Let's try and put our investigative head on and see what the research says about all these different types of exercise.
Are some better for certain conditions?
Some more beneficial for males?
Let's see if we can Sherlock Holmes our way through this!
HIIT (High Intensity Interval Training)
What is it?
This is a form of exercise that involves high intensity intervals (i.e., > 90% of heart Rate max) separated by low intensity active rest periods (i.e., < 75% of heart rate max).
What does the research say?
When a group of studies that investigated the effect of HIIT on various parameters in PCOS individuals were evaluated, it was shown that partaking in HIIT, when compared to either moderate or no exercise, improved the individual's insulin resistance markers. It also positively impacted on their BMI levels. A further 2022 study has shown that in PCOS individuals, carrying out either high volume HIIT (4 min exercise blocks) compared to low volume HIIT (1 min exercise blocks) made no difference to the regularity of menstrual cycles. In both cases, and the control (no exercise), they improved, basically meaning there was no impact specifically due to the form of HIIT. What their data did show, although in small numbers, was that more women got pregnant from carrying out the low volume HIIT routines. Unfortunately I wasn't able to read the entire research paper so my interpretation for this is limited.
Insulin resistance and a higher BMI are often seen with PCOS, and this may therefore be a form of exercise to consider in these cases, potentially with shorter time intervals of high intensity.
Yoga
What is it?
Yoga is a physical, mental and spiritual practice that originated in ancient India. Modern yoga is most commonly associated with the physical practice of asana, a series of postures often weaved together in styles such as Vinyasa Flow or Ashtanga.
What does the research say?
Again, in individuals with PCOS, a positive impact was seen after following a regular yoga practice for 6 weeks. Significant reductions in hip circumference and hirsutism (excessive hair growth) were noted. The size of this study was quite small, therefore the results should be interpreted with caution, however, previous studies have shown time and again, the benefits of yoga on stress levels, and when stress is reduced you may find a multitude of hormonal benefits.
Not forgetting the males, a 2020 study showed that a regular 1 hour yoga practice led to a reduced level of DNA fragmentation (~DNA damage) and oxidative stress markers seen in the semen. There was also an improvement seen in sperm motility. It needs to be noted, however, that this was an extremely small study group (5 men) and they didn't report any significance in the results, most likely due to the small numbers involved. Due to the positive impact yoga may have on stress levels, this may then impact further positively affecting the levels of oxidative stress and DNA damage.
Resistance training
What is it?
Resistance exercise is a form of exercise that is intended to increase muscular strength. It utilises a form of resistance, either through using weights, bands, or your own body weight.
What does the research say?
A review of studies in 2021, utilising resistance training as a means of exercise for individuals with PCOS, showed a range of differing positive and significant changes, including: waist circumference, lean muscle mass, fasting glucose, percent body fat. The studies investigated differed in many ways, and contained small numbers of participants, making it difficult to extrapolate any overall results. However, positive results were noted, including on mental health, which supports the beneficial impact that resistance training has shown in many other health conditions.
In a group of males that partook in resistance training for 24 weeks, improvements were seen in semen parameters, sperm DNA integrity, oxidative stress and inflammation markers, allowing for an increase in their fertility potential. They also noted significant reductions in BMI and body weight.
SO what does all this mean? Are we any wiser?
One of the main conclusions that I've taken from reading through these studies is that movement, in whichever form you choose, may be beneficial for fertility. This was also shown in another study that noted in obese women, the time it took them to conceive was less if they engaged in walking regularly. Nothing heavy, just walking.
Regular movement.
Many of the studies published feature individuals with PCOS as it is such a commonly diagnosed cause of female infertility, however, some extrapolation may be taken to non-PCOS individuals.
One thing to note is that intense forms of endurance exercise are known to increase levels of physical stress / oxidative stress in the body and may negatively affect hormonal patterns. Incorporating shorter bursts of intense exercise, such as HIIT, may prove to be more fertility friendly whilst still getting that intense feeling.
If intense is not your thing tough, incorporating yoga, resistance training, or a daily walk into your routine may be avenues to investigate. The physical and mental benefits appear to be numerous, with positive effects reported for both men and women!
My final piece of advice would be to find WHAT YOU ENJOY as that will make you stick at it and be more consistent. It may be salsa dancing, rock climbing, tai chi, whatever it is, FIND YOUR FLOW!
If you're still struggling, there are lots of personal trainers who specialise specifically in fertility and IVF support, and would love to support you. Check out the interview with Fitness Fertility founder, Maria McMaster and see what she has to say about it.
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