Fitness and Infertility Part 2

Fitness and Infertility Part 2

running

Last week, I wrote about what the science says about fitness and infertility. Now, I want to write about real life.   In 2010, my husband and I decided we wanted to start trying to get pregnant. Being on birth control for so long, I really did not know what to expect on how long this process would take. After ovulating on a very rare basis, I saw my doctor for basic blood tests. Everything came back normal. Using prescribed progesterone helped for 1-2 months but we were still not able to get pregnant. My OB suggested a fertility doctor.

“Infertility” is usually defined as trying to conceive for 1 year with no success. However, this is if your cycles are normal, which mine were obviously not. I was not ready for a fertility doctor yet. I don’t know why. Looking back, I was probably a little ashamed, embarrassed and a little scared. I had spent the greater part of my adult life living, preaching and practicing a healthy lifestyle. I worked out 6 days a week, I watched what I ate religiously, I worked in the fitness field…how could anything be wrong with me? My husband and I decided to try to wait a few more months and then finally went for a consult. At the initial consult, my doctor was looking at my blood test results and my lifestyle and medical history information. She said, ‘how can you possibly have high cholesterol?’ I had always chalked it up to family history since I ate well and exercised quite a bit. She asked if she could do an ultrasound right then. I agreed. As she expected I had cystic ovaries and was diagnosed with Poly Cystic Ovarian Syndrome, the most cause of infertility among women. The three most common symptoms of PCOS are obesity, excessive hair growth and acne, none of which I had. I was diagnosed with ‘lean PCOS.’ 1 in 5 women have PCOS but many with the lean type might now know it until they try to conceive. PCOS is also characterized by insulin resistance and higher androgen levels (male hormones)  Part of me was relieved to have a reason….part of me was devastated. I immediately asked the Dr. if this was why I have always had to work extremely hard to keep weight off or keep my weight down. She said yes and I will probably have this struggle for the rest of my life. However, at the same time, I was also diagnosed Hypothalamic from excessive exercise! So I have an insulin regulating problem that many PCOS people can take care of with exercise and diet BUT I could not do too much exercise.  Sadly, I was put on exercise restrictions…no more than 3 hours of cardio a week, limit my caffeine and alcohol and keep to a low carb diet. To top it off she put me on a diabetes medication. Now, I realize that this medication was not for diabetes but in essence it was to help me control my insulin levels, same for diabetics. This was a HUGE blow to my ego. Though this might not seem like a big deal to some, it was crushing to me. Being put on a maintenance medication was one of the hardest things for me to accept and I was embarrassed to tell anyone that I was on an insulin regulation drug.  I was so upset. I have been in the fitness industry for almost 15 years and I preach against medications as I believe diet, exercise and sleep are the best medications.

Before moving forward with fertility treatments, my husband was tested. One of his numbers came back lower than ideal. We were basically dealing with a double whammy. I don’t ovulate regularly and my husband’s motility was low. Healthy couples have about a 10-15% chance of conceiving every month (pretty low, right?) Since we basically had both female and male ‘issues’ our chances were even less. When seeking a 2nd option, we were told that we had less a 5% of conceiving on our own. To make it even worse, the doctor told us that basically we were a bad combo.   If either of us were with a different partner, we might not have fertility issues.  Heartbreaking.

Our Dr. goes through our options…3-4 IUIs (artificial insemination) which have low success rates (15-18%) then IVF if those fail. The next year was an onslaught of appointments, blood work, ultrasounds, medications and emotions. Once the first medications did not work as well as hoped and 2 IUIS failed, we moved on to shots and some very powerful meds. Emotionally starting to get very scared as we had planned on doing only 4 IUIs and now 2 have failed.  I was getting closer to the end. Go to injections (double the cost and side effects, a little higher success rate). 3rd IUI Failed.  April 2012, our last chance.  Failed.  Devastated.  We had decided to do no more than 4 as the success rate decreases after 4 and we could be using that money towards other treatments. I became angry, resentful, sad then would have periods of extreme gratitude when I looked at what I had been blessed with, a great family and friends, husband, job, place I love to live etc. It was an extreme roller coaster. I became so low that I finally seek counseling.

I finally accepted that IVF was our only option to conceive a child. I was terrified that there was still a possibility that IVF could not work but could not let that hold us back from trying.  3 days before I was supposed to start the first round of medication and 2 days before leaving for a fitness conference (where I would be doing a large amount of exercise over the course of 4 days) I took a pregnancy test…For 2 years, these tests have been negative so I had already set myself up for disappointment.  It was positive, faint but positive!!  I have never been more shocked.

