IVF for Runners

If you are part of this unfortunate group, I am so sorry that you are here. Throughout my IVF journey, it’s been so hard to find this information. I’ve asked my doctors for advice, Googled a lot, listened to a lot of podcasts, and tried to sift through medical papers. The information is not straightforward and every person’s situation is different. However, what I can provide you with is my perspective and experiences while going through fertility treatment. My story is just one of many. I hope you find what you are looking for.

Everyone’s protocol is different. What was prescribed for me may not be what is prescribed to you. Please listen to your medical care team.

IUI cycle

The IUI cycle: I was on two medications. I started with clomid and was allergic to it. I moved on to letrozole. This was used for ovulation induction, which would ensure that an egg would be released by the dominant follicle grown during that cycle. I then used ovidrel as a trigger shot, which causes ovulation 24-36 hours later. I went in to my fertility clinic for my IUI. On the same day, my partner provided a sample which was sent through processing and selection. The same was then injected into my uterus through a catheter.

IUI activity restrictions: After I started taking the clomid/letrozole, I was restricted from any running, strength training, yoga, cycling, etc. Essentially just take it easy. Walking was okay but for 30 minutes. Keep it zone 1 or zone 2.

IUI two week wait: Pretty standard. No running, strength training, yoga, cycling, etc. Walking max 30 minutes and normal daily activities are okay. Could not go swimming or take baths. Cannot take long hot showers. Essentially, don’t do anything that will raise your core temperature or heart rate.

Physical recovery: easy peasy. Low side effects for me.

Level of physical agony: very low

IVF – egg retrieval cycle

I’ve gone through 3 egg retrieval cycles and am coming up on a fourth and possibly a fifth.

IVF-ER cycle: On the first day of my period, I notify the clinic and they schedule me for baseline bloodwork and ultrasound. If everything checks out, I can start my medications on cycle day 3. For one week, I take ovarian stimulation medications (typically gonal-f and menopur) every night. After 5-7 days, based on my bloodwork and ultrasounds, I start ovulation delaying medication (cetrotide or fyremadel). That goes on for about 5-7 days. After more ultrasounds and blood work, they will tell me when to take my ovulation trigger shot. For me it was a 2-step shot: one at 8:30pm and then 12 hours later at 8:30am. My egg retrieval is typically the next day.

The egg retrieval is done under anesthesia. You typically aren’t supposed to be in pain when you wake up, but it is inevitable. After all, they took a syringe and punctured through your vaginal wall and ovarian follicles to drain them. That is not very comfortable. Depending on your response to medication, they may provide medication for ovarian hyperstimulation syndrome, nausea, and pain.

IVF-ER cycle activity restrictions: no cardio, strength training, cycling, swimming, yoga etc once you start your ovarian stimulation shots. There is a very real risk of ovarian torsion (where your ovaries twist and blood supply is cut off). If you want to do any activities, perhaps 30 min walk on the treadmill. Keep it easy. Honestly, the meds made me feel terrible so I didn’t feel like doing anything anyway.

IVF-ER two week wait: This really depends if you are doing a fresh or frozen transfer. If you do a fresh transfer, you’ll want to continue with your cycle activity restrictions. No cardio, strength training, cycling, swimming, yoga, etc. Don’t take baths (meaning, don’t submerge yourself in water) since you have vaginal wounds that are still healing. Don’t raise your core temperature. If you want to resume activity, at least wait for your period (7-10 days).

Physical recovery: rough. My ovaries were so swollen that it was tough to discern when I had to use the bathroom. I practically had to sit upright or hover on the toilet in order to go. I had to set reminders to go to the bathroom. After anesthesia, my bowels stopped doing their thing, so I had to be very diligent about stool softeners and laxatives. You are also probably very poofy, so clothes aren’t fitting as well as they used to. That can really play mind games with you.

Level of physical agony: high to very high. Get some stretchy pants, laxatives, and electrolytes.

Complicated IVF-ER cycles: I’ve graduated to more complex cycles. It consists of daily priming medications, like HGH and naltrexone, in addition to supplements to support ovarian health.

FET – Frozen embryo transfer cycle

FET cycle: After my period starts, I go in for my baseline ultrasounds and blood work. For my previous uncomplicated cycles, I would start with estrogen patches for about a week. Every other day the dose would double. After a week, I maintained the same estrogen patch dosage but then started on my progesterone in oil intramuscular injections. When my body is ready for the embryo transfer, I go in to my clinic and it is generally painless. You have to go in with a mostly full bladder, which is the most uncomfortable part. However, it’s nothing like the egg retrieval. From start to finish it’s probably 15 minutes and you are awake for the whole thing. You continue your daily progesterone in oil shots until either a negative pregnancy test or 12 weeks of pregnancy, whichever comes first.

FET activity restrictions: No running and strength training. Light yoga and walking is okay. Swimming is fine until your embryo transfer. After the transfer there is no swimming or submerging. Keep your heart rate low and don’t elevate your core temperature.

FET two week wait: It’s fine with exception of the daily progesterone shots. Those can get very uncomfortable if you don’t take the time to do it well. Make sure to massage your injection sites and to warm up the oil before injecting it.

Physical recovery: Medium. Progesterone gave me hot flashes and makes me very tired. I only had energy to get up, work, and then after work I pretty much just climb back into bed.

Level of physical agony: Low. Spent most of my time poofy, tired, and hungry!

Complicated FET cycles: If you have repeated implantation failure like me, you’ll end up on wild immune protocols that includes things like prednisone and lovenox (blood thinners). Prednisone made me feel awful, hungry, and hypomanic. Blood thinners bruise your injection sites and burn. To me they feel like someone is ashing a cigarette out on my stomach. Towards the end of one of my failed FET cycles, I went ahead and ran a 5K. My injection site started bleeding and didn’t stop until about 2 hours after my run.

Mock cycle for ERA, ReceptivaDx, etc

Pretty much the same as FET but there is no embryo that is transferred. The biopsy was pretty rough on me. They say it will feel like a pinch, but it actually feels more like a pinch of skin that is ripped out of your insides. (Surprise, that’s what a uterine biopsy is!)

My non-medical recommendation for runners going through IVF

IVF sucks. Take it easy. Consider this your extended taper. Stock up on some more stretchy pants and shirts. Go up a clothing size. Buy clothes that fit your new body. Work through your list of running movies, books, and podcasts. Running will still be there when you are ready to get back into it. IVF will be tougher than any training season or race you’ve ever done. Take care of your mental health. It’s okay to take breaks during IVF.

If you really can’t sit still, take an easy stroll.

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