deal with weight control if you dont workout? For me, walking and a strict diet is not enough.

Green Fertility Marie said...

Let me ask: do you eat a high carb diet? Transfats? Almost everyone I know who's gone a lower-carb (wheat free) no transfat diet eventually gets to the setpoint: the skinnies go up, the overweight people go down. A lot of it has to do with insulin resistance. The acupuncture people are all very skinny but none of them exercise in the gym. They do eat lots of fruits and veggies (This is an ok crab--I'm more talking about refined carbs, esp grains).

Vegetarians I know who eat a lot of carbs do tend to blimp up, also, stress makesyou gather fat around your middle. People look at our high fat diet (meat, peanut butter, avocadoes) and can't figure out why we have LOWER cholesterol than they do...google insulin resistance.

Also, a good lower carb, non-insane diet to try is the Specific Carbohydrate Diet.

Carla said...

(I was the only who posted the weight question "anonymous")

To answer the above questions: I am gluten intolerant, so I don’t eat any processed carbs, sugars and haven’t for quiet some time. I also don’t eat any dairy. The only grains I really eat are brown, red, black, wild rice.

I do load up on lots of fruits and veggies, eat lean protein, etc but the fact of the matter is, I still have PCOS and though diet has gotten be down to a more livable size, exercise (running, biking, weights) really shape my body and get rid of the rest of the fat, especially in the belly area. I don’t ovulate unless I exercise. I have an apple shape by nature and no matter how strict my diet is, I have to add heavy cardio to the mix.

Green Fertility Marie said...

Hi Carla,

Here's a post I did for Adoption.com on PCOS. Your diet already sounds very healthy although you *might* want to try SCD for a bit (i.e., no grains at all, sorry) and see if you feel better and lose weight. I did it w/o dairy, and still go on it when I feel yeasty. It's possible (again, I ain't a doctor) that your insulin resistance is contributing to extra weight. Also, the apple shape puts you at risk for heart disease...taht, too is related to insulin resistance!

I used to lift weights, etc., all the time but now I'm leaner than I used to be and mostly just walk and occasionally run.

Good luck!!!



Polycystic Ovarian Syndrome PCOS

Nancy, our fearless editor, had a great post about her granddaughter's astute observation of a correlation between fertility problems and obesity, and she mentioned how Polycycstic Ovarian Syndrome (PCOS) is probably one of the most common conditions and causes of female infertility.

Interestingly, it is also secondarily related to obesity because it involves hormonal imbalances, particularly insulin resistance. Sound familiar? In my post on the Specific Carbohydrate diet, I wrote about how a bunch of us, in trying to help our children's digestive problems, at the same time straightened out our excess carb intake (and exercise a lot more, what with all the veggie shredding and nut-flour grinding, etc.)--and then, oops! became pregnant. There was at least one oops! that was caused by a woman with PCOS assuming she was (and she ain't no more) infertile.

PCOS is a syndrome, not a disease, which means it's not a biological pathology on its own, it's diagnosed by a constellation of symptoms, which include:

Irregular/few, or absent, menstrual periods; cycles that do occur may comprise heavy bleeding (*****check with a gynecologist, since heavy bleeding is also an early warning sign of endometrial cancer, for which women with PCOS are at higher risk)

Infertility, generally resulting from chronic anovulation (lack of ovulation)

Elevated serum (blood) levels of androgens (male hormones), specifically testosterone, androstenedione, and dehydroepiandrosterone sulfate (DHEAS)

Hirsutism (excess hair)

Androgenic alopecia (baldness)

Acne / oily skin / seborrhea

Acanthosis nigricans (dark patches of skin, tan to dark brown/black)

Acrochordons (skin tags) - tiny flaps of skin

Prolonged periods of PMS-like symptoms (bloating, mood swings, pelvic pain, backaches)

Sleep apnea

And, last but not least, the symptom of obesity centered around the lower half of the torso: again, the stress-induced spare-tire fat that is also a sign of cortisol(a stress hormone) induced weight gain. Are we seeing a pattern here?

One of the reasons PCOS is so common is that it's the ovaries' JOB to make cysts, basically, with the monthly release of the egg; these are called "functional cysts". However, this action is regulated by an intricate mix of hormones (estrogen, testosterone, etc.), which can be thrown off kilter by the many outside factors that have become a part of our lives.

Again, I'm not a medical professional, and all I have is my own experience, but having a healthy hormonal balance, no matter where you are in life, helps you enjoy life more. I am horrified to think of how my doctor merely prescribed hormonal birth control pills for me when I was having painful menses. They didn't help that much, and with the SC diet, acupuncture, and my Fertility Blend vitamins, I'm much better. My sister was having similar problems and I was horrified to hear her doctor was prescribing Prozac for her. I think I'd rather try eating nut-flour muffins first...

Carla said...

Thank you for this info. I've been studying PCOS since I was diagnosed in 2000 and I STILL learn new things about it on a regular basis. The funny thing is, because of my diet I don’t have insulin resistance anymore, but the belly fat wont go away w/o exercise (heavy cardio). I just thought that some people are built to be thin w/o much effort and others have to work hard for it.

I am also addressing my digestive issues with contributes to a distended abdomen too (just started working with a nutritionist).

I always wonder how people who practice Yoga and stay slim.

Green Fertility Marie said...

Perhaps you can ask your nutritionist about the diet, as the bloaty thing is very often gas + undigested food. The SCD is all about only feeding your body easy to digest monosaccharides as opposed to things like grains, which are disaccharides and harder to digest. It's very weird eating mostly protein, veggies, and fruit at first...but then you'll find you don't get hungry bec. you don't have the "crashes." That's what my husband and I feel, at least.

I don't do SCD strictly now because too high protein is bad for ammonia issues, but it has (along wtih acupuncture) kept my digestion a little speedier. There's an unappetizing test you can do to see how fast your transit time is--if you're interested email me and I'll tell it to you privately...