Whether you’ve yet to meet someone to build a family with, or you have major goals you want to accomplish before diving into parenthood, you may be drawn to investing in your fertility. And if so, you’d be far from alone. The process of freezing your eggs or embryos has skyrocketed in the past decade. The most recent stats from 2020 show that the number of total egg freezing cycles in the U.S. has increased by more than 104 percent since 2009, according to the Society for Assisted Reproductive Technology.
Putting your eggs or embryos aside for later use sounds like potentially the greatest gift you could give your future self. However, the process can be grueling for your body, mind, and spirit.
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“Egg freezing is as much a mental and emotional journey as it is a physical journey,” says Jasmine Pedroso, M.D., FACOG, and OB-GYN for Kindbody based in San Francisco. “If exercise plays a large role in controlling your stress levels, it’s important to continue.”
But given the risks of overexertion during an egg freezing cycle, modifications are a must, says Dr. Pedroso. Yet, it can be tough to pinpoint exactly what a safe workout should look like — and to determine which workout routines actually beneficial for your well-being while undergoing fertility treatment. Here, Dr. Pedroso and other experts offer clarity on how you can safely exercise while going through an egg or embryo freezing cycle.
What Happens During an Egg Freezing Cycle
A quick lowdown on what you can expect during an egg or embryo (aka fertilized egg) freezing experience: Depending on your age, menstrual cycles, preferred timing, and other factors, your process starts either when you get your period or after being on a course of birth control pills. Then, for 10 to 14 days, you’ll give yourself nightly injections of medication. While the specific medications your doctor prescribes dependon your individual biology, they usually include a follicle-stimulating hormone (FYI, follicles are small sacs inside the ovaries that fill with fluid and contain developing eggs). This injection induces your ovaries to produce multiple mature eggs (as opposed to the one egg that’s typically released during ovulation, which occurs once a month around day 14 of your cycle). Your medications will also include an antagonist, which prevents your body from ovulating early and releasing eggs before your scheduled egg retrieval.
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Once your follicles have grown to about 12-19 mm in diameter, you’ll inject a “trigger” shot of human chorionic gonadotropin, which kicks off the process of helping eggs mature. Then, you’ll undergo egg retrieval, during which an ultrasound probe is inserted into the vagina to identify developing eggs, which are then removed using a suction device. On the day you do the retrieval, eggs are identified as mature by checking under a microscope to see if a small cell (known as the polar body) is visible in the shell of the egg. Finally, depending on whether or not you’ve decided on a sperm provider, the mature eggs are frozen or fertilized (to become embryos) and later frozen.
How the Physical Side Effects of Egg Freezing Affect Your Workout
With so many factors at play during an egg-freezing cycle, you might be wondering just how all the medications and procedures will impact your ability to work out. Here, experts share the physical symptoms and side effects you might experience while freezing your eggs, and how these can affect your ability to work out safely and comfortably.
You'll experience bloating and pressure in your abdomen.
The fertility medications cause the ovaries to swell from the size of strawberries all the way up to potentially the size of grapefruits, depending on how many follicles are growing during the process, explains Jessica Ryniec, M.D., ob-gyn, and reproductive endocrinology and infertility specialist at CCRM Fertility in Boston. "With this increase in ovary size, there is an increase in bloating and pressure — [such as] a feeling of being full," she explains. This side effect can make you feel more lethargic than usual, nudging you to slow down your usual workout routine.
You run the risk of ovarian torsion.
When it comes to offering advice about how to work out during an egg or embryo freezing cycle, doctors are most concerned about the risk of ovarian torsion.
“The larger your ovaries become throughout the process of egg freezing, the more vulnerable your ovaries are to twisting and cutting off their blood supply,” explains Dr. Pedroso. “While rare, not only does this cause severe pain, but it is a surgical emergency that can result in loss of your ovarian function.”
For this reason, your doctor will advise against high-impact workouts during an egg-freezing cycle. "It is typically not recommended for people to be doing any exceptionally vigorous activities, because those increase the risk of torsion," says Dr. Ryniec. She adds that this advice applies while you're undergoing ovarian stimulation, as well as for about 10 days after egg retrieval while the ovaries recover.
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As you begin injections and your follicles begin to grow, your healthcare provider will likely encourage you to stick with low-impact exercise. After all, exercise may improve blood flow and could make you feel a little better through the process, says Dr. Ryniec.
One key thing to keep in mind: Ovarian stimulation heightens the risk of dehydration, notes Sheeva Talebian, M.D., board-certified reproductive endocrinologist with CCRM New York. So make sure that when you're working out you make a point to hydrate — even more so than you think you need to — and increase electrolytes.
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Here, explore ways to move that are safe and potentially beneficial during an egg or embryo freezing cycle. Of course, always speak with your healthcare provider before starting a new workout or modifying your exercise routine.
Go for a walk outside.
Taking a leisurely-paced walk isn’t just a lovely way to get fresh air and boost your mood — it’s also one of the most frequently recommended workouts for people freezing their eggs, among the experts interviewed.
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You might hit a local trail or simply walk to a destination versus driving while running an errand, says Shannon Decker, ISSA-certified trainer and pre- and postnatal fitness specialist. “It might be the last thing you want to do, but it is safe, can be done anytime, and will make you feel better physically and mentally,” she says. Walking can be made even more enjoyable by meeting up with a walking buddy, calling a friend to catch up, or listening to a podcast, she adds.
Do incline walking on a treadmill.
If you’re missing out on that beloved HIIT class and feel like you need a cardio fix during your egg freezing cycle, opt for incline walking on a treadmill for about 20 to 30 minutes. Incline walking will support healthy blood flow and lower stores of the stress hormone cortisol, which might be on the upswing from the heightened stress of the egg or embryo freezing process, explains Katie Breard, pre- and postnatal training specialist. “Low-impact cardiovascular movement, [such as] incline walking, is also great for aiding digestion, which can be majorly slowed by [your meds],” she says.
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Plus, even a low incline will activate your hamstrings, glutes, and calf muscles, says Maggie Priore, NASM-certified personal trainer and pre- and postnatal fitness specialist. “Just maintain a moderate pace to avoid bouncing [and impact] and running,” she notes.
If you have access to a pool, you'll do well to take a dip — another form of movement that's much-loved by Breard. Not only is it easy on your joints, but you burn about 250 calories for 30 minutes of swimming, she says.
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There’s a spiritual benefit of swimming to consider as well, according to Darby McCullough, E-RYT 500, yoga teacher and Y7 instructor. “Water is associated with the sacral chakra, located at the lower belly and inner pelvis and tied to reproductive health,” she explains. “So swimming can be a wonderful way to tune into and support that energy, which is heightened and often taxed during an egg or embryo freezing cycle.”
Step up stretching and foam rolling.
While it might not sound like a “workout,” per se, any complete fitness routine involves recovery practices that will bolster mobility. Consider the egg freezing process as an opportunity to commit to this part of your routine. Most of Priore’s clients undergoing fertility treatment begin sessions with gentle stretching, foam rolling, and potentially using a massage gun or myofascial release techniques, which relieves tight fascia and reduces inflammation, she notes.
"Both methods are also really good for blood flow and to get the body moving, especially when [you're] feeling sore and tired," she points out.
Lift lighter in a modified position.
"Strength training in a seated or standing position that does not entail bending, jumping, or twisting can be safe the entire time," points out Dr. Talebian, who recommends steering clear of heavy lifting.
And depending on how you feel, you might prefer to focus on upper body moves, such as standing triceps kickbacks, biceps curls, and shoulder presses, which don't entail twisting or putting pressure on the core, notes Priore. Reminder: Pressure on the core could cause ovarian torsion and impact your ovarian function during the fertility treatment and beyond.
Do restorative yoga.
“Yoga and breathwork are great at balancing our hormones as well as the endocrine and lymphatic systems — both of which hold onto stress and tension,” says McCullough. But avoid any Vinyasa and/or heated classes in which you’re sweating a ton and doing inversions, which might elevate the risk of ovarian torsion.
Instead, McCullough suggests taking a Yin yoga class, a practice that involves resting in passive poses that are meant to bolster your flexibility. “A slow, deep practice, [such as] Yin — or Hatha — can really help to regulate your breath, balance your mood, and reduce cortisol,” she notes. It’s also advisable to work with a yoga teacher who’s experienced in variations and open to chatting about guiding you through them, so you don’t feel pressured to bend yourself into an uncomfortable pose.
The Main Takeaway On Exercise During Egg Freezing
Ultimately, you'll do well to listen to your body to tell you which movements are dos — and which might be best put on the back burner. "If it's stressful, if you're too out of breath, if you feel like you're pushing through, it might be a don't," says McCullough. Going through an egg or embryo freezing cycle is a time to stay in your comfort zone, she concludes.
"Certainly if any activities are causing discomfort in any way, it's time to alter the routine or pause," adds Dr. Ryniec. And if you're in doubt about how to keep up your routine, "It's always best to consult with your provider about the safest activities for you while going through fertility treatment," she advises.
If it turns out that you do need to slow your routine down more than you anticipated, Decker recommends reframing the time-out. "Rest will only motivate and prime you to be even more excited when it's time to get back to it," she notes.