Maternal physical activity before IVF/ICSI cycles improves clinical pregnancy rate and live birth rate: a systematic review and meta-analysis
Open accessAbstract
This meta-analysis was aimed to evaluate the association between maternal physical activity before IVF/ICSI cycles and reproductive outcomes. We searched databases of PubMed, EMBASE and Web of Science electronic databases, and ongoing trials up to November 2017 to identify studies that focused on the relationship between maternal physical activity before IVF/ICSI cycles and reproductive outcomes, including implantation rate, clinical pregnancy rate, miscarriage rate and live birth rate. Odds ratio (OR) with 95% confidence intervals, were calculated to assess the results of each outcome. Eight published studies encompassing 3683 infertile couples undergoing IVF/ICSI treatment were included into the analysis. There was an increasing, but not statistically significant, trend in implantation rate for physically active women when compared with physically inactive women (OR = 1.95, 95% CI 0.99–3.83, I 2 = 77%). No significant difference was found in miscarriage rate between physically active women and physically inactive women (OR = 0.76, 95% CI 0.41–1.44, I 2 = 49%). However, rates of clinical pregnancy and live births in physically active women were significantly higher than those in physically inactive women (OR = 1.96, 95% CI 1.40, 2.73, I 2 = 42% and OR = 1.95, 95% CI 1.06–3.59, I 2 = 82%, respectively). Subgroup analysis helped to confirm these results. Female physical activity before IVF/ICSI cycles was associated with increased rates of clinical pregnancy and live births, whereas only a small but not statistically significant increase was found in implantation rate, and no effect was shown on miscarriage rate.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In women undergoing fertility treatment, moderate physical activity is associated with higher pregnancy and live birth rates.
“For women undergoing fertility treatment, moderate physical activity is associated with increased pregnancy and live birth rates (Rao 2018).”
From Preconception lifestyle advice for people with infertility (2021) · cites this paper as Rao 2018
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series
(2008) · doi:10.1002/9780470712184 · Cited by 25,048 · see citing works
Dermyshi, E., Wang, Y., Yan, C., Hong, W., Qiu, G., Gong, X., & Zhang, T. (2017) · Neonatology · doi:10.1159/000454668 · Cited by 24,577 · see citing works
Stang, A. (2010) · European Journal of Epidemiology · doi:10.1007/s10654-010-9491-z · Cited by 17,396 · see citing works
GRADE guidelines: 1. Introduction—GRADE evidence profiles and summary of findings tables
Guyatt, G., Oxman, A. D., Akl, E. A., Kunz, R., Vist, G., Brozek, J., Norris, S., Falck-Ytter, Y., Glasziou, P., & deBeer, H. (2011) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2010.04.026 · Cited by 10,681 · see citing works
Grading quality of evidence and strength of recommendations
(2004) · BMJ · doi:10.1136/bmj.328.7454.1490 · Cited by 8,477 · see citing works
Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1. The Cochrane Collaboration
Higgins, J., Green, S. R., & Higgins, J. (2008) · Cited by 5,544 · see citing works
Physical activity and reduced occurrence of non–insulin-dependent diabetes mellitus
Helmrich, S. P., Ragland, D. R., Leung, R. W., & Paffenbarger, R. S. (1991) · New England Journal of Medicine · doi:10.1056/nejm199107183250302 · Cited by 1,634 · see citing works
(2007) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e318149f111 · Cited by 1,554 · see citing works
Reproducibility and validity of a self-administered physical activity questionnaire
WOLF, A. M., HUNTER, D. J., COLDITZ, G. A., MANSON, J. E., STAMPFER, M. J., CORSANO, K. A., ROSNER, B., KRISKA, A., & WILLETT, W. C. (1994) · International Journal of Epidemiology · doi:10.1093/ije/23.5.991 · Cited by 1,038 · see citing works
ACSM Position Stand: The Female Athlete Triad
Otis, C. L., Drinkwater, B., Johnson, M., Loucks, A., & Wilmore, J. (1997) · Medicine &amp Science in Sports &amp Exercise · doi:10.1097/00005768-199705000-00037 · Cited by 515 · see citing works
The effects of intense exercise on the female reproductive system
Warren, M., & Perlroth, N. (2001) · Journal of Endocrinology · doi:10.1677/joe.0.1700003 · Cited by 446 · see citing works
Physical Activity, Body Mass Index, and Ovulatory Disorder Infertility
Rich-Edwards, J. W., Spiegelman, D., Garland, M., Hertzmark, E., Hunter, D. J., Colditz, G. A., Willett, W. C., Wand, H., & Manson, J. E. (2002) · Epidemiology · doi:10.1097/00001648-200203000-00013 · Cited by 411 · see citing works
Aerobic exercise for women during pregnancy.
Kramer, M., & McDonald, S. (2006) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000180.pub2 · Cited by 399 · see citing works
Frederiksen, Y., Farver-Vestergaard, I., Skovgård, N. G., Ingerslev, H. J., & Zachariae, R. (2015) · BMJ Open · doi:10.1136/bmjopen-2014-006592 · Cited by 380 · cited 1× · see citing works
“Additionally, regular physical activity can help relieve stress and anxiety, which have been shown to be important risk factors affecting the assisted reproductive outcome [33, 42].”
BackgroundStress, distress and outcome of assisted reproductive technology (ART): a meta-analysis
Matthiesen, S. M. S., Frederiksen, Y., Ingerslev, H. J., & Zachariae, R. H. (2011) · Human Reproduction · doi:10.1093/humrep/der246 · Cited by 292 · see citing works
Evaluation of the Kaiser Physical Activity Survey in women
Ainsworth, B. E., Sternfeld, B., Richardson, M. T., & Jackson, K. L. (2000) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-200007000-00022 · Cited by 281 · see citing works
Hämmerli, K., Znoj, H., & Barth, J. (2009) · Human Reproduction Update · doi:10.1093/humupd/dmp002 · Cited by 218 · see citing works
Physical activity and fertility in women: the North-Trondelag Health Study
Guðmundsdóttir, S. L., Flanders, W. D., & Augestad, L. B. (2009) · Human Reproduction · doi:10.1093/humrep/dep337 · Cited by 174 · see citing works
Effect of Exercise on Pregnancy Outcome
GAVARD, J. A., & ARTAL, R. (2008) · Clinical Obstetrics & Gynecology · doi:10.1097/grf.0b013e31816feb1d · Cited by 155 · see citing works
An, Y., Sun, Z., Li, L., Zhang, Y., & Ji, H. (2012) · Journal of Assisted Reproduction and Genetics · doi:10.1007/s10815-012-9904-x · Cited by 127 · see citing works
Hardefeldt, P. J., Penninkilampi, R., Edirimanne, S., & Eslick, G. D. (2017) · Clinical Breast Cancer · doi:10.1016/j.clbc.2017.10.010 · Cited by 117 · see citing works
Validação de um questionário de freqüência de consumo alimentar para população adulta
Ribeiro, A. C., Sávio, K. E. O., Rodrigues, M. D. L., da Costa, T. H. M., & Schmitz, B. D. A. S. (2006) · Revista de Nutrição · doi:10.1590/s1415-52732006000500003 · Cited by 115 · see citing works
A prospective cohort study of physical activity and time to pregnancy
Wise, L. A., Rothman, K. J., Mikkelsen, E. M., Sørensen, H. T., Riis, A. H., & Hatch, E. E. (2012) · Fertility and Sterility · doi:10.1016/j.fertnstert.2012.02.025 · Cited by 114 · see citing works
Palomba, S., Falbo, A. I., & Sala, G. B. L. (2012) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.12070 · Cited by 108 · see citing works
Effects of Lifetime Exercise on the Outcome of In Vitro Fertilization
Morris, S., Missmer, S. A., Cramer, D. W., Powers, R. D., McShane, P. M., & Hornstein, M. D. (2006) · Obstetrics and Gynecology · doi:10.1097/01.aog.0000235704.45652.0b · Cited by 107 · see citing works
Moran, L., Tsagareli, V., Norman, R. J., & Noakes, M. (2011) · Australian and New Zealand Journal of Obstetrics and Gynaecology · doi:10.1111/j.1479-828x.2011.01343.x · Cited by 106 · see citing works
Physical activity and its effects on reproduction
Redman, L. M. (2006) · Reproductive BioMedicine Online · doi:10.1016/s1472-6483(10)61183-2 · Cited by 103 · see citing works
Evenson, K. R., Chasan‐Taber, L., Downs, D. S., & Pearce, E. (2012) · Paediatric and Perinatal Epidemiology · doi:10.1111/j.1365-3016.2012.01311.x · Cited by 90 · see citing works
Physical activity before IVF and ICSI cycles in infertile obese women: an observational cohort study
Palomba, S., Falbo, A., Valli, B., Morini, D., Villani, M. T., Nicoli, A., & La Sala, G. B. (2014) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2014.03.006 · Cited by 87 · see citing works
Zhai, J., Liu, C., Tian, Z.-R., Jiang, Q., & Sun, Y. (2012) · Biology of Reproduction · doi:10.1095/biolreprod.112.099788 · Cited by 77 · see citing works
McLaren, J. F. (2012) · Obstetrics and Gynecology Clinics of North America · doi:10.1016/j.ogc.2012.09.001 · Cited by 69 · see citing works
Palomba, S., Falbo, A. I., Russo, T., Orio, F., Tolino, A., & Zullo, F. (2010) · Human Reproduction · doi:10.1093/humrep/dep466 · Cited by 67 · see citing works
The impact of lifestyle behaviors on infertility treatment outcome
Rooney, K. L., & Domar, A. D. (2014) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/gco.0000000000000069 · Cited by 66 · see citing works
Küçük, M., Doymaz, F., & Urman, B. (2009) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2009.11.011 · Cited by 43 · see citing works
Evenson, K. R., Calhoun, K. C., Herring, A. H., Pritchard, D., Wen, F., & Steiner, A. Z. (2014) · Fertility and Sterility · doi:10.1016/j.fertnstert.2013.12.041 · Cited by 42 · see citing works
Physical Activity, Obesity and Eating Habits Can Influence Assisted Reproduction Outcomes
Ferreira, R. C., Halpern, G., Figueira, R. D. C. S., Braga, D. P. D. A. F., Iaconelli, A., & Borges, E. (2010) · Women s Health · doi:10.2217/whe.10.40 · Cited by 39 · see citing works
Maternal physical and sedentary activities in relation to reproductive outcomes following IVF
Gaskins, A., Williams, P. L., Keller, M. G., Souter, I., Hauser, R., & Chavarro, J. (2016) · Reproductive Biomedicine Online · doi:10.1016/j.rbmo.2016.07.002 · Cited by 35 · see citing works
Body-mass index, abdominal adiposity, and cardiovascular risk
Yusuf, S., & Anand, S. S. (2011) · The Lancet · doi:10.1016/s0140-6736(11)61120-3 · Cited by 26 · see citing works
Honnma, H., Endo, T., Kiya, T., Shimizu, A., Nagasawa, K., Baba, T., Fujimoto, T., Henmi, H., Kitajima, Y., Manase, K., et al. (2010) · Reproductive Biology and Endocrinology · doi:10.1186/1477-7827-8-73 · Cited by 24 · see citing works
Ramezanzadeh, F., Kazemi, A., Yavari, P., et al. (2012) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2012.03.035 · Cited by 22 · see citing works
Wang, Y., Qu, J., Wu, X., Hou, L., Erkkola, R. U., & Wang, Y. (2009) · Fertility and Sterility · doi:10.1016/j.fertnstert.2009.07.1678 · Cited by 18 · see citing works
Rasiah, R., Thangiah, G., Yusoff, K., Manikam, R., Chandrasekaran, S. K., Mustafa, R., & Bakar, N. A. (2015) · BMC Public Health · doi:10.1186/s12889-015-2577-5 · Cited by 16 · see citing works
Cleanthous, X., Noakes, M., Brinkworth, G. D., Keogh, J. B., Williams, G., & Clifton, P. M. (2010) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2009.09.002 · Cited by 12 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Preconception lifestyle advice for people with infertility
Boedt, T., Vanhove, A.-C., Vercoe, M. A., Matthys, C., Dancet, E., & Lie Fong, S. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008189.pub3 · Cited by 66 · see citing works
- Authors
- Rao, M., Zeng, Z., & Tang, L.
- Affiliations
- First Affiliated Hospital of Kunming Medical University (CN)
- Corresponding author
- Tang, Li
- Venue
- Reproductive Biology and Endocrinology
- Published
- 2018-02-07
- Volume
- 16
- Issue
- 1
- Pages
- 11-11
- ISSN
- 1477-7827 (ISSN-L)
- PMC
- PMC5803901
- OpenAlex
- W2796909644
- Cited by
- 74
- References
- 43
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 12 · 2023: 8 · 2022: 14 · 2021: 10 · 2020: 9 · 2019: 4 · 2018: 2
- FWCI
- 0.94
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Reproductive Biology and Endocrinology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Assisted Reproductive Technology and Twin Pregnancy
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
- Keywords
- maternal physical activity, in vitro fertilization, intracytoplasmic sperm injection, clinical pregnancy rate, live birth rate, implantation rate, miscarriage rate, female infertility, reproductive outcomes
- MeSH terms
- Birth Rate, Female, Fertilization in Vitro, Humans, Pregnancy, Exercise, Pregnancy Rate, Sperm Injections, Intracytoplasmic, Live Birth
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
