Exercise Before, During and After!
One of the questions I get the most after an embryo transfer is “How long do I have to be in bed rest?” The truth is that there is no scientific evidence that bed rest is of any benefit when doing IVF. Research shows that it does not make a difference and may even decrease success rates. Patients often follow with the question “Can the embryos fall off the wall of the uterus if I walk around today?” The answer is “No”. At this time estrogen levels are very high, so the addition of bed rest can increase the risk of blood clots.
However I do usually recommend some precautions. It is not the time to take a long, hot bath and of course scuba diving is out. Rather, do something that is conducive to relaxation and mindfulness; make sure you continue to eat healthy, avoid artificial ingredients and environmental toxins as much as possible.
In December 2015, the American College of Obstetrician and Gynecologists released a document with strong recommendations for physicians and nurses caring for pregnant women. It said “Physical activity in pregnancy has minimal risks and has been shown to benefit most women, although some modification to exercise routines may be necessary. Women with uncomplicated pregnancies should be encouraged to engage in aerobic and strength-conditioning exercises before, during, and after pregnancy. Regular physical activity during pregnancy improves or maintains physical fitness, helps with weight management, reduces the risk of gestational diabetes in obese women, and enhances psychological well-being. An exercise program that leads to an eventual goal of moderate-intensity exercise for at least 20–30 minutes per day on most or all days of the week should be developed with the patient and adjusted as medically indicated.”
The recommendations are valid for women with normal body weight and for women who are obese (BMI above 30). Exercise itself does not typically result in significant weight loss, unless it is combined with a change in eating habits. Therefore, women with a normal body weight should not typically fear losing too much weight. On the contrary, exercising can enhance weight loss for obese women who are in the process of changing their eating habits. The time to pregnancy is longer for women who are obese with multiple reproductive parameters being impaired. Once pregnant, the risks of miscarriage, preeclampsia, diabetes, large for gestational age babies and stillborn is increased.
Why is the title of this post “Exercise before, during and after? Well, it seems that after delivering the baby, it is important to keep weight gain in check. Another recent study published in the prestigious journal, The Lancet, from December 2015 showed that gaining more than 4 units of BMI between pregnancies resulted in more than 50% increased risk of stillbirth in the subsequent pregnancy. But losing more than 2 units of BMI after delivery significantly decreased the risk of infant mortality.
So what is not to love about exercising and eating healthy for Moms to be and current Moms? If you don’t know it, you can calculate your BMI here and see where your numbers are…..
Laura Londra MD, FACOG