Tuesday, February 28, 2012

To Run or Not to Run

I mentioned in my last post that I am a pretty consistent runner. And I have some words to say about that, specifically with being a runner and infertility.

As much pressure as there is out there to eat healthy and lose weight, I think there is also some amount of pressure to eat junky foods and park your butt on the couch. I'm talking about turning down dessert, or refraining from a doughnut or cheese dip during office potlucks. People look at me like I'm crazy if I don't attack the sweets and stuff my face.

The same can be said about my running. "You're running again?" "I only run when I'm being chased!" "you must be crazy!" and, my favorite: "Do you think the running has anything to do with.... [insert euphemism for infertility here]?"

I know with that last question that the people who ask it are probably genuinely trying to help. And it is a fair enough question - there is a lot of information (and misinformation) about exercise and infertility. So I've decided to do a bit of investigation to ensure I'm making an informed decision when I go out for a run... and also to have a well-researched response to folks who suggest that being active has somehow hurt my chances for baby.

General Guidelines for Exercise
The CDC recommends at least 2.5 hours of moderate-intensity aerobic activity or 1.25 hours of vigorous aerobic activity every week for good health benefits. For even BETTER health benefits, the CDC recommends 5 hours of moderate intensity aerobic activity or 2.5 hours at vigorous intensity per week. There's more info about what constitutes moderate and vigorous activity, but jogging / running falls into the vigorous category.

Another CDC page (here) says that people who are active "about 7 hours a week have a 40 percent lower risk of dying early than those who are active for less than 30 minutes a week." So, in general, exercise = good.

Exercise + Fertility
The Mayo Clinic states that more than 7 hours a week of aerobic exercise is associated with infertility.

After a little more digging, I happened upon this article from the American Journal of Public Health. It's called "Exercise as a risk factor for infertility with ovulatory dysfunction." The study looks at a bunch of women who have an infertility problem - specifically with ovulatory issues (ahem, me) - next to a control group of women without infertility problems, and compares their exercise habits, with other controls for all sorts of stuff. Here's the result I care about the most:

Compared with non-exercisers (who they define as people who exercise vigorously for fewer than 7 minutes per day), with a baseline risk of "1":
  • people who exercise on average between 8 and 60 minutes per day have a lower risk at 0.6
  • people who exercise on average more than 60 minutes per day have a higher risk at 1.9
Another study, for which I only had access to the abstract,I discusses an increased risk for ovulatory infertility when there is a BMI (body mass index - figure out yours here) below 20 or above 24. The study also finds that an increase in vigorous activity (NOT moderate activity) reduces relative risk of ovulatory infertility. In fact, the more hours of activity, the less the risk. Their results suggest that ovulatory infertility is caused more by being overweight and underactive than to being underweight and overexertion. 

Exercise + Premature Ovarian Failure
Here's where my research hits a dead end. From what I can find, there has been approximately zero research done on whether or not exercise, vigorous or moderate, regardless of minutes/hours spent, affects your ability to conceive if you have POF. Bummer.

My Situation
I started running three years ago. And I absolutely hated it. Getting in shape sucks a LOT. I remember not being able to run a single mile. Every muscle hurt. I had a cramp. I couldn't breathe. My heart rate was crazy. But I kept at it, as suck-tastic as I was, and slowly, over time, I started to get better. I could run longer and harder while feeling stronger. And one day I started to not hate it. Not long after that, I started to like it. And now I love it. Now I need it, to maintain my sanity. Without running: I'm grumpy, negative, and stressed to the max (including an obnoxious persistent eye twitch). With running: slightly less grumpy, more hopeful, less irritated by everyone in the world, more productive, better in general.
My cat loves stinky running shoes
I would classify myself as a moderate exerciser. I exercise way fewer than 7 hours a week, but I do run every single day (at least a mile. Usually two to five miles. Sometimes a lot more if I'm training for something). One mile for me = about 10 minutes. So on a typical day, I'll run for about 20 - 50 minutes. Sometimes less. Sometimes more. Last week, I ran 24 miles from Monday to Sunday, so a little more than 5 hours. It averages out to 36 minutes per day.

I'm in relatively good shape. My resting heart rate is usually around 60-65. I can run 5 miles without feeling super winded (although it's all about pacing!). I'm at a healthy weight. My BMI is somewhere around a 22-24 (I should get this checked out at my gym next time I'm there... the little online calculator only works if you don't have a lot of muscle. And while I'm not ripped, I think I probably have more muscle than a typical gal, due to the running).

The Question: To Run or Not to Run
I've been training for a half marathon for the past 6 weeks and I'm making great progress. However. I am getting a serious itch to do a full marathon. My friend from college has enthusiastically agreed to train with me for a full marathon in 12 weeks. We checked out some training plans and are now tentatively working on one. Tentatively because while I am a huge endorser of running and maintaining a healthy lifestyle, I don't want to do anything that might, even in the slightest, hurt my chances of conceiving. Granted, my chances of conceiving in the next 12 weeks are about .0001% (made up stat), but why put any obstacles in my way, right?

Except. What if I wasn't going to conceive in the next 12 weeks anyway? "Run a full marathon" is in the top three on my "MUST DO" bucket list. Should I just wait forever? Clearly, I would rather get pregnant than run a full marathon, but does this also mean I just have to wait until the end of time? It's not like if I do get pregnant, I'll be able to run a full marathon any time in the next... oh, I don't know... 10 years... From what I hear, having a kid is pretty time consuming.

I know this is a stupid dilemma. Because the difference between "not running a marathon" and "not having a baby" are so ridiculously incomparable that it should be an absolute no-brainer. But it's not. Because I don't think it's an either/or problem. It's probably a marathon and no baby... or no baby and no marathon. And it's just one more thing to withhold from myself (because gluten, refined sugar, and most dairy just isn't enough, right?).

I know. I'm being very pessimistic. But my decision now is to just talk to my doctor about it. I'm going back in a couple of days so hopefully I will figure this out soon. I would like to note, however, that after a few simple calculations according to my training plan for a marathon, my very highest week of mileage would have me exercising an average of 69 minutes per day. For one week. The rest would stay under 60 minutes / day.

What do you think? Where do you draw the line with exercise? Any advice on whether or not I should go for the marathon?


  1. Oh my gosh! Someone else has the persistent eye twitch!!! Mine started at the age of 29. It's not bothered me in months... but I just wait for it to come back! Hah!

    Run! Run the marathon! I'm going to sign up for one myself! And our ovaries WILL come back and thrive... they aren't on hiatus because of a jog. ;)

  2. That's too funny you have the eye twitch as well! Mine is always the left eye and I think is directly related to my [lack of] coping with stress.

    Congrats on the decision to run a marathon, Ashley Sue! You'll have to let me know which one you decide on (or post about it) so I can cheer you on!

  3. For me it was a tattoo. What if after all this trying, I was in my first weeks of pregnancy when I got my tattoo. I really wanted this tattoo, I had waited for it for a long time. But, what if the stress from the pain made me have an early miscarriage, or stopped me from ovulating, or I got an infection... Sounds silly to most, but I am sure you understand.

    I got the tattoo. I am glad I did too. Sometimes,I forget to keep living. It is like I am standing still, waiting for my ovaries to start working, and that is all I can focus on. So it felt good to let go for a minute.

  4. Here through a recommendation from a friend. We're alike - infertile runner chicks. :)

    So I decided to take a break from treatments and run a marathon last fall after IVF #5 failed. It was SO AWESOME, and something I will do again.

    My advice? Go for the marathon.

    You've looked at the ill effects of running on your body in this post, but what about the benefits? There are lots of studies that talks about the impact of reducing situational depression and the effects on your chance of getting pregnant.

    Not to mention the fact that your body is used to running; it's your new normal. Maybe not marathon training, yes. But physically, if I don't run I feel sore and tight and tense and stressed out.

    I find it ironic that the same people who say "just relax!" are the same people who will say "don't run!"

    Because they don't get that a run can actually be relaxing, a way to find your Zen. And honestly? It gave me some faith in my body back. My uterus may kill embryos, but after a run I feel healthy, and strong, and empowered.

    Anyway. I will be actively cycling (FETs) AND training for two half marathons this fall. Including speedwork, tempo runs, long runs, everything. I can't put my life on hold anymore in order to get pregnant. And so I pretty much ignore anyone who tells me I need to chill out with the running.

    Go for it! I'll be following. :)


  5. Very interesting! I just got a new pair of Brooks today and tried it for a comb 1MT+3MB. Exercise makes me feel less like a loser some days,especially when I start to feel like I'm about to enter into a tear jerk phase...I think absolutely there are benefits for exercising(feeling accomplished for one), maybe not rigorous (triathlon?) exercise, while eating smart, have plenty friends and things to occupied the "empty slots",there is nothing a gal can't do! :) Well, ideally speaking of course. I'm so glad you are a sports gal! Yay keep it up!

  6. Just came across your blog and I was so happy to read this post! I have basically the same running history as you and have questioned whether or not it is affecting my ability to conceive. At my peak (sadly I am not there anymore but plan to get back to it soon!) I was running about every other day for about 4 to 5 miles. Several Dr.s told me that was great and to keep it up. When we started doing IUIs they told me to "keep it at a conversational pace"...well I don't know what that is really! So for the last 6 months I would ovulate and we would attempt to get pregnant either naturally or with IUI and I would be too worried that maybe running would stress my body just enough to prevent the little embryo from sticking. So then I wouldn't go until sure enough I would get my period. The two weeks of trying to get into my running routine and then having a two week break has been depressing. I am now done with IUIs (sadly they didn't work) and I am so looking forward to getting back into my running grove and getting back into the shape I was in last summer while we figure out the whole IVF thing.