What to do to make an IUI stick?

May 10, 2016 5:30 PM

I just did our first attempt at intrauterine insemination (IUI), and I'd like to give it the best possible chance of working. But the internet and the fertility clinic are giving me very mixed messages about what level of exercise is okay during the post-IUI phase.

More details on me: I'm in my early 30s, we've been trying to have a baby for 18 months, we're doing an IUI partly because my husband's sperm is on the low end of normal and partly because we couldn't always pinpoint my ovulation correctly. I'm otherwise very healthy and fit.

I usually work out almost every day, either playing frisbee, biking, running, or rock climbing. I asked the nurse which of those I could do and at what point after the IUI. She told me that I should avoid 'high impact' like running because that could jostle me/it and avoid climbing because I could 'fall and injure myself.'

Everything I've found online says to cut back on strenuous exercise, not because of jostling (which several sites specifically say is not a thing) but because it can stress your body out if overdone. No one seems to agree on what level of exercise is safe. Some sites suggest not exercising for 24 hours after the IUI, which is fine. I can climb without falling, if that's the only risk there. I can cut back running to some acceptable level. I just don't know what that level is.

Can anyone point me to real sources or papers on how exercise impacts implantation and successful pregnancy or what level is ok? I don't want to not exercise for two weeks every month while we're dealing with this - I'm already grumpy enough without taking away my stress relief and social outlet.

(I know that there are sources that say over-exercise can interfere with ovulation and mess up the menstrual cycle. I'm aware of those and using those recommendations. It's specifically the after ovulation phase that I'm interested in)

posted by oryelle to Health & Fitness (6 answers total)

I can't think of any studies in this area. It would be hard to study. Can you take those two weeks and specifically focus on low-stress ways to move your body? Eat healthy. Do yoga, meditation, focus on getting sleep, keeping hydrated. You don't want your body to compete for resources, you want it to focus on making a baby. I don't really think it's about "jostling." Maybe that will help you find some outlets.

It's so frustrating that we don't really have answers. You'd think that we would know *everything* by now.
posted by amanda at 7:01 PM on May 10, 2016

The lack of available, consistent studies on ART is maddening. The jury on post-IUI exercise is--as it is on most other ART subjects--out. I don't expect I can point to more sources than your own Googling has revealed. I can share anecdata, but it won't relieve your uncertainty. Sorry about this. It super sucks.

All I know is you're the only one who has to live your life. You've already asked a nurse's advice and known in your gut (and Internet search) that it's not the right advice for you. Ask your doctor as well. Ask another nurse. Weigh their different opinions against your own knowledge of how to take care of yourself and your body.

FWIW, whenever I abstained from exercise for IF treatment, it was a bad time for my brain chemistry.

Good luck, good luck, good luck.
posted by AteYourLembas at 7:06 PM on May 10, 2016

There is a lot of conflicting information out there and so our philosophy has always been to do what MY doctor said. For what it's worth, she said there is no way to 'jostle' it out. It doesn't work that way.

Anecdotally, I didn't feel up to much afterward so I took it easy. Best of luck to you. It worked for us and I hope you have similar successes.
posted by JoannaC at 6:14 AM on May 11, 2016

I've worked with ART/fertility specialists and, while there's not a lot of research about this as that would have some serious ethical issues, anecdotally, most all of them recommended a small amount of gentle exercise and not to do anything that actively recruits the abdominals. Some suggested this approach until a good implantation and progression could be established and some wanted this approach through the first 8 weeks. Once you have an established, secure pregnancy, you can go back to most of your activities without issue. Many of the ones I worked with had some strong opinions based on what they observed in years of practice, but didn't always share that with patients as it wasn't rigorous research and also couldn't be backed-up with research because there isn't a lot out there.

Good luck and I hope it sticks nicely for you.
posted by quince at 2:58 PM on May 11, 2016

Jostling is definitely not a thing.

There IS some research on this. Here is one study I am familiar with. It is a prospective cohort study of over 3600 women. It suggests that "vigorous exercise" is negatively correlated with fecundability.

Caveat: women undergoing infertility treatment were excluded from this study. However, when I was undergoing infertility treatment, my attitude was that I'm paying way too much for this, and stressing out way too much, to do anything that might be associated with F#$%ing it up. For me, I did not do any exercise on the day of IUI. I switched from running to yoga, and I've been a very happy yoga practitioner ever since - used to think yoga wasn't serious exercise (or fun), that clearly was because I hadn't tried it. Yoga was great for my mental health when I was undergoing all that infertility awfulness too. If I were you, I'd exercise for sure. I was in the best shape of my life at that time. I did yoga an hour a day, 5-6 times a week. It was great sublimation. I definitely know other people who kept running during infertility treatment but based on the limited data available, it seemed to me that running might be too high impact and I cut it out completely. My anecdata - I have PCOS, took metformin and I did about 4 failed IUIs with Clomid, one with letrozole, and then had a successful cycle and pregnancy with injectables+IUI. I now have two children - no infertility treatment needed for #2!

I do want to say though that vigorous exercise, drugs and alcohol aside, there is very little that you can do to "make this stick". Embrace the lack of control. I know it's hard. I hated it. But the more you realize you don't control this process, hopefully the less you blame yourself when it doesn't work. Because it isn't that you did something wrong, even though it feels it somehow must be. Give yourself a break and take great care of yourself, love yourself, do things that you enjoy. Those are the best ways I know to survive infertility. Best of luck, thinking sticky thoughts your way.
posted by treehorn+bunny at 2:55 AM on May 12, 2016

Another one I just noticed is in press right now related to the subject - intriguing and supports the idea that exercise is good, says that moderate exercise increased fecundability for all women, and vigorous exercise was good only for obese women (in the prior study I linked, it was thin women, not obese women, who had a negative effect with vigorous exercise).
posted by treehorn+bunny at 3:05 AM on May 12, 2016