Exercise and Fertility

Exercise may already be a part of your everyday lifestyle. Most adults need both aerobic activity and strength training for overall health. The CDC recommends 150 minutes each week of cardiovascular exercise. That can be broken into smaller blocks of time, including anything from brisk walking to running and muscle-strengthening activities two or more times per week [R] But do the guidelines change if you are trying to conceive?  How does exercise impact your fertility?

Benefits of Exercise

 

There are many benefits of exercise, including weight management, blood sugar and insulin levels, improvement of mental health and mood, reduction of cancer risk, improved sleep, and improved sexual health, among others. [R] All of these facets can impact fertility in both men and women. 

Couples who are overweight may encounter more difficulties when trying to conceive. Women with a higher BMI may experience menstrual dysfunction and anovulation, placing them at risk for lowered conception rates or infertility.  [R] Increased weight in men has been associated with a lower testosterone level, poorer sperm quality, and reduced fertility as compared to men of average weight. [R] Exercise helps to increase metabolism, or how many calories you burn in a day. When combined with healthy eating, individuals may experience weight loss and lowered BMI, improving the chances of conception. 

Exercise can reduce the glucose in your blood and make you more sensitive to insulin. Insulin resistance affects ovulation, fertilization, and embryo implantation, causing first trimester miscarriages and infertility. [R] 

Stress hormones such as cortisol have been shown to play a role in the length of time needed for a couple to conceive successfully. [R] Cortisol also plays a role in your libido. It may sound like common sense, but having a low desire can affect your conception if you aren’t having sex within your ovulation window. Regular cardiovascular exercise was found to mitigate the health impact of psychological stress. [R] 

Exercise can help to mitigate the risk of certain cancers. This is particularly true of cancers which have increased risk related to BMI, insulin sensitivity, and increased estrogen levels. [R] According to the summary of the research cited, even recreational exercise levels showed benefits in reducing colorectal and breast cancer risks. 

Adequate sleep is necessary for maintaining optimal health. Irregular sleep patterns might adversely affect the hormone secretion impacting ovulatory cycles. The hormone disruption could additionally contribute to “insulin resistance and glucose intolerance potentially contributing to infertility and early pregnancy loss, particularly among women with PCOS.” [R] Exercise appears to have a positive correlation to sleep, especially in middle-aged and older adults. Regular exercise was found to have moderate and strong positive effects on overall sleep quality. In contrast, chronic exercise appeared to increase the total sleep time and sleep efficiency to some degree. [R] 

Finally, it appears exercise has a relationship to sexual health, including increased sexual drive, sexual activity, and sexual satisfaction. Obesity and inactivity have some relationship to sexual dysfunction, and in males, a high BMI can correlate to erectile dysfunction. [R] Among both men and women, moderate amounts of exercise appeared to stimulate sexual interest and behavior. [R] However, too much activity was associated with a decrease in testosterone, and other male hormones, which may decrease sexual desire [R]. Libido in men is dependent both on testosterone levels and on psychological factors

 

Exercise and Fertility

 

While it can be acknowledged that physical activity benefits overall health and well-being, does exercise specifically relate to fertility health? 

Lack of exercise or inadequate amounts of physical activity may result in health complications such as increased BMI, increased insulin resistance, and higher amounts of cortisol and estrogen in the bloodstream could affect poorer ovulation, fertilization rates, and embryo implantation. [R]  In males, lack of exercise and higher BMI has been linked to a lower testosterone level, poor sperm quality, and reduced fertility compared to men of normal weight. [R] 

When individuals begin exercising “too much,” it can also be counterproductive to fertility efforts as well. Studies done on both male and female athletes have shown that endurance training, such has long-distance running, has been linked to altering fertility. [R, R]  In some females vigorous exercise for extended periods can be linked with anovulation which can affect fertility. [R]. 

There appears to be an “upper limit” of exercise, especially when working with individuals who are elite athletes. In such cases, they may benefit from working closely with their medical professionals and trainers to develop a customized plan to ensure their well-being and fertility during conception efforts and pregnancy. [R[

The yoga asanas also help to strengthen the body and improve blood flow to the reproductive organs. Some research has shown improved blood flow and circulation as it relates to a higher abdominal temperature that may correlate to enhanced fertility. 

Physical activity such as yoga, pilates, and barre may be particularly helpful for fertility as the asanas, or physical poses, can bring a calming energy to the pelvis, stimulate the endocrine system and restore hormonal balance where needed. This applies to men as well as women.   [R]  Choosing yoga poses that target specific trigger points may help to regulate monthly cycles, improve libido, rebalance thyroid function, stabilize blood sugar, and support fertility health. To help support hormone balance, you might select poses such as fish pose, sun salutations, garland pose, mariachi’s pose, and the bound angle pose. Illustrations of these can be found here. 

Women who are physically active prior to receiving IVF or ICSI appear to benefit from physical activity and demonstrate higher success rates compared to women who are physically inactive. [R]  However, depending on your personal health history, your doctor may recommend you decrease your exercise levels. 

Integrative fertility may be a choice for you if you would like to combine natural and modern therapies in your fertility journey. If you are interested in a consultation to see if integrative techniques can further support your fertility journey, contact me for more information.

