From IVF to Third Trimester: How Rachael Continued Strength Training Throughout Fertility Treatment and Pregnancy

On 3 January 2023 my husband and I had an appointment with our doctor to discuss the issues we were experiencing falling pregnant. We had been married for almost 4 years and stopped using contraception after our wedding. Having not experienced pregnancy before, I didn’t know what to expect if we were to conceive. I did know however that I would want to continue strength training to stay as strong, fit and healthy for both myself and the baby.

The following months involved lots of tests, a disappointing appointment with a fertility specialist, and you guessed it – more tests. On 27 March 2023, we met with Dr. Robert Lahoud from IVF Australia who was very empathetic and informative. He explained that our best chance of falling pregnant was IVF (In Vitro Fertilisation) combined with ICSI (Intracytoplasmic Sperm Injection). By the end of that appointment, we were booked in for our first (and hopefully last) round of IVF.

Today I will be discussing my personal experience strength training throughout IVF and pregnancy. Before I get into the nitty-gritty, my pregnancy has been low-risk with minor pregnancy-related symptoms. Always consult with a medical professional about your training and exercise regime during fertility treatment and pregnancy.

If you’d like to skip to a specific section, you can click on one of the following links to go straight there:

  1. Training Throughout IVF
  2. Training Throughout My First Trimester
  3. Training Throughout My Second Trimester
  4. Training Throughout My Third Trimester
Pregnancy Announcement

Training Throughout IVF

Hormone Injections

On 22 April 2023 I started a round of IVF. Spoiler alert: we had a very successful round and hopefully we won’t have to do another one. There were only 16 days between my first Follicle Stimulating Hormone (