Running

I went to a seminar a few weeks ago. It was a Resolve support group (I started a post about my different support groups through this, but it’s stuck on my phone; I will finish it eventually). That week they had a guest speaker discussing the mind-body connection, as well as yoga for fertility. It was interesting. Definitely less scientific than my usual approach to things, but they kept throwing out statistics that I had a hard time believing.

There is a body of literature out there that I like to refer to as “pseudo-science.” That is when something sounds good in theory, but it has never been studied in practice, so it’s not known whether the theory holds up in real life. This is a failure of the scientific method. You are supposed to develop a hypothesis, and then TEST IT. You then revise your hypothesis, retest it, and so on. You can’t just come up with a hypothesis then say “this is the way it is, you all should follow these recommendations.” But there is a lot of that out there, particularly in the field of diet and weight loss. But I digress…

The work in the mind-body field in infertility is interesting, and has been studied. They suggest that if you have less stress in your life, you have better outcomes with IVF. I’m willing to believe that, and the interventions they recommend are pretty harmless and actually probably helpful. Except for the $700 class they were advertising. I’m not *that* stressed out. Instead, I bought this book. It’s an interesting read.

The yoga for fertility portion of the evening brought out my inner skeptic. Yes, yoga is good. Yes, there are probably certain poses you should avoid when you are trying to conceive. But when she said that you should not exercise at all while trying to conceive (other than yoga of course), I had to speak up. “You just told us stress is bad, but now you are telling me to stop exercising, which is certainly going to cause me stress. I need to exercise, it keeps me sane.” Her response? Yoga. And then she started quoting studies.

Apparently women who engaged in more than moderate amounts of exercise in the 9 years prior to IVF had worse outcomes. And if you stress out monkeys, put them on diets and make them exercise, they stop menstruating (yes, monkeys menstruate). Together, this data indicates we should all stop exercising in preparation for IVF.

I love to debunk science, so I looked up the actual studies. The first study was a survey of women undergoing IVF at Harvard. They asked them their exercise patterns for what seems like most of their life. The results, quoted directly from the article: “In general, women who reported regular exercise were no more likely to have a live birth compared with those women who did not report exercise.” Sounds good to me. But then they did subgroup analyses (these are always bad–never trust data from a subgroup analysis!). Women who reported more than 4 hours of exercise per week for the 1-9 years prior to IVF had a lower liklihood of a live birth. That sounds bad. That is what they were quoting at our seminar as a reason not to exercise. But there are problems with this data. One, only 65% of the eligible patients participated in the survey. In general with epidemiologic studies you want >70% participation to ensure you are getting a broad sample of the population. Second, they did not adjust their results for the underlying diagnosis. If all the women who exercised were women with hypothalamic infertility (which is often due to excessive exercise and dieting), of course they had higher failure rates! Maybe they were PCOS patients, who are supposed to diet and exercise, but have lower success rates with IVF. We don’t know. So you can’t take that data and apply it to everyone.

But the part I found most interesting was that women who exercised any amount for more than 9 years had no difference in outcomes than women who did not exercise. So long term exercise is not harmful. Even the authors state that this data is not convincing enough to change clinical practice or make any recommendations for exercise and IVF.

As for the monkey study, well that’s just ridiculous. Yes, if you stop having periods you are going to have a hard time getting pregnant. So don’t diet and exercise to the point where you stop menstruating.

I accept that there are many factors out there that affect fertility, and we don’t understand a lot of them. I think we are a classic example of this. Trying to have a baby for 2 1/2 years, two losses and still no explanation as to why this is so hard. I’m pretty sure it’s not my running though, and my doctor agrees. She has given me permission to run a 1/2 marathon. Now I just need to get off my ass and start running again…

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