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New eBook! Jumpstart Your Fertility

As a healthcare provider, it can be challenging to share everything that I’d like a patient to know about their fertility during one office visit.  A visit with a fertility specialist will typically include gathering medical history, explaining procedures, setings expectation for patients, and answer their questions.  Often, I wish I had more time during a visit to talk through all of the ways a patient can optimize their health for fertility.   This is what inspired me to write an eBook, Jumpstart Your Fertility – A Guide to Enhancing Your Fertility at Home.

I’m thrilled to announce that after many months of hard work, I’ve poured my integrative fertility knowledge into one FREE resource.  This eBook is packed with easy, everyday tips to improve your fertility at home.

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Male Infertility

Infertility can affect as many as one in eight couples trying to conceive. While many people tend to believe infertility is “a woman’s problem,” male infertility is a factor in roughly one-third of all infertility cases (25% in combination with female infertility factors and 8% as a singular factor). [R]  Male infertility can be categorized as endocrine or systemic causes, testicular defects in spermatogenesis, sperm transport disorders, and idiopathic male infertility. [R]. Treatment is often available, and many couples are able to conceive after receiving a medical intervention. 

 

Types of Male Infertility

Endocrine or Systemic Causes

 

Endocrine or systemic causes make up about 2 – 5% of male infertility cases. They refer to dysfunction of the hypothalamic-pituitary-gonadal axis, and like most hormonal pathways within the body, are sensitive to disruption and can be indicative of other disorders. [R] Excess estrogen appears to have an adverse effect on the balance of the HPG axis. 

 

While some estrogen and estradiol are necessary for male biological function and reproduction, excess estrogen appears to be damaging to the balance of the HPG axis and could be a contributing factor to male infertility. As in women, excess estrogen in the body can be produced as a result of obesity, stress, or environmental factors [R, R, R]. 

 

Testicular Defects in Spermatogenesis

 

Some more common disorders that affect the testicles include trauma, torsion, cancer, epididymitis, and hypogonadism.  Infection and inflammation of the reproductive tract are significant causes of male factor infertility.

 

Depending on the nature of the trauma, it is possible scar tissue may result within the testicular tissue leading to reduced to halted sperm production.  Trauma did not appear to be a major cause affecting spermatogenesis, as early repair of any trauma seemed to preserve normal functionality. [R]  Testicular torsion occurs when a testicle rotates, twisting the spermatic cord that brings blood to the scrotum. Adequate sperm needed for fertilization can be produced from one testicle, While medical intervention may be possible to repair and preserve the damaged testicle, the effects of testicular torsion on fertility remain unclear. [R] 

 

If the testicular defect is a result of cancer, chemotherapy treatment could have an adverse effect on sperm production and fertility, so patients may wish to speak to their treatment provider about sperm banking before treatment begins. [R].   The epididymis is part of the male reproductive tract where spermatozoa acquire motility and the ability to fertilize the egg. When this area becomes damaged, usually through inflammation or infection such as a urinary tract infection or sexually transmitted disease, it can cause harm to the maturing sperm. 

 

Male hypogonadism is a condition where the body does not produce enough testosterone and other hormones needed for masculine growth and development during puberty or enough sperm or both. The condition may be acquired or congenital. 

Sperm Transport Disorders

 

In order for fertilization to occur, sperm must successfully reach the female egg. If there are difficulties in the sperm reaching the egg, it could be a potential cause of infertility. Sperm transport disorders account for 5% of male infertility cases. [R] 

 

Causes of sperm transport issues may be congenital, surgical, or acquired through infection or disease. Congenital causes may include the absence of the vas deferens, incomplete development of the sperm ducts, or lack of the seminal vesicles which store sperm. Surgical intervention might be a vasectomy. Infection or disease-related causes of sperm transport disorders could be a result of a sexually transmitted disease which has led to scarring. 

 

Idiopathic Male Infertility

 

Idiopathic male infertility, or IMI, affects approximately 10 – 15% of males in their prime reproductive age. [R] Men presenting with idiopathic infertility have no obvious history of fertility problems and both physical examination and endocrine laboratory testing are normal. However, semen analysis as routinely performed reveals sperm abnormalities that come alone or in combination. 

 

Testing for Male Infertility

 

When seeking support for male infertility, the initial evaluation typically focuses on detecting the small percentage of causes that can be treated to restore normal fertility. The remainder of the evaluation of male infertility is focused on determining which couples with male factor infertility might benefit from assisted reproductive technologies (ART). [R] A medical history, physical examination, and semen analysis are usually common. While additional components of the exam may go on to include endocrine testing, imaging of the glands and ducts, and genetic tests. [R]

 

Can Male Infertility Be Treated?

 

In cases where male infertility is related to hormonal imbalance, such as endocrine dysfunction or hypogonadism, sperm production or motility may be increased through the use of certain medical treatment. Usually, the focus is increasing testosterone production, increasing follicle-stimulating hormone (FSH) levels, and normalizing the testosterone to estrogen ratio. [R]

 

Depending on the nature of the testicular defect, surgery, hormonal intervention, or sperm banking may be an appropriate intervention for fertility. 

Sperm transport disorders may be resolved through surgery, as in the case of reversing a vasectomy, or through the use of IVF procedures. 

 

ART did not seem to be as successful with male infertility related to sperm DNA damage such as caused by cases of damage to the epididymis [R]

 

If you’d like to schedule a consultation for male fertility testing contact Pacific Reproductive Center today. 

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