How do you know if you have a high-risk pregnancy?

At your initial prenatal appointment, your doctor or midwife will assess your personal history and any current medical conditions to determine your risk status. This will be monitored and assessed throughout your pregnancy as well. 

A pregnancy is generally classified as high-risk when there are one or more factors that increase your risk of prenatal health complications or preterm delivery. These factors include things like age, being underweight or overweight, carrying multiples, having a history of pregnancy complications, or an existing condition such as high blood pressure or diabetes. Every pregnancy is unique, and your healthcare professional should work with you to help you understand your risk factors and any recommendations for exercise restrictions.

That brings us to the topic at hand today: IVF treatments and subsequent pregnancies.

Are IVF pregnancies considered high risk?

In the US, it’s estimated that just under 2% of live births will come from IVF conception each year. Studies have shown that pregnancies achieved through assisted reproductive technologies — which includes IVF — do have a higher risk of maternal and perinatal complications. However, simply using IVF doesn’t mean you will automatically be considered high-risk once pregnant. The associated conditions that contribute to infertility are generally what leads to a high-risk pregnancy classification — not the fact that you used IVF to conceive.

So yes, many IVF pregnancies will be high-risk due to personal history or existing medical conditions. However, carrying an IVF-assisted pregnancy doesn’t mean that you can’t exercise at all, and many IVF pregnancies can follow the same exercise guidelines as non-assisted pregnancies.

When we reached out to our audience to ask about your experience with exercise and IVF, 55% of individuals who had undergone IVF reported that they continued with gentle exercise throughout their pregnancy. However, the remaining respondents felt hesitant about exercising at all. That led to more questions on exercising while receiving IVF treatments in the preconception stage, which brings us to an important topic…

What you need to know about exercising during IVF treatments

The majority of exercise restrictions related to IVF are focused on the treatment stages. A key feature of IVF treatments includes ovarian stimulation medications, which release hormones that encourage the ovaries to mature more eggs at once, thus increasing the success of egg retrieval. This can lead to the ovaries increasing in size, which is to be expected to a degree. However, this enlargement can cause ovarian hyperstimulation syndrome — which is when the ovaries swell too much. Mild cases of this are believed to impact around 1 in 3 women who undergo IVF, but moderate and severe cases are thought to impact less than 1% of women going through this treatment.

So… what does that have to do with exercise? Since the ovaries increase in size as part of IVF treatments, it can elevate your risk for something called ovarian torsion. This condition is very rare and treatable, but it is a serious complication to be aware of as, if left untreated, it can lead to tissue damage. The main concern here is that overly strenuous and high-impact exercises that involve a lot of sudden movements could cause ovaries and fallopian tubes to twist and interrupt blood supply to the area.

We know that can sound a bit scary, but it’s important to remember that this is a very rare condition (impacting less than 0.5% of individuals going through IVF). However, during your treatments, it’s highly recommended to avoid any high-impact workouts that would require you to aggressively twist or contort your body. Light aerobics (such as walking or the elliptical), lifting light weights, or doing prenatal yoga is generally safe at this time.

Again, every body and every IVF situation can vary, so it’s incredibly important to talk with your doctor and/or fertility specialist directly to make sure you understand what’s safest for you. Here are a few other questions we received from our audience on the topic of IVF and exercise…

Should I stop exercising entirely when I’m ovulating (around egg retrieval)?

Many doctors recommend avoiding exercise altogether the week of egg retrieval — largely due to the risk of ovarian torsion. The medications you’ll be taking can also make you feel incredibly fatigued and bloated around ovulation, and your body might not feel up for much physical activity.

Above all, we encourage you to listen to your body, as you’re going through an intricate process. If you’re going to take a rest week, this is the week to do so. However, if you do want to stay active, it’s important to focus on very low-impact routines that won’t put an additional strain on your body, and that’s why things like gentle walking or restorative yoga are great options.

Are there any exercises that I should avoid for IVF success?

As mentioned above, routines that require you to twist or contort your body, or involving jumping or direct body impact are a definite 'no-go’ in the treatment stages, just to be safe. 

If you’re researching this topic yourself, you may come across a widely referenced study on IVF and exercise that has suggested over-exercising could have a negative impact on IVF success. It’s one of the largest scale studies of its kind, following over 2200 women who were receiving IVF for the first time — but there are some things we want to make sure you’re aware of. The researchers only found there to be negative impacts on IVF outcomes for women who had been exercising for 4+ hours a week for the past 1-9 years. However, like so many research studies, this one does have its limitations. It was not made clear what types of workouts these women were doing each week, and the researchers themselves state that “our findings are not strong enough to encourage women to abandon exercise and embrace a sedentary lifestyle”.

So what should you take away from this? If you are going through IVF treatment it’s a good idea to keep your workouts to a low to moderate intensity. It’s also important to be mindful of how much you’re exercising throughout the week, as now isn’t the time to put added strain on your body. It’s more about maintaining daily movement and activity, which is in line with general recommendations of 150 minutes per week (2.5 hours) of low-moderate exercise activity. 

At the end of the day, exercise limitations around IVF treatment should be taken seriously, but low-impact gentle routines such as walking, using the elliptical, stretching, and gentle yoga are considered safe options. Above all else, listen to your body and let this be a time where you focus on nourishing yourself and treating your body well.

Are there any differences in pregnancy-safe exercise when it comes to IVF vs non-assisted?

In general, the same exercise safety guidelines apply for IVF pregnancies once you have a confirmed pregnancy! The bulk of those strict exercise restrictions related to ovarian torsion are focused on the treatment phases and the initial weeks after successful fertilization.

As we mentioned earlier, women who undergo IVF may have other conditions that can lead to a high-risk pregnancy classification, so it’s important to have that conversation with your doctor to determine if there are additional exercise restrictions that you should be aware of.

Will I be put on bed rest during IVF treatments or pregnancy?

Bedrest used to be required following embryo transfers, but that was over 30 years ago and guidance has since changed. In fact, fertility specialists now strongly advise against bed rest. The reason is that IVF medications increase estrogen, and high levels of estrogen alongside being sedentary can increase the risk of blood clots and insulin resistance. So it’s very unlikely that anyone is put on bed rest when going through IVF.

Remember, exercise restrictions are specific to each individual and each pregnancy. It’s important to follow your doctor’s guidance on what is best for you and your situation. As we always say, above all else please listen to your body and what feels best to you — as you are the only one who actually knows how your body feels.

For weekly workout programs personalized to you and your stage of TTC, pregnancy, or postpartum, be sure to download the Baby2Body app!