Along with “Can I drink wine?” one of the most common questions people going through the egg stimulation process in preparation for an egg freezing, egg donation, or IVF procedure is what they can do if they would like to continue to work out. And the answer is often tricky—with special concerns for avoiding exercises that include twisting and certain movements that can up the chances of exercise-induced ovarian torsion, they’ve had few options, and certainly no dedicated workout plan. But the Pvolve Method is here to change that.
We’ve partnered with the experts at Spring Fertility to create Moving During Fertility Treatment a first-of-its-kind slow and steady workout program designed for people going through egg stimulation and retrieval who have been cleared for exercise. The program avoids the jumping, twisting, and excessive pelvis movements that doctors advise against during this period. We also provide restorative techniques as well as Q&As with doctors in the field for that extra bit of support that can make all the difference in helping your state of mind. It’s all created for those who crave movement and self-care as they go through the process of hormone injections and egg retrieval—and it’s here for you whenever you need it.*
Want to learn more about the ovarian stimulation process?
Dr. Kolbe Hancock, MD, fertility specialist at Spring Fertility, who has completed a Fellowship in Reproductive Endocrinology and Infertility, as well as Residency in Obstetrics and Gynecology at Weill Cornell Medical Center and Dr. Shannon Devore, MD, Clinical Assistant Professor in the Department of Obstetrics and Gynecology at New York University’s Grossman School of Medicine and a member of Pvolve’s Clinical Advisory Board paired up to answer the most asked questions about ovarian stimulation and the fertility process.
*As with any fitness program, consult your doctor before starting.
What is ovarian stimulation?
Each month your ovaries offer up a group of eggs for a chance at ovulation. In a regular menstrual cycle, your body allows just one out of this group to grow, and eventually ovulate mid cycle. Ovarian stimulation is the process by which we stimulate the month’s entire cohort of follicles (which contain eggs) to grow and develop. We use the same hormones, FSH and LH, released by your brain, but in higher quantities. In a normal menstrual cycle, the increasing estrogen released by the developing follicle turns off this hormone. During ovarian stimulation we override that negative feedback by continuing to give FSH/LH. The result is many follicles (and thus eggs) grow and develop rather than just one. This multi-follicular recruitment allows us to optimize the cycle because it takes numerous eggs to make an embryo.
What are the phases of ovarian stimulation?
The whole stimulation process typically takes 10-14 days and can be divided into a few phases.
Early Follicular Phase
The early follicular phase is the first 4-5 days of stimulation. The follicles and ovaries are typically still small and most women do not have significant symptoms or feel very different.
Late Follicular Phase
The late follicular phase is the latter half of the stimulation up until the last shot—the trigger injection. During this phase the ovaries and follicles are growing and may become quite uncomfortable. Bloating and fatigue are the most common complaints, however there is a huge range of symptoms including but not limited to headaches, sore breasts, abdominal discomfort, and mood changes.
Luteal Phase
The luteal phase consists of the time between the egg retrieval and your period. The follicles have transformed into corpus lutea which secrete progesterone. Women may experience bloating, abdominal discomfort, fatigue, breast swelling/tenderness as well as constipation. A very small percentage of women may develop symptoms of ovarian hyperstimulation syndrome such as rapid weight gain, difficulty breathing, severe abdominal pain, significant nausea/vomiting, and decreased urination. You should alert your doctor immediately if you develop any of these symptoms.
Who typically goes through the process of ovarian stimulation?
Women who are preserving their fertility for the future by freezing eggs and/or embryos as well as women with infertility who are making embryos for immediate implantation. Some women who choose to donate eggs may also undergo this process.
What are the general Dos and Don'ts you tell your patients during this period (outside of movement)?
Generally we recommend against heavy drinking during the egg freezing or IVF process, not because it impacts the egg quality or the success of the cycle, but because your body’s homeostasis and fluid balance is disrupted by ovarian stimulation and will be further impacted with significant alcohol consumption. That being said, if you have a special event a glass or two of wine, particularly early in the cycle, is absolutely acceptable. We do recommend self-care with stress-reducing activities such as safe movement, meditation, mindfulness and acupuncture. Anything that boosts your overall wellbeing will help you feel your best during the treatment.
What kind of movement do you suggest during each phase?
The type of movements we suggest correlate with the three phases of ovarian stimulation. The goal is always to keep the pelvis neutral position and free from large or sudden movements, twisting, and inversions to reduce the risk of ovarian torsion.
During the early follicular phase, the movements are a bit bigger and heart rate is up, as the ovaries grow and you enter the ovarian stimulation phase the movements are pared back and great care is taken to reduce the risk of torsion.
As your period comes on about 10 days after retrieval, your ovaries are nearly back to their original size, and regular exercise can be started again.
Is there anything you can do to prep for ovarian stimulation?
This is always a difficult question because for better or worse there is not a tremendous amount you can do to positively or negatively impact this process in terms of the number of eggs, or quality of the eggs or embryos. A great deal of it is out of your control. That being said, you will feel your best if you eat a well-balanced diet full of healthy fats, protein, fruits, and vegetables. Stress-reducing activities such as movement, meditation, and acupuncture will be beneficial to your physical and mental health before and during this process. Studies show certain supplements may improve egg quality so ask your physician if they are appropriate for you.
How long after you finish the process can you jump back into your normal routine?
Most women feel ready to get back to their regular routine by the time their first period after the retrieval arrives (typically around 10-12 days after the egg retrieval). Exceptions are women who had or were at risk for ovarian hyperstimulation syndrome, they may take more time to feel back to baseline and should consult with their doctor about when to resume certain activities. Be kind to yourself, everyone recovers at different paces and your period is sometimes not the magical end date of symptoms.
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