Recent findings presented at the ASRM Scientific Congress & Expo indicate that maintaining physical activity during ovarian stimulation can lower stress levels for women undergoing in vitro fertilization (IVF), without increasing the risk of ovarian torsion.
Dr. Maren Shapiro, a reproductive endocrinologist and infertility specialist at the University of California, San Francisco, explained that while many individuals rely on exercise for stress relief, traditional fertility treatment protocols often advise against physical activity during ovarian stimulation. This recommendation stems from concerns about potential increases in ovarian torsion and uncertain impacts on IVF outcomes.
Dr. Shapiro and her research team conducted the randomized controlled PACE trial, which involved 213 women aged 18 to 43 (average age 35) initiating their first ovarian stimulation cycle for IVF or oocyte cryopreservation at the UCSF fertility clinic. Participants were randomly divided into two groups: one group followed the standard care protocol, which involved limiting exercise (n = 106), while the other group continued their exercise routines, encouraged to engage in 75 minutes of vigorous or 150 minutes of moderate exercise weekly (n = 107). Participants used Apple Watches to track their activity levels and filled out nightly surveys assessing their physical activity and stress levels both before treatment and during follow-up.
The primary outcome measured was stress, evaluated using the Perceived Stress Score. Secondary outcomes included rates of ovarian torsion and various IVF metrics.
Before treatment, the Perceived Stress Score was 22 for the continued exercise group and 21 for the standard care group. After oocyte retrieval, a trend emerged indicating higher stress levels in the standard care group compared to those who maintained their exercise routines, with a change in score of 2 points versus –1 point (P = .04). Among the 157 participants who were active prior to the study, those in the standard care group reported significantly higher stress levels post-retrieval compared to their exercising counterparts (P = .004). Notably, there were no significant differences in stress levels among women who were inactive at baseline.
The IVF outcomes—including the number of oocytes collected, fertilization rates, cleavage rates, and blastocyst rates—remained consistent across both groups. Importantly, no instances of ovarian torsion were reported during the study, although the researchers noted that the study was not designed to detect differences in ovarian torsion rates.
“These findings suggest that existing exercise restrictions may be doing more harm than good, without providing clear benefits,” Dr. Shapiro concluded, advocating for a reevaluation of activity limitations during ovarian stimulation.
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