IVF#2: To Exercise, or Not to Exercise?

This question plagues me every single time we get close to an FET/IVF/TWW, and to be honest, I am no where closer to a solid answer on this.

As most of you know, I am a very physically active person. I played multiple sports on a competitive level. My regular schedule of activity before TTC was intense hockey games 2-3 days a week, plus weight lifting 3-4 days a week. My body loved it, my mind loved it. Sometimes I wonder if that’s how I managed to keep my depression at bay without meds for so long.

When we started doing the IUIs, I continued playing hockey twice a week, weight lifted 2-3 days a week, and limited my exercise to regular daily activities during the TWW (no hockey, no weights). In between BFN’s, I would go back to playing hockey and lifting. In total, I had 4 BFNs from IUIs.

When we moved to IVF last year, I went down to playing ice hockey once a week, and continued weight lifting. Once my ovaries started becoming palpable from the outside (approx stim day 8), I stopped everything except for walking the dogs. We got lots of eggs that round. 21 mature –> 14 fertilized –> 7 day five blastocysts.

Embryo transfers 1 and 2 were DW’s, and she weight lifted once a week plus dog walks before the fresh transfer, and only dog walks during her TWW. After her 5 week miscarriage she joined me back playing hockey once a week. After her second transfer, she only did dog walks, until her miscarriage again at 5 weeks.

Prior to embryo transfer #3, I was playing ball hockey twice a week, and walking the dogs almost daily until the TWW. During pregnancy, I only did dog walks a couple of days a week, until 6 weeks when I went back to weight lifting, and then miscarried sometime during week 7/8.

I returned to the gym a week after my D&C at week 9, and for three months, lifted heavy weights and did compound lifts (squats, deadlifts) 3-4 days a week. I also did sprints 2 days a week. This is until embryo transfer #4, after which I did nothing but dog walks.

After embryo transfer #4 = BFN, I look two weeks off due to being depressed and Christmas holidays. For the past two weeks, I have been working through this high volume fitness competition program. I am on week three of the muscle building phase. Since I started it, I’ve packed on three pounds, but it’s hard to know if it’s just water weight from re-introducing carbs (from 15% to 35% of my macros), muscle mass, or gosh fat (from eating nearly 500 more calories daily than before). I am loving the program so far, and find that I am so hungry even with the increase in calories (from more muscles?), but realize that I shouldn’t be continuing this program once I start stims. The program has me lifting for 90 minutes 6 days a week, plus the 3 days of cardio that I’m not doing (I don’t want to create a calorie deficit). I realize that this is too much, and too frequent for a body trying to optimize reproduction.

Now, I’m trying to decide whether to limit myself to dog walks soon, or whether it’s safe to keep lifting, but at a much lighter resistance.

During my research, I find things like this, which has me thinking that since I have worked out regularly for over 15 years now, no matter what I do, my outcome will be the same. This study essentially says that women who have a history of exercising regularly for five or more years generally have poorer outcomes than sedentary women, regardless of if they exercised during IVF or not.

Then of course, there’s this, which has me totally thinking that I shouldn’t exercise during the first 18 weeks of pregnancy because of the greater risk of miscarriage, but then confuses me by showing studies that say exercise helps to prevent miscarriage. Though, neither really matters to me right now because my concern is about IVF outcomes.

The alternative medicine doctor part of me thinks that all strenuous activity (things that make you sweat, hold your breath, increase your intraabdominal pressure) should take a back seat during stims and the TWW because these kinds of activities drain the resources (Qi) needed to make and nourish developing eggs/embryos. From a primal/paleo perspective, these activities would mimic the unfavourable conditions of running away from predators, or having to hunt/forage, both of which indicate to the body that right now food is scarce and not a good time for baby making. Also, heavy lifting encourages the cycle of muscle damage and repair, which is the basis of muscle building. This increases the oxidative load on the body, and the resultant increase in metabolism increases the amount of free radicals floating around, which is also bad.

As for light exercise such as walking, and light cleaning, I believe these activities are good during stims and the TWW. They increase the circulation through the body, and get some good endorphins flowing.

What I would love to see is a study comparing consecutive IVF cycles- one with exercise and one without, with identical treatment plans, and what the resultant embryo numbers and qualities are. Too bad I can’t find anything like that, as it would shed some light on what I should do.

What I do Know
– I have already stopped doing cardio because it is counterproductive to try to burn calories
– I will keep my calories the same as right now (well-fed and higher than maintenance).
– I will definitely not put myself at risk of ovarian torsion.
– I will not exercise while my ovaries are healing from egg retrieval (last time took two weeks to have a non-painful poop)

Those of you who have done IVF- what kind of activity did you maintain during your stims? What kind of outcome did you have from your IVF? What would you do if you had to do IVF again? What was recommended to you by your RE?

