How Much Activity Enhances Fertility? A New Study Says...

Balance is one of the hardest things to achieve in life, and it seems like that's especially true for women who are trying to get pregnant. You know that overall health and fitness play a role in fertility, but you've also heard that there really can be too much of a good thing. Trying to keep up with the "do this, do that" of research data can make you want to throw your hands up and say "I quit!"

Image: Ambro / FreeDigitalPhotos.net 

But you don't have to be an exercise physiologist or a registered dietitian to understand a few simple points amid the building database of knowledge about fertility's connections to weight and physical activity.

And here's the latest: Moderate activity wins the game. Again.

A just-released study (from Fertility & Sterility) of more than 3,000 Danish and U.S. women ages 18 to 40 found that moderate levels of physical activity resulted in "small decreases in time to pregnancy" for women of all body mass index (BMI) levels.

If you're struggling to get pregnant, that finding may not seem so exciting. But factor in the rest of the story and fertility patients may feel a little uplifted by this study.

Importantly, the subjects in this study were drawn from the general population, not from among fertility patients. Requirements of participation included:

• being in a stable relationship with a male partner
• planning to get pregnant
• not receiving fertility treatment

Participants were followed for a year or until they conceived. The researchers looked at several variables, including differences in length of time to conception for women throughout the BMI range. They found that vigorous physical activity either works against you (for women of "normal weight," BMI under 25) or doesn't do anything for you (for overweight or obese women, BMI of 25 or above) in terms of time it took to get pregnant.

In this study, vigorous activity included running, fast cycling, aerobics, gymnastics, and swimming.

The "winners" -- in this case, those who took the shortest amount of time to pregnancy -- were women who engaged in 20 to 39 MET hours (total metabolic equivalents assigned to different kinds of activity) per week of physical activity. And moderate activity was key.

Though the authors concede more data is warranted to investigate different types of physical activity in relation to fertility, their study suggests that overweight or obese women might benefit from any physical activity and lean women will likely enhance their fertility by switching to moderate, rather than vigorous, activity.

So what's moderate?

Brisk walking, leisurely cycling, golfing and gardening.


Source: A prospective cohort study of physical activity and time to pregnancy
             L. A. Wise et al., Fertil Steril 2012

Does Race Really Impact Fertility Treatment Success?

When a single research study looks at tens of thousands of ART procedures, the conclusions can be quite meaningful. Such a study received attention by Reuters this week with the headline "Weight, race tied to fertility treatment success".

Besides bolstering what we already know about weight and fertility, the study published in Fertility and Sterility determined that both failure to achieve a pregnancy and failure to achieve live birth are significantly more likely among non-white ethnicities. This finding was in light of adjusting for body mass index (BMI).

Unfortunately, since limited data was available to the researchers, their final conclusion about the difference in treatment success between white women (the reference group, having accounted for nearly 25,000 of the total 31,672 transfers researched) and black, Hispanic, or Asian women is that more studies are needed to discern reasons: "Future research should focus on clarifying the underlying causes of these disparities."

Having provided fertility care for over a decade now in a very ethnically diverse metropolitan area, here are my thoughts on possible connections between race and fertility treatment success numbers:

First, we know from past research that people from certain communities are not accessing fertility care as often as other groups. Financial reasons may seem to top the list, but the truth is that for some groups, there exist tremendous taboos against infertility treatment. Another related reason -- especially for Hispanic or Asian couples -- is language barrier.

That's one of the reasons Houston Fertility Center is hosting free Spanish-language educational opportunities -- to remove the language barrier as an obstacle to seeking fertility care. We hope, too, that our culturally diverse staff will be able to help curious couples feel comfortable enough to ask questions and find out about their family-building options.

Trying to determine what affects success rates based on ethnicity is not as simple as it may seem on the surface. For example, if the study did not include a breakdown based on how many patients used donor egg or not, we might see their results as skewed. That's because donor egg use is highly likely in older, white mothers-to-be and has an impact on success rate numbers.

I applaud researchers who undertake large-scale studies, and I look forward to future findings that can assist medical professionals like myself in our mission to truly make the finest fertility care accessible. In the meantime, the Houston Fertility Center staff and I will continue to reach out beyond our clinic doors to extend family-building services to all.

Some Folks Will Do Anything to Get Pregnant

You've probably caught yourself saying things like "I'd stand on my head if it would help me have a baby!" A recently published study from Israel of 219 women going through IVF found that bringing in the clowns can help.

It sounds pretty funny, but this was bona fide research published in Fertility & Sterility, the journal of my esteemed colleagues, the American Society for Reproductive Medicine.

The clinic employed the services of a "medical clown" who performed a standardized routine for each patient on some days. Women who attended clinic on a "non-clown" day were less likely to get pregnant, even taking into consideration factors like age, infertility cause, and the number of embryos transferred.

Like the lead researcher, Dr. Shevach Friedler, says, it's "one of the least hazardous interventions" for IVF patients.

While I'm sorry to say that we don't have a clown on staff here at Houston Fertility Center (yet), we do take pretty seriously the growing body of research that points to connections between stress and treatment success. Besides offering a soothing environment at our clinics with staff members who are sensitive to your worries, we refer patients to massage, acupuncture, and counseling professionals, all of whom specialize in the needs of fertility patients. I'm a believer in the value of learning personal stress management and the positive impact on infertility and treatment.

You never know what people will try next. So the next time you're at our place for an appointment, don't be surprised if you hear laughter. After all, helping people make their dreams come true can be pretty fun!