7 November 2019

Preconception Health: Exercise, Sleep and Stress

Preconception Health
Medical Director
Cesar Diaz-Garcia
MD PhD Assoc Prof
IVI London


Preconception health is now recognised as a vital factor in a healthy conception, pregnancy and birth. You could even re-think the duration of pregnancy as being one year long rather than a nine-month project. There’s plenty of information out there on the importance of avoiding the harm that tobacco, alcohol and illegal drugs can do, but not so much on the ‘softer’ aspects of preconception health care, revolving around exercise, sleep and stress.

In this article we look at some recommendations to improve preconception health and health care, focusing on these lifestyle aspects. We will see how each one plays an important role in the likelihood of conception. However, a problem with one of these issues rarely exists in isolation and they can be closely linked with one other. When they all get out of kilter, they can have a surprisingly detrimental impact on your fertility.


Understanding preconception health

The NHS recommends that you take a dual approach to preconception health care. The first step is to have a medical check-up in order to identify any pre-existing conditions, such as diabetes or epilepsy, that can affect your pregnancy, or to discover if there is any risk of passing on a genetic abnormality to your child. This will start off with a visit to your GP, midwife or gynaecologist.

The other aspect of preconception health care relates to making sure that you and your partner give yourselves the best chances of conception and a healthy pregnancy through improvements in your own health – this should be considered before even trying for a baby. Advice on these aspects, which include weight management, exercise, sleep and stress, can be accessed through practice nurses and health visitors, or your local family planning and well woman clinics.


Exercise: vital, but a double-edged sword

As part of your pre-conception preparation, it’s a good idea to take stock and decide on your goals; do you want to lose or gain weight, improve your strength or improve your cardiovascular efficiency? Good general exercise choices for general health improvement could be cycling, swimming, walking or aerobics. Yoga also works well as it improves flexibility and can reduce stress.

The downside of exercise is that too much is almost as bad as too little from the point of view of conception fitness. For some people, a stress response can lead to compulsive exercise. One study found that women who participate in a lot of cardio workouts are less likely to have a successful live birth than those who exercise in moderation. In relation to IVF outcomes, it also found that women who worked out for over four hours a week were actually less likely to have a successful birth as a result of IVF treatment. The conclusion would seem to be that exercise in moderation is essential for preconception fitness but going overboard is not such a good idea.


Sleep: the importance of getting enough shut-eye

Over recent years, there has been a growing understanding of the importance of adequate sleep and this applies to preconception health as much as any other aspect of life. Disrupted sleep can affect ovulation, and it has been shown that working night shifts can lead to irregular menstruation for some women. Even if you are not at the night shift extreme, for many people the stress of balancing work-life commitments, a high-pressure job or a stressful caring role can easily lead to disrupted sleep. Studies show that people who sleep for fewer than five hours a night have a higher risk of obesity, and this has a negative impact on fertility.

Here, too, the link with stress is obvious. A lifestyle that involves late nights, early wake-up alarms, a busy day in between and the resulting long-term lack of sleep will affect your stress levels as well as your fertility. If you can possibly avoid working night shifts you should do so and try the classic methods of getting adequate sleep. Measures you can take include sticking to a regular bedtime routine, avoiding caffeine and work activities for a few hours prior to sleep and keeping your bedroom free from computer or TV screens.


Stress: its impact on your fertility and how to manage it

Researchers have found that for women, there is a link between higher reported stress levels and a reduction in the likelihood of conception. The extent to which this link is a result of stress leading to less frequent intercourse and increased incidence of menstrual irregularity is not clear. Obviously, if lifestyle-associated stress levels are such that they can disrupt sleep, they could also lead to a knock-on effect on frequency of sex, either due to reduced libido or to relationship problems. If you know you are stressed and concerned about your preconception health, try the following tips:

  • Practise relaxation techniques such as yoga, meditation or a candle-lit bath before bedtime. These will also stand you in good stead for managing your labour when the time comes.
  • Pay extra attention to maintaining a healthy diet, because stress can all too easily lead to overeating or compulsive dieting. If you feel that your response to stress is affecting your relationship with food, talking to a counsellor or medical practitioner could help you to regain a healthy balance.
  • When you’re trying to get pregnant, timed sex can be a turn-off in the bedroom. If a sex schedule is proving stressful for you and your partner, just ditch the diary for a few weeks.


Getting help with infertility

If it should turn out that, after following the recommendations to improve preconception health and health care, the longed-for conception still has not happened, it could be time to contact IVI about the help that’s available. You can browse our website to find out what to expect from your first visit, take a virtual tour of our London clinic or come to an open evening in Harley Street. We can assure you that the experience will be as stress-free as possible.


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