Exercising has a lot of benefits. It keeps your heart healthy, eases depression, and makes your bones stronger. And when you’re struggling with the stress of infertility, its ability to increase well-being by decreasing anxiety can be a mood enhancer. But if you’re trying to get pregnant, too much exercise can sometimes cause health complications. Going overboard with your fitness routine can not only lead to menstrual irregularities — which means a lack of regular ovulation — but vigorous exercise during some fertility treatments can lead to ovarian torsion, a painful condition that can reduce or cut off blood to the ovary. Here’s why:

During a normal menstrual cycle, the body prepares a follicle inside the ovary that matures, ruptures, and releases an egg. If you’re trying to get pregnant, and all goes as planned, a sperm will fertilize the egg on its way down the Fallopian tube and the embryo will attach itself to the uterus.

But if an ovary isn’t releasing an egg regularly, or at all, doctors can use hormonal treatment to induce ovulation. For women with polycystic ovarian syndrome — a hormonal imbalance that can cause infertility — the procedure is designed to stimulate the growth of a single follicle. But for women with undetermined infertility and those who choose assisted reproductive therapy like intrauterine inception or in vitro fertilization, ovulation induction produces many more follicles, greatly increasing the size of the ovary.

“When we do IVF, we intentionally try to get the ovary to try to produce 10 to 25 follicles per month,” says Dr. Eve Feinberg, an OBGYN who specializes in reproductive endocrinology and infertility at Northwestern Medicine in Chicago. “So the ovary enlarges markedly. It’s not usual for an ovary of a woman who is doing IVF to be larger than a grapefruit in size.”

Why running is out
Dr. Feinberg pointed out that ovaries are usually about 2 or 3 cm, so having two of them the size of softballs requires extra care. If someone who has hyperstimulated, enlarged ovaries engages in intense exercise with a lot of bouncing — like running — the larger ovaries have a higher chance of twisting on the ligaments that hold them in place, cutting off blood supply. “Ovarian torsion is a surgical emergency,” says Dr. Feinberg. “If left untreated, it may lead to the removal of that ovary.”

The ovary will remain enlarged during IVF cycles. Depending on the individual, that can mean multiple cycles. “IVF doesn’t always take on the first try,” says Dr. Feinberg. “I always tell people IVF is like a marathon. It’s not a 5k.” The ovary shrinks when hormone treatment has stopped. It’ll be back to its normal size after you’ve had a period, says Dr. Feinberg.  

Yoga is in
Studies show yoga decreases stress, but there isn’t any scientific evidence that the practice actually increases pregnancy rates. However, the psychological benefits of being around others who are going through the same process — trying to have a baby — can keep patients involved in their treatment, which is more likely to result in pregnancy, says Dr. Feinberg.

“Patients are their biggest barriers to achieving success because it’s so stressful and it’s so difficult to stay engaged in treatment,” says Dr. Feinberg. “Yoga, I think, helps people with consistency in classmates and instructors and helps people get through a difficult time in their life.”

How to keep moving
Exercise during that preconception period of time is good — up to a point. But if you’re struggling with menstrual irregularity, opt for exercises like yoga or walking, which aren’t associated with nearly as many menstrual disturbance as running, says Dr. Feinberg. And the type of fertility treatment you need can determine which exercises you need to avoid. So make sure to talk with your doctor about what is best.

Keri Wiginton is a writer and photographer focusing on issues related to women's health, mental well-being, and feminism. Her work has appeared in the Chicago Tribune, Washington Post, Austin-American Statesman, Tampa Bay Times and Houston Chronicle. Follow her work at www.keriwiginton.com or on Twitter at @keriphoto.