Habitual physical activity levels in women attending the one-stop infertility clinic: a prospective cross-sectional observational study
Authors: Tempest Nicola , France-Ratcliffe Madeleine , Al-Lamee Hannan , Oliver Evie R , Slaine Emily E , Drakeley Andrew J , Sprung Victoria S , Hapangama Dharani K 
Published: September 2022

Optimisation of lifestyle factors such as smoking and alcohol is encouraged to improve fecundability rates in the fertility setting. Currently, routine fertility consultations do not involve counselling or imparting advice regarding habitual physical activity (PA) and/or structured exercise, despite data showing that vigorous PA can be associated with delayed time to pregnancy. Therefore, this study aimed to determine habitual PA in a sample of women attending the one-stop infertility (OSI) clinic. In total, 250 women attending a large tertiary level NHS fertility unit prospectively completed a questionnaire anonymously over a period of 9 months. The participants (mean age: 34 ± 5 years, mean BMI: 29 ± 7 kg/m2) habitual PA levels varied from vigorous exercise on ≥5 days/week (8%, n  = 17) to no moderate or high-intensity activities across the whole week (66%, n  = 29). A majority of women reported no structured exercise (72%, n  = 179). No association was identified between any domain of PA and BMI, age, alcohol units, regular periods, or time spent trying to conceive (P > 0.05). The participants habitual PA levels varied widely and no association between any domain of PA and background of the women was identified. No existing evidence and/or guidelines to explicitly inform women attempting to conceive regarding recommended PA levels are available, despite PA being a modifiable, affordable, and feasible lifestyle choice with the possible potential to improve fertility. A large-scale, clinical trial assessing the effects of PA on fecundability is warranted to gain insight into the potential of this lifestyle factor to improve fertility outcomes and to explore the underlying biological mechanisms involved.

Lay summary
Infertility affects approximately one in seven couples with many and varied causes, including lifestyle factors such as smoking, alcohol, and diet. Lifestyle changes are low-cost unimposing options to implement in routine fertility care. Information on regular physical activity is not currently enquired from women and no agreement regarding the best levels of exercise exists for fertility patients. In this study, we aimed to determine the exercise habits of women attending the OSI clinic. In total. 250 women attending OSI clinic over a period of 9 months completed a questionnaire collecting data on their exercise habits. The levels of physical activity performed varied widely from vigorous exercise on ≥5 days/week to no moderate or high-intensity activities across the whole week. A majority of women did no structured exercise (72%). These novel data highlight the variations in form, type and intensity of exercise women who attend OSI clinics perform. Currently, there is no existing evidence and/or guidelines to explicitly inform women attempting to conceive regarding the recommended physical activity levels. Physical activity is a modifiable, affordable, and feasible lifestyle choice that is not currently acknowledged in the fertility setting and has the potential to improve fertility.