Physical activity before IVF and ICSI cycles in infertile obese women: an observational cohort study

Abstract

This study assessed the relationship between regular physical activity and reproductive performance in obese infertile patients who receive assisted reproduction cycles with stable bodyweight. A total of 216 obese infertile women at their first fresh assisted reproduction attempt with stable body mass index (BMI) and available data on their physical activity carried out up to the beginning of the treatment cycle were enrolled in this observational cohort study. Clinical and biological data were recorded and analysed. There were 41 obese patients who did regular physical activity and 175 obese controls who did not. Total pregnancies (16/41, 39.0% versus 28/175, 16.0%, respectively; P = 0.002) and live births (10/41, 24.4% versus 13/175, 7.4%, respectively; P = 0.004) were significantly higher in patients who did physical activity regularly compared with those who did not. After adjusting for confounders, in obese infertile patients who did physical activity regularly, the relative risks for a clinical pregnancy and live birth were 3.22 (95% CI 1.53-6.78; P = 0.002) and 3.71 (95% CI 1.51-9.11; P = 0.004), respectively. In conclusion, regular physical activity carried out before a assisted reproduction cycle is significantly related with improved reproductive performance in obese infertile patients, irrespective of bodyweight loss. Body weight loss improves not only spontaneous pregnancy rates but also those of assisted reproductive techniques (ARTs). Moreover, almost all studies refer to body weight loss due to lifestyle intervention programs consisting in hypocaloric diet and increased physical activity. Instead, very little is known about the specific effects of physical activity alone on human reproduction. Based on these considerations, we designed the present study to assess the relationship between regular physical activity and reproductive outcome in infertile obese patients who receive ARTs. Two-hundred-sixteen obese infertile women with stable body mass index (BMI) and at their first fresh ART attempt were enrolled, and clinical and biological data were recorded and analyzed. Our results demonstrate that the chances to obtain a pregnancy and a baby are 3-fold higher in obese infertile patients who does physical activity regularly in comparison with those who does not, suggesting that regular physical activity before ART cycles improves the reproductive performance in obese women irrespective to body weight loss.

Independent factors influencing large-for-gestation birth weight in singletons born after in vitro fertilization

“…Are there some other fertility factors that put them in the Bgood prognosis^group? For example, it has been shown that chances to obtain a pregnancy and live birth are threefold higher in obese infertile patients who are regularly physically active in comparison to those who are not, irrespective to their body weight loss [45]. We investigated irregular menstrual cycle rate in order to discover whether PCO syndrome represents a risk for an LGA singleton, and we found no connection to LGA.…”

Maternal physical and sedentary activities in relation to reproductive outcomes following IVF

“…Results of previous studies on physical activity and outcomes of assisted reproduction have been inconsistent, with two studies finding a beneficial effect (Evenson et al ., 2014; Palomba et al ., 2014), two finding no effect (Kucuk et al ., 2010; Moran et al ., 2011), and one finding a detrimental effect (Morris et al ., 2006). The accuracy and time frame of physical activity assessment could be one explanation for the heterogeneous results across studies.…”

“…A third study (Moran et al ., 2011), a small trial that randomized overweight women to a lifestyle intervention, including a reduced energy diet and a home-based physical conditioning and walking programme before IVF, observed no differences in pregnancies or live births compared with a group receiving standard treatment. Finally, the two most recent cohort studies showed that regular physical activity carried out before an assisted reproduction cycle was related to improved live birth rates in a cohort of obese patients (Palomba et al ., 2014) and improved clinical pregnancy rates in a general IVF population (Evenson et al ., 2014). …”

Sedentary behavior, physical inactivity and body composition in relation to idiopathic infertility among men and women

“…Some previous studies failed to demonstrate a relationship between PA and semen quality [11,12]. In women, moderate PA increased fecundity parameters and live birth rates, regardless of body mass index (BMI) [13,14]—even during assisted reproductive treatment [15–17]. However, vigorous activity has been associated with lower semen quality in men [18–20] and decreased fertility in women [21–23].…”