If exercise is an important part of your life, one of your first questions when starting IVF may be: "Can I still work out?" The answer is nuanced — it depends on the type of exercise, the phase of treatment you are in, and how your body is responding. But the short version is reassuring: you do not need to stop moving entirely. In fact, staying moderately active during IVF can benefit both your physical and mental wellbeing.
This guide breaks down the exercise recommendations for each stage of an IVF cycle, grounded in current medical research and the clinical guidance that most fertility specialists provide.
Why Exercise Matters During Fertility Treatment
Before diving into what is safe and what to avoid, it is worth understanding why exercise is valuable during IVF — beyond the obvious cardiovascular and mental health benefits.
Stress reduction: IVF is stressful. Moderate exercise has been shown to reduce cortisol levels, improve mood, and alleviate symptoms of anxiety and depression. When you are navigating daily injections, frequent clinic visits, and emotional uncertainty, movement can be a genuine form of self-care.
Improved blood flow: Gentle exercise promotes healthy circulation, including blood flow to the reproductive organs. Walking, in particular, supports pelvic circulation without placing stress on enlarged ovaries.
Better sleep: Sleep quality is important for hormonal balance and overall wellbeing during treatment (as we discuss in our article on sleep and fertility). Regular moderate exercise can improve sleep duration and quality.
Weight management: While IVF medications can cause bloating and temporary weight gain, maintaining a healthy baseline through moderate activity can support overall metabolic health.
However, there is an important caveat. One of the largest studies on exercise and IVF — which followed 2,232 patients — found that women who exercised regularly were no more likely to achieve a live birth than those who did not exercise. This does not mean exercise is harmful; rather, it underscores that the primary value of exercise during IVF is general wellbeing and coping, not a direct boost to success rates.
Before Stimulation Begins: The Preparation Phase
In the weeks and months leading up to your IVF cycle, before any medications have started, you generally have the most flexibility with exercise.
What Is Safe
- Your normal routine, within reason. If you are already a runner, swimmer, or regular gym-goer, you can continue your established activities.
- Moderate cardio: Walking, cycling, swimming, elliptical training — aim for the general guideline of approximately 150 minutes of moderate aerobic activity per week.
- Strength training: Light to moderate weight training is fine. Focus on maintaining fitness rather than building strength or pushing new personal records.
- Yoga and Pilates: Both are excellent choices for building body awareness, flexibility, and stress resilience.
- Mind-body practices: Tai chi, gentle stretching, and mindfulness-based movement are all beneficial.
What to Reconsider
- Extreme endurance training. Training for marathons, ultramarathons, or other extreme endurance events has been associated with disrupted menstrual cycles in some women. If you are preparing for IVF, it is worth scaling back from extreme training loads.
- Very intense strength training. Powerlifting at maximal capacity places significant stress on the body. Consider reducing intensity during the months leading up to treatment.
During Ovarian Stimulation: Days 1 Through Retrieval
This is the phase where exercise guidelines change most significantly. During stimulation, your ovaries are growing — sometimes dramatically. As follicles develop and enlarge, your ovaries can swell from their normal walnut size to something closer to the size of oranges or even grapefruits. This enlargement is the primary reason for exercise restrictions during this phase.
The Key Risk: Ovarian Torsion
The most serious exercise-related concern during stimulation is ovarian torsion — a condition in which an enlarged ovary twists on its own blood supply. Torsion is a medical emergency that can cause severe pain, nausea, and, if untreated, loss of the ovary. While torsion is relatively rare, the risk increases with enlarged ovaries, which is why high-impact and twisting movements are restricted.
What Is Safe During Stimulation
- Walking: This is the gold standard exercise during stimulation. You can walk daily at a comfortable pace. There is no need to power walk — a gentle, leisurely pace is ideal.
- Light stretching: Gentle stretches that do not involve twisting your torso are fine and can relieve the stiffness that comes from reduced activity.
- Elliptical training at low intensity: Low-resistance, low-speed elliptical sessions provide gentle cardio without the jarring impact of running.
- Very gentle swimming: Easy laps or water walking can feel soothing, especially if bloating is making you uncomfortable. However, some clinics advise against swimming during the latter days of stimulation or after retrieval due to infection risk — check with your specific clinic.
- Restorative yoga: Gentle, restorative yoga that avoids inversions, deep twists, and intense core engagement is generally acceptable.
What to Avoid During Stimulation
- Running and jogging: The repetitive impact can cause enlarged ovaries to bounce and twist. Even if you are an experienced runner, the risk of torsion makes this inadvisable during stimulation.
- High-intensity interval training (HIIT): The explosive movements, jumping, and rapid position changes in HIIT workouts are too high-risk during stimulation.
- CrossFit: The combination of heavy lifting, plyometrics, and intense conditioning is not compatible with enlarged ovaries.
- Contact sports: Any sport with a risk of abdominal impact (soccer, basketball, martial arts) should be avoided.
- Core exercises: Sit-ups, crunches, planks, and exercises that create significant intra-abdominal pressure can be uncomfortable and potentially risky with enlarged ovaries.
- Twisting movements: Russian twists, torso rotations, and similar movements should be avoided due to torsion risk.
- Jumping: Box jumps, jump rope, burpees, and any plyometric exercises are off-limits.
- Heavy weightlifting: Heavy squats, deadlifts, and overhead presses create significant intra-abdominal pressure. If you want to continue strength training, switch to very light weights with higher reps and avoid any exercise that makes you strain or hold your breath.
Listen to Your Body
As stimulation progresses, you may find that even walking becomes uncomfortable. That is okay. If your abdomen feels heavy, swollen, or painful, rest. The final few days before retrieval are often the most uncomfortable, and many women naturally reduce their activity during this time.
After Egg Retrieval: Recovery Days
Egg retrieval is a minor surgical procedure performed under sedation. Your ovaries will still be enlarged and tender afterward, and you will need time to recover.
The First 24 to 48 Hours
Rest is the priority. Most clinics advise taking it easy for the remainder of retrieval day and the following day. You may experience cramping, bloating, and fatigue. This is not the time for exercise beyond moving around your home.
Days 3 to 7 Post-Retrieval
You can gradually reintroduce gentle walking as you feel able. Start with short, slow walks and increase distance and pace based on your comfort level. Continue to avoid anything high-impact, twisting, or strenuous until your clinic clears you.
Your ovaries do not return to their normal size immediately after retrieval. It can take one to two weeks for the swelling to fully resolve, so the precautions against torsion still apply during this period.
During the Two-Week Wait: After Embryo Transfer
If you are proceeding with a fresh embryo transfer (or having a frozen embryo transfer in a subsequent cycle), the guidelines during the two-week wait are similar: gentle movement is encouraged, but intensity should remain low.
What Is Recommended
- Walking: Continue daily walks. Many clinics recommend aiming for approximately 150 minutes of gentle activity per week during this phase.
- Light upper body exercises: Gentle arm exercises, resistance band work for shoulders and arms, and seated exercises are generally fine.
- Gentle stretching and restorative yoga: Continue to avoid deep twists and inversions.
- Keep exertion moderate: A useful guideline is to keep your perceived exertion below a 5 out of 10. You should be able to carry on a conversation comfortably while exercising.
What to Avoid
- Everything listed in the "avoid during stimulation" section still applies.
- Hot yoga or hot Pilates: Elevated core body temperature in early pregnancy is not recommended. Avoid any exercise in excessively heated environments.
- Exercises that target the core: Avoid movements that put significant tension on your abdominal muscles.
- Anything that causes pain, pulling, or discomfort in your lower abdomen.
After a Positive Pregnancy Test: First Trimester
If your transfer is successful, congratulations. As your pregnancy progresses, you will transition from IVF-specific exercise guidelines to general prenatal exercise recommendations.
Most OB-GYNs and reproductive endocrinologists recommend continuing moderate exercise throughout the first trimester, with a few adjustments:
- Continue to avoid high-impact activities and contact sports.
- Avoid exercises that involve lying flat on your back for extended periods after the first trimester.
- Stay hydrated and avoid overheating.
- Listen to your body and reduce intensity if you experience pain, dizziness, or shortness of breath.
- Discuss your exercise plans with your OB-GYN, particularly if your pregnancy is high-risk.
Creating a Sustainable Exercise Plan for Your IVF Cycle
Here is a practical framework for planning exercise across your cycle:
| Phase | Recommended Activities | Intensity Level |
|---|---|---|
| ------- | ---------------------- | ----------------- |
| Pre-treatment | Most normal activities | Moderate |
| Stimulation (Days 1-5) | Walking, gentle swimming, light yoga | Light to moderate |
| Stimulation (Days 6+) | Walking, gentle stretching | Light |
| Post-retrieval (Days 1-3) | Rest, gentle household movement | Minimal |
| Post-retrieval (Days 4-7) | Short walks, gentle stretching | Light |
| Two-week wait | Walking, light upper body work | Light to moderate |
| Early pregnancy | Prenatal exercise per OB guidance | Moderate |
A Note on Medical Guidance
This article is for informational purposes only and is not a substitute for professional medical advice. The authors of this blog are not doctors or medical professionals. Always consult with your fertility specialist or healthcare provider before making any decisions about your treatment. Every person's fertility journey is unique, and your doctor can provide guidance tailored to your specific situation.
Conclusion
Exercise during IVF is not an all-or-nothing proposition. You do not need to stop moving entirely, but you do need to adjust the type and intensity of your activity based on where you are in your treatment cycle. The overarching principle is simple: move your body in ways that feel good and support your wellbeing, while respecting the physical realities of what your ovaries and body are going through.
Walking is your best friend throughout the entire process. It is gentle, accessible, and does not require special equipment or a gym membership. On days when even walking feels like too much, give yourself permission to rest. Your body is doing something extraordinary, and it deserves your patience and care.