Limbo

Wow, I haven’t posted in a while. I’ve been cooking up a storm, adapting new recipes, and washing lots of dishes. Yesterday I made my first gluten-free (GF) turkey meatloaf, and today I made GF turkey meatballs, and tomato sauce with produce from our garden. I plan to serve it for dinner on shredded spaghetti squash (also from our garden). Props go to DW for growing me all of these amazingly gorgeous organic vegetables and herbs!

Time seems to be moving at a very strange pace for me. Being home every day means that my sense of time is dictated by my daily chores, appointments, and the return of DW from work. I have been running errands, hiking on the conservation lands with the dogs, preparing elaborate dinners, and probably not cleaning as much as I should be. We have been relaxing at the cottage on weekends, so my routine is kind of messed up in this way too.

Obviously, in many ways I’m glad that I’m not at work. I suffered from an alarming level of anxiety from being dealt a ridiculously unfair schedule, a lack of support from the people that are supposed to be supporting me, as well as doing my best (and failing) at trying to provide meaningful learning moments for kids that are the most challenging in the district. I was not eating. I was not sleeping. I had fleeting thoughts of self-harm. My family doctor insisted that I take a break from all of it to regroup and grieve our loss. I am currently about one third through my leave of absence, and I am terrified of going back.

I feel like I’m just beginning to heal physically. I’m still spotting daily, and I definitely notice my athletic limitations compared to pre-pregnancy: lower cardiovascular endurance, core strength is gone, and my strength has severely decreased. I have been lifting weights again every other day for the past week and a half, and my energy and motivation has been lacking. Pre-pregnancy, working out has always been a treat and a stress-reliever, but now I feel like I’m dragging my heels and my body just won’t do what I want it to do.

Interestingly, my eyesight has significantly changed as well. I had an eye exam two days ago, and my vision, which has been stable since 2007, has gotten worse by almost 2 diopters in both eyes! I suspect that all of the pregnancy hormones have messed up my body in many ways that I am unaware of.

Emotionally, I am really struggling. Part of me wishes that I was back at work (I really enjoy my career- just not at this particular school and schedule), as I miss the kids, routine, and socializing with my colleagues. In particular, I miss the first two schools that I was at. The kids were amazing, and the staff made me feel like family. Even the administration were very personable and supportive. However, my past two schools have been really difficult- due to the administration (lack of support and disciplining of students), and the particular classes that I have been assigned (the classes that nobody wants because it involves teaching the most difficult content to the most poorly behaved students). Unfortunately, being in a union (don’t get me wrong, I am so appreciative of unions) so much of where you teach and what you teach is dependent on seniority, and being a relatively new teacher in a school board that is shrinking, I am at the bottom of the food chain. So the most experienced teachers can choose to teach the easiest students and their first choice of subject, and the new teachers with the least experience get what nobody else wants. Not to mention that I get paid half what they get paid, and end up working extra hours at home prepping every night.Makes sense right? Ugh.

Look at me. Three weeks off from work and I’m still bitching about it. Now and again I have to remind myself that I am so lucky to have job security and benefits, and an (unpaid) summer off.

In happier news, I came home to a gift today:

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A friend of mine sent it with their condolences on our loss, and for a moment I was so touched but also so frustrated that miscarriages are often such a hush-hush secret. I know they are common, but given the lengths that we have gone to make a baby, our repeated losses seem even more tragic. For example, we can’t just have sex a ton more times and get pregnant (though- this should not dissuade anyone from trying this strategy ;)). We apparently can’t even get an IUI to work. Very frustrating.

In the meantime, I will wait for DW to get home before diving into these:

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I saw a new Doctor of Traditional Chinese Medicine this week. He lectures annually for the acupuncture program that I used to teach for. He is a fertility specialist, and until now, I haven’t been able to see him because he only treats on weekdays (teacher schedule). The appointment went well. He is very thorough and has a three-phase plan for me. The first phase is getting my natural period to come and flush out all of the stagnation in my uterus (and what energetically remains of the pregnancy). Then, we work on building my yin, which is quite depleted in me, and what likely causes my long follicular phases (eggs need more time to mature because my yin is too weak). Lastly, we will work on lengthening my luteal phase, which is super short. He says that even if I were getting pregnant naturally, my luteal phase is so short that proper implantation can’t even occur. Sometimes, regulating the follicular phase also fixes the luteal phase as well. He’s got me on some herbs right now, which are in the form of high potency granules. While I’m very proficient at acupuncture and general TCM principles, I was not trained in the healing properties of herbs, which can have incredible synergy with the acupuncture treatments. I am glad he is healing me through the use of both. He suggests that I sit this next cycle out, and try again the following cycle. So essentially, I’m in limbo for another 9 or so weeks.