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Impact of maternal physical activity on outcome of assisted reproduction
James Geiger1, Alexander Quaas2, Philipp Quaas1
1Department of Reproductive Medicine and Gynecological Endocrinology, University Hospital Basel, Basel, Switzerland.
Introduction:
The influence of physical activity on outcomes of assisted reproductive technology (ART) remains incompletely understood, with conflicting evidence regarding the impact of exercise intensity and frequency. This study aimed to evaluate the association between self-reported physical activity and reproductive outcomes in patients undergoing ART.
Methods:
This retrospective single-center cohort study included 2,576 patients undergoing 6,850 ART cycles with embryo transfer between 2000 and 2021. Patients were categorized according to self-reported weekly physical activity as no regular exercise (Group A), exercise 1-2 times per week (Group B), and exercise ≥3 times per week, including competitive athletes (Group C). The primary outcome was cumulative live birth rate per oocyte pick-up (OPU), including fresh and frozen embryo transfers within one year following OPU. Secondary outcomes included cumulative pregnancy rate, pregnancy rate per embryo transfer, live birth rate per transfer, miscarriage rate, and number of oocytes retrieved.
Results:
Patients exercising 1-2 times weekly demonstrated the most favorable reproductive outcomes. Pregnancy rate per embryo transfer was highest in Group B (34.8%) compared with Group A (32.5%) and Group C (29.7%, p<0.005). Similarly, live birth rate per transfer was higher in Group B (25.6%) than in Groups A (23.0%) and C (22.4%, p<0.05). Cumulative pregnancy rate per OPU was highest in Group B (58.7%) compared with Group A (52.5%) and Group C (49.5%, p<0.001). Cumulative live birth rate per OPU was also higher in Group B (43.1%) compared with Group A (37.2%) and Group C (37.1%, p<0.01).
Discussion:
Moderate physical activity was associated with more favorable ART outcomes, including higher cumulative pregnancy and live birth rates, compared with both no regular exercise and high levels of physical activity. These findings suggest that moderate exercise may represent a beneficial lifestyle factor for patients undergoing ART and may support individualized patient counseling.
