Too Much Exercise Delays Pregnancy in Normal-Weight Women: Study

THURSDAY, March 15 (HealthDay News) — Exercise is a plus for
women trying to become pregnant, but overdoing workouts might make it
harder to conceive — unless you’re overweight, researchers report.

Usually a risk factor for most health problems, being overweight or
obese didn’t hinder fertility in heavy women who logged vigorous
workouts — running, fast cycling and aerobics. However, healthy-weight
women who performed more intense workouts were more likely to experience
delays becoming pregnant.

The study was led by U.S. and Danish researchers who tracked physical
activity and fertility in thousands of Danish women.

While moderate physical activity was associated with a small increase
in fertility rates among all women, study author Lauren Wise, an associate
professor of epidemiology at the Boston University School of Public
Health, said, “Our study found that higher levels of vigorous exercise
were associated with lower fertility rates in normal-weight women, but not
overweight and obese women.”

Wise said the findings indicate that physical activity of any type
might improve fertility among heavier women, but their normal-weight
counterparts who want to improve their pregnancy odds should sub in
low-key workouts such as brisk walking and gardening. In other words,
marathon runners who want to conceive might want to scale back on those
pavement-pounding workouts, she said.

Other studies of competitive female athletes suggest that intense
workouts disturb women’s monthly menstrual cycles and lead to a lack of
ovulation and even the absence of menstrual periods, among other problems,
Wise said. But, she added, high-intensity exercise might also impair
implantation when a fertilized egg attaches to the wall of the uterus.

The researchers of the observational study recruited and administered
questionnaires over the Internet to 3,628 women who ranged in age from 18
to 40. They had to be in stable relationships with male partners and
planning to become pregnant, but not involved in any fertility
treatments.

The researchers collected information on height, weight, reproductive
and medical history, plus lifestyle and behavioral details, and then sent
out follow-up questionnaires by email every two months for 12 months, or
until a woman became pregnant.

At the study’s start, the women were asked about the average number of
hours per week they exercised and about what types of moderate or vigorous
physical activity they performed. Running, fast cycling, aerobics,
gymnastics and swimming were considered vigorous. Brisk walking,
leisurely cycling, golfing and gardening were defined as moderate.

The participants were categorized by their exercise levels and the
results were evaluated according to body mass index (BMI, a ratio of
weight to height). A BMI over 25 is considered overweight or obese.

While moderate physical activity was linked to becoming pregnant faster
across all BMI ranges, the researchers found that there was an “inverse
association” between vigorous physical activity and how long it took to
become pregnant for normal-weight women (a BMI under 25). In overweight
or obese women, there was no link between vigorous exercise and a longer
time to pregnancy.

The study findings, which did not prove a cause-and-effect
relationship, were published March 15 in the journal Fertility and
Sterility
.

Wise noted that in other research, being overweight or obese has been
associated with lower fertility rates compared to normal-weight women.
Obesity has also been associated with menstrual cycle disturbances. She
said increased physical activity in this study might reverse the harmful
effects of obesity and improve the overweight women’s overall fertility
rates.

The exact mechanisms for why physical activity might enhance fertility
in overweight and obese women remain unclear, though, and the researchers
didn’t delve into them, Wise said.

Dr. Dimitrios Mastrogiannis, director of the division of maternal-fetal
medicine and an associate professor of obstetrics, gynecology and
reproductive sciences at Temple University School of Medicine in
Philadelphia, said, “Obesity is a different ballgame. Different hormones
are playing around in obesity — fatty tissue produces more female
hormones, more estrogens. Other hormones are transformed into female
hormones in the adipose tissue.”

The research does not suggest packing on pounds to get pregnant, or
backing off physical activity completely, he said.

“Exercise is a good thing. It’s linked to less cardiovascular disease,
less cancers, less diabetes,” said Mastrogiannis, noting that physical
activity is also linked to better pregnancies, easier labors, less pain
and fewer induced births.

The bottom line of the study is that normal, non-obese women who want
to become pregnant should stick to moderate aerobic exercise,
Mastrogiannis said.

“We recommend our patients get moderate aerobic exercise, akin to 30
minutes a day is usually what we say. Walking is very important,” he
said.

“If they engage in very vigorous exercise — running, fast cycling,
gymnastics or swimming — more than five hours a week, it makes them less
fertile,” Mastrogiannis said.

More information

For more on pre-conception health, visit the American Pregnancy Association.

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