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How to Create a Fertility-Friendly Exercise Plan

“Fertility Rules” by Leslie Schrock is an extensively researched and genuinely helpful guide to preparing for conception & pregnancy. Read an excerpt below and grab a copy for everyone you know who hopes to have a baby someday.

Even with an abundance of data disproving it, many women believe that exercising before trying to conceive and during pregnancy is a no-no. If you still think that’s true, it may be because, fifty years ago, doctors told their patients that exercise could make them barren.

The myth persists thanks to outdated theories about what disrupts ovulation. Anovulation — when an egg doesn't release from your ovary during your menstrual cycle — is the cause of around 30 percent of female infertility. But PCOS, not overexercising, is the cause of 80 percent of anovulatory infertility, and moderate exercise reduces symptoms for PCOS patients.

There’s another big reason for women to begin exercising before conceiving. Pregnancy is physically (and emotionally) taxing, and going through it with a strong body makes the experience easier. It can also prevent postpartum pelvic floor dysfunction like incontinence, which is experienced by 33 percent of women. (That number is likely low since pelvic floor conditions frequently go undiagnosed and untreated.)

Strong abdominals help with pushing the baby out, and may facilitate faster recovery from cesarean births and conditions like diastasis recti, which persist in 60 percent of women during the postpartum period.

Activity benefits babies too. It protects them from developing metabolic problems even with a high-fat maternal diet. Infants born to mothers who exercised during pregnancy had better motor skills and cardiovascular function, too.

How Much Should You Exercise for Fertility?

The official recommendation is that all adults between eighteen and sixty-four years old get 150 minutes per week of moderate-intensity physical activity. Today’s options are endless, and the goal should be finding an activity you enjoy that best serves your body.

Pilates, yoga, swimming, and walking are all well-known fertility-friendly activities. If that’s not your jam, there are many others, and one activity that may surprise you. Only 20 percent of women do any form of strength or resistance training, as there is an assumption that it makes you bulky or the time isn’t worth the effort (it doesn’t, and it is), but strength training is a great option even into pregnancy.

What Does ‘Moderate-Intensity Exercise’ Mean, Anyway?

The advice to pursue “moderate” activity sounds easy enough, but really, how do you know? The short answer is, it’s personal, and what is intense to one person might be easy for an elite athlete.

One tool that can help is the Borg Rating of Perceived Exertion (RPE). It uses a scale that runs between six and twenty (one to five are basically sitting still), with six equaling watching television and twenty finishing the last leg of an intense race. You use the scale to self-report how hard an exercise feels. Moderate exercise on Borg’s scale is between twelve and fifteen. (Multiplying that perceived exertion level by ten should be about the same as the heart rate, which on the top end is around 150 beats per minute. If you work with a physician or trainer with a clinical background, this may be how they frame it.)

If this sounds too complicated or you don’t want to wear a heart rate monitor, try the talk test. It’s how physicians suggest pregnant women calibrate their exercise and works well for anyone, anytime. It’s simple: if you can talk through an exercise and aren’t so winded that words are tough to choke out, you’re working out at a moderate level. If you stay at a heart-pounding pace and cannot talk, you are in the intense-exercise category and should slow it down. Duration wise, if conception is imminent, keep your workouts, especially anything close to strenuous, to under an hour at a time.

Building The Optimal Fertility-Friendly Exercise Plan

If you are starting a new routine, or are new to exercise, talk to your doctor before jumping in—especially if you have a chronic condition or are trying to conceive. To kick you off, here are a few tips all personal trainers and physical therapists wish people would follow regardless of the activity they are pursuing, from beginners to experienced athletes.

Don’t go too hard too fast

Starting a new routine is exciting, but if your body isn’t used to much or any activity, you’re more likely to get injured. Intense activity that comes out of nowhere can negatively jolt your muscles, heart, and joints. Instead, start with light- or moderate-level exercise, then add time and more difficult movement types as you progress over a few weeks or months.

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Warm up and cooling down

It may not be the most exciting part of an exercise routine but taking a few minutes to warm up and cool down increases the likelihood that you stay injury-free and will improve the quality of your workouts. Light movements like arm circles or neck stretching or foam rolling help to loosen your muscles and joints and initiate blood flow throughout your body. To cool down, slow down whatever movement you’re doing to allow your heart rate to drop. After it has, do a few deep stretches of the areas that you worked to help with recovery. Beyond protecting against injuries, it will decrease muscle soreness the next day. Neither must be long—five to ten minutes is all it takes. And there is no right way—target the muscles and areas that feel most fatigued and hold each pose until you feel the area release.

Stay hydrated

If you live in a hot climate or high altitude, this is especially important. Drink water—that’s it. No fancy sports drinks promising to restore your electrolyte levels. Most have close to your daily sugar allotment and zero nutritional content. Unless you are an elite athlete or doing something truly strenuous (and hey, we’re not doing that, right?) it isn’t necessary. Drink a minimum of twenty-four ounces of water per hour of moderate exercise, during or after.

Plan exercise during your peak energy hours

With everything else we have going on, it’s easy for exercise to fall by the wayside. Intent and follow-through is everything when establishing new habits, so work it into your day in a way that feels sustainable. Enlist a buddy or trainer if you need extra accountability. What time of day you exercise can determine the strength and type of metabolic response too. Your circadian clock is responsible for biological processes like metabolism, hormone production, immunity, and behavior. And it’s all communicated to the body via light exposure. Exercise timing rewires intra-tissue and inter-tissue metabolite correlations, and whether it’s done early in the day or later in the day changes the function of some of our organs and metabolism. We can’t say definitively whether working out in the wee hours or early evening is better, as each carries different benefits, so it’s best to do it when your life allows.

Exercise with the phases of your menstrual cycle

There may be no universally perfect time of day to move your body, but for women, we know that the body responds to activity uniquely through the menstrual cycle as different phases are associated with varying energy levels. If you’re ready to tune in, you can synchronize specific activity types with menstrual cycle phases. A cycle-friendly routine optimizes for the best output at each phase. Using a textbook twenty-eight-day cycle as a template, the menstrual phase (days one through seven) is for gentle exercise, follicular (days eight through thirteen) is for more intensity, ovulatory (days fourteen through twenty-one) is for heavy weights, then it’s time to dial things back during the luteal phase (days twenty-two through twenty-eight).

If existing pain or injuries are stopping you from exercising, or you want a workout that will help even out muscle imbalances (and prevent pain and injury), consider working with a physical therapist who specializes in reproductive health. They’ll perform a full body assessment and determine the best exercises for you. They can also help if you’ve been diagnosed with mechanical infertility.

Leslie Schrock, author of Fertility Rules
Leslie Schrock

Leslie Schrock is an author and angel investor working at the convergence of health and technology. Her breakout hit, Bumpin’: The Modern Guide to Pregnancy mixes the latest clinical research with practical advice for working families. Her second book, Fertility Rules, (Simon Element, Spring 2023) addresses male and female fertility. Leslie was named one of Fast Company’s Most Creative People in Business, and her work has been featured in The Economist, Fortune, NPR, Time, GQ, CNBC, Forbes, Wired, and The New York Times.

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