Exercise While Trying to Conceive: A Newport Beach Fertility Doctor’s Guide

The good news first

Regular exercise helps fertility for most people. It improves insulin sensitivity, supports healthy ovulation, especially in PMOS, builds strength, helps with sleep, and is one of the best tools we have for managing the stress of trying to conceive. Orange County makes it easy to stay active, between beach runs, hiking trails, and a yoga studio on every corner.

So I almost never tell patients to stop moving. What I do talk about, a lot, is balance: how much you’re training compared with how much you’re eating and resting.

Strength training is supported

I get asked all the time whether lifting weights is safe while trying to conceive. Yes. Strength training is supported by the evidence, and I encourage it. Building muscle improves how your body handles blood sugar, because muscle is where most of the glucose from a meal ends up. It also protects your bones, which matters even more if you’ve had a stretch of low estrogen from hypothalamic amenorrhea.

You don’t need a complicated program. Two or three sessions a week that work your major muscle groups, with weights, bands, or your own body weight, is a great place to start. Lift with good form, progress gradually, and eat enough protein and carbohydrates to recover. The one exception is IVF and egg freezing stimulation, when I ask you to pause heavy lifting until after retrieval (more on that below).

Walking and insulin resistance

Walking is underrated. It’s gentle, it’s free, and it works. Insulin resistance is common in PMOS, including in people at a normal weight, and it can disrupt ovulation. Regular walking helps your muscles take up glucose with less insulin, which over time can improve insulin resistance and, for some people, cycle regularity.

Timing helps too. A 10 to 15 minute walk after meals lowers the blood sugar spike that follows eating. If you have PMOS or insulin resistance, a short walk after dinner along the bay or around the neighborhood is one of the simplest habits I can recommend. Walking also pairs well with strength training: lifting builds the muscle, and walking keeps it using glucose throughout the day.

Walking is also the exercise I recommend during IVF stimulation and after embryo transfer, so it’s a habit that can stay with you through every stage of treatment.

When exercise starts working against you

Your brain is constantly checking whether your body has enough energy to support a pregnancy. When you burn more than you take in for long enough, especially when stress is high too, the brain turns down the signals that tell your ovaries to ovulate. Periods become irregular or stop. This is called functional hypothalamic amenorrhea, or FHA.

FHA isn’t only for elite athletes. I see it in recreational runners, people training for their first marathon, busy professionals who exercise hard and eat on the go, and people who have been dieting for a long time. Many of them are surprised, because they feel healthy and look fit.

What my research found

I’ve studied FHA closely. My team’s mixed-methods study, Food, fitness and fertility in functional hypothalamic amenorrhea, which I presented at the American Society for Reproductive Medicine meeting in 2023, looked at the experiences of people living with FHA, not just their lab values. We also presented a new screening tool, which we called STAFF, to help clinicians recognize FHA earlier and rethink how it shows up in modern life.

A big lesson from that work: FHA is often missed or brushed off for years. Many people are told to “just relax” or are put on birth control, which creates a monthly bleed but doesn’t fix the underlying problem. If your period has gone missing, you deserve a real explanation.

Signs your training may be too much

• Your periods are irregular, lighter than they used to be, or have stopped
• You’re often cold, tired, or getting sick
• You’ve had a stress fracture or nagging injuries
• Your libido has dropped
• You feel anxious if you miss a workout, or you exercise to “earn” food

If any of these sound familiar, please don’t ignore them. A missing period is a vital sign, not a convenience.

For runners

Running and fertility can absolutely coexist. When I see a runner whose cycles have changed, the problem is usually under-fueling, not running itself. Eating more, particularly carbohydrates around training, adding rest days, and easing back on mileage for a stretch often brings ovulation back. That can be a hard message for people who love their sport, so we work on it together, with a sports dietitian when helpful.

Exercise during IVF and egg freezing

During stimulation, your ovaries get larger than usual. To lower the small risk of ovarian torsion (twisting), I ask patients to switch to walking, easy cycling, or gentle yoga from mid-stimulation until after retrieval, and to skip running, jumping, heavy lifting, and deep twisting. After an embryo transfer, light activity is fine. Bed rest hasn’t been shown to help.

Once you’re pregnant

For most healthy pregnancies, guidelines recommend about 150 minutes a week of moderate activity. If you were a runner before pregnancy, you can usually keep running with your doctor’s okay, adjusting as you go. Avoid overheating and activities with a high fall or impact risk.

The bottom line

Move in ways you enjoy, fuel that movement, and treat your cycle as feedback. If it changes, let’s figure out why. Food matters as much as fitness here, so read my fertility nutrition page too, and see my PMOS and hypothalamic amenorrhea page for more on diagnosis and treatment.