After telling my husband in a frightened and excited way, we know we need to go to the doctor to get my hormones level checked to make sure I could sustain the pregnancy.  I get blood work that morning; receive a call that afternoon that I am in fact pregnant!  My nurse tells me I need to make it 48 more hours to make sure my HCG number doubles.  48 hours later, my numbers are good. One more major milestone to go, 7 weeks, to hear the heartbeat of the baby.  We go on vacation to Costa Rica in shock, excited but still cautiously optimistic.  After we return, we actually change our already scheduled IVF appointment for our first ultrasound!!  Truly a miracle, we beat the odds.  We conceived naturally.  In March of 2013, I delivered a healthy, beautiful baby boy.

I talked to my other fitness friends who had trouble conceiving as I wanted to know if their doctor linked exercise and infertility.  Two of them were not directly told that their exercise and lifestyle was causing their infertility but the doctors suggested that exercise is another form of stress (like I mentioned in Part I of this blog). Again, it’s the stress that can be an infertility issue.   Another one of my friends simply read that you should back off exercise when trying to conceive so she did. She however began Reiki (a Japanese technique for stress reduction and relaxation that also promotes healing.) and “learned it was her mind blocking her body from getting pregnant.”

So to answer the question that I asked in the last blog post. Are exercise and infertility related? Yes and No.

The point of this long 🙂 blog post is not to tell you how I was able to conceive. I don’t know why we were suddenly able to conceive. Maybe I was able to let go once I accepted the possibility of IVF. Maybe it was the decrease in exercise and therefore stress. The point was to share my story so my readers know a little more of my background of becoming a mother.

As always would love to hear from you! XOXO

Fitness and Infertility Part 1

Are fitness and infertility related? Before I even begin my blog (as my first post was just an introduction), I want to make a disclaimer. I am not an OBGYN, an endocrinologist or any type of medical doctor. I understand that every pregnancy and post-pregnancy experience is very different and unique to the individual and even each pregnancy for the same woman can be very different. I will be writing about my personal experience through infertility, exercising before, during and after my pregnancy as well as my experience working with clients before, during and after. Again, my goal of this blog is education, but I realize that the information will not apply to everyone and just as I tell all my clients, please check with your doctor if you have any questions before, during or after your pregnancy.

Back to infertility and fitness.   There are so many causes of infertility that I am not even going to attempt to discuss each one. However, I do want to talk about fitness and infertility since this is a fitness blog. Can too much exercise cause infertility? Yes and No. Exercise is stress on your body. For the average exerciser, this stress is good stress. Your body benefits from the exercise. However, for some people possibly combined with other stressors (poor nutrition, work stress, relationship stress etc.) too much exercise could pose a problem.

According to Dr. James Clapp, one of the most well respected researchers in pre- and post-natal exercise and author of “Exercising Through Your Pregnancy,” believes that infertility and exercise were first seen as related because infertility is rather common (5 to 10 percent of couples) and so is exercising. Dr. Clapp states in his book that due to the fact it is rather expensive and often difficult to find reasons for diagnosis, a doctor would often look at lifestyle factors.   Many doctors couldn’t find anything specific so they would suggest for women to cut back on their exercise and gain a few pounds and that would solve the issue. This belief was then supported by two studies in the 1980’s. One of the studies showed that exercise can suppress or alter the normal pattern of hormonal secretion that regulate the production and the release of eggs from the ovary.   Dr. Clapp states that this study was atypical as it took untrained women and suddenly put them on a very high-volume training regimen. In the second study, the poor nutritional intake and other stressors could have contributed to the infertility.

Dr. Clapp continues this subject in his book with his own study conducted on 500 women trying to get pregnant. Most of the women were recreational athletes (defined as exercising 20-60 minutes, three to five times a week) Dr. Clapp came to the conclusion that “most healthy women can exercise vigorously without interfering with their fertility.”

Yet, just like many things, there can be too much of a good thing. Dr. Clapp’s study was only conducted on specific type of women with specific types of exercises. So though in his research he did not see a correlation between exercise and infertility he does state that “I suspect that there is a threshold level of exercise above which infertility does become a problem.” Therefore women performing at much higher training levels could see a problem.

Dr. Clapp thinks that the threshold for exercise tolerance before it becomes an issue for women trying to conceive is very high but agrees can be compounded by other stressors. For some women exercise stress, combined with others stressors can cause issues. Other women can continue high intensity exercise with no issues, hence my answer of ‘yes’ and ‘no’ if exercise can cause infertility.

Stay tuned for Part II of “Fitness and Infertility” where I will share my own journey as well as a few of my other fitness friends battle with infertility.

I would love to hear from you! Please feel free to comment below.