P-161 Impact of physical activity (PA) on oocyte quality: a prospective study among IVF/ICSI patients
Authors: Olaso F , Mendoza R , Echeverria I , Malaina I , Ibañez J , Irazusta J , Matorras J R 
Published: June 2023

Abstract

Study question
To determine if various levels of PA have an influence on oocyte quality, ovarian response to controlled stimulation and IVF/ICSI success rate.

Summary answer
Globally, PA has no influence on ovarian response in IVF cycles. However, in certain subgroups (endometriosis, disovulation, normal-BMI) high PA is associated with higher response.

What is known already
Lifestyle is considered a key factor concerning health. According to WHO, moderate PA is an effective way to lower the risk of many pathologic conditions, although the impact of PA on female fertility is still unknown.
There is scientific evidence that vigorous exercise can be detrimental for female fertility Studies evaluating the effect of PA on oocyte quality are lacking. However, murine models show that PA may have a positive impact on it.

Study design, size, duration
Prospective observational study.
PA was evaluated before the IVF cycle, using the International PA Questionnaire (IPAQ) (n = 617), assessing frequency and duration of PA in the previous week, and using accelerometer (n = 102). Mean age of women was 35.
Patients were classified into three levels of PA: low, moderate, high. The following outcome measures were analysed: number of collected oocytes, mature oocytes, ovarian response, biochemical pregnancy rate.
Size: 617 infertile women undergoing IVF/ICSI cycles
January 2019 - October 2020

Participants/materials, setting, methods
617 participants voluntarily fulfilled the IPAQ prior to IVF/ICSI cycle. Ethical approval was obtained from the Clinical Research Ethics Committee (CEIC E19/06).
IPAQ’s results were measured in metabolic equivalent of task (METs-min/week) (Walking =  3.3 METs; Moderate PA = 4 METs; Vigorous PA = 8 METs). 1 MET  =  resting metabolic rate.
In 102 participants PA was objectively measured for 7 consecutive days, prior to IVF cycle, using triaxial accelerometry.
Setting: Human Reproduction Unit of a Universitary Hospital (Spain)

Main results and the role of chance
The number of collected oocytes was similar in all three groups according IPAQ (9.23 ± 7.72; 8.35 ± 5.57; 8.82 ± 6.38). Something similar happened with the number of mature oocytes (MII) (6.97 ± 5.99; 6.84 ± 4.85; 7.05 ± 5.61) and fertilized oocytes (3.72 ± 3.84; 4.16 ± 3.35; 3.98 ±  3.88).
Biochemical pregnancy rate was slightly superior in high PA vs moderate vs low (38% vs 34.8% vs 29%), but without statistical significance.
In the subgroup of patients having endometriosis the number of MII oocytes was significantly superior in high and moderate vs low PA (p = 0.024). In the group of disovulating women there were also more MII oocytes in high vs moderate vs low PA (p = 0.038).
When performing the analysis according to accelerometer, even though the number of total collected oocytes (9.93 ± 9.1; 7.93 ± 5.38), MII oocytes (8.36 ± 7.64; 6.79 ± 4.63) and fertilized oocytes (5.25 ± 6.41; 3.91 ± 2.82), tended to be slightly superior in high vs moderate PA, there were no significant differences.
In women with normal BMI, high PA was associated with a greater number of collected oocytes (p = 0.005), MII oocytes (p = 0.004) and fertilized oocytes (p = 0.007).

Limitations, reasons for caution
This study was performed in infertile women undergoing IVF/ICSI cycles. Hence, it is not possible to determine if PA has an impact on natural fertility.
The self-administration of IPAQ has some disadvantages as subjectivity, memory bias or overestimation of PA. Subgroups’ sample size was small.

Wider implications of the findings
In general it does not seem that modifying short-term PA in women undergoing IVF could improve oocyte quality. However in some subgroups of patients (endometriosis, disovulation, normal-weight women), perhaps changes in PA could improve oocyte quality and ART success rates. More prospective clinical studies are needed.

Trial registration number
Not applicable