# Impact of Physical Activity on Ovarian Response: A Prospective Study Among In Vitro Fertilization Patients

## TL;DR

This study found that physical activity generally does not affect ovarian response in IVF, but may help in specific groups like those with endometriosis or normal BMI.

## Contribution

The study identifies specific subgroups where physical activity improves ovarian response during IVF.

## Key findings

- Overall, physical activity levels did not affect the number of retrieved or mature oocytes.
- In women with endometriosis and ovulatory disorders, higher physical activity was linked to more mature oocytes.
- Normal-BMI women with high physical activity had more retrieved and mature oocytes.

## Abstract

Introduction

Scientific evidence has shown that regular physical activity (PA) is beneficial to health. However, no consensus has been reached on the association between PA and the success rates of assisted reproduction treatments. The purpose of the present study was to determine whether various levels of physical activity have an influence on ovarian response to controlled stimulation in ‘in vitro fertilization’ (IVF) or ‘intracytoplasmic sperm injection’ (ICSI) cycles, defined as number of retrieved and mature oocytes.

Methods

This prospective observational study included 617 infertile women undergoing IVF/ICSI cycles between January 2019 and October 2020. PA was assessed prior to the IVF cycle, using the International Physical Activity Questionnaire short form (IPAQ) and triaxial accelerometers. Patients were classified into three groups: low, moderate and high PA.

Results

Globally, the number of retrieved oocytes was similar in all three groups according to IPAQ (9.23 ± 7.72; 8.35 ± 5.57; 8.82 ± 6.38). Something similar happened with the number of mature oocytes (6.97 ± 5.99; 6.84 ± 4.85; 7.05 ± 5.61). PA did not influence the number of oocytes (retrieved or mature) in most clinical subgroups established (age, smoking, body mass index (BMI), anti-mullerian hormone (AMH)). However, in the subgroup 'endometriosis' the number of mature oocytes was significantly superior in high and moderate vs low PA (p=0.024). In the subgroup 'ovulatory disorders' there were also more mature oocytes in high and moderate vs low PA (p=0.038).

When performing the analysis according to accelerometer there were globally no significant differences between PA groups, nor in most clinical subgroups considered. Only in women with normal BMI, high PA was significantly associated with a greater number of collected (p=0.005) and mature oocytes (p=0.004).

Conclusion

Globally, PA had no influence on ovarian response in IVF cycles, defined as number of retrieved and mature oocytes. However, in certain clinical subgroups (endometriosis, ovulatory disorders, normal-BMI) high PA was associated with a superior ovarian response.