Do Physical Activity Behaviours Influence the Success of Assisted Reproductive Technology? A Systematic Review of the Literature.

Abstract

Physical activity (PA) behaviours after assisted reproductive technology (ART) may influence its success. Bedrest is frequently recommended immediately after intrauterine insemination (IUI) or embryo transfer (ET), and women are also commonly advised to restrict PA after ART. However, these recommendations are not grounded on evidence-based information. The purpose of this systematic review was to assess the impact of PA behaviours during ART on ART success (positive pregnancy test, clinical pregnancy, live birth). A systematic search of the literature was conducted in PubMed, Medline, SPORTdiscus, and CINAHL. The Grading of Recommendations Assessment, Development, and Evaluation system was applied to studies by clinical outcome and used to rate quality of evidence. Twelve studies were included in the review. Our findings suggest that the effect of bedrest immediately after IUI or ET on ART success depends on the procedure used, with favourable effects after IUI ("moderate" quality evidence on clinical pregnancy) but no effect, and even possible unfavourable effects, after ET ("very low" quality evidence on positive pregnancy test and clinical pregnancy). "Very low" quality evidence suggested a decreased live birth rate with bedrest after ET (n = 1) but an increased rate with bedrest after IUI (n = 1). "Very low" quality of evidence suggested no deleterious effect of moderate PA on clinical pregnancy and live birth after ET. On the basis of our findings, studies with more rigourous design and methodology, and considering live birth as an outcome, are needed to provide further evidence on the most appropriate PA behaviours women should adopt to improve ART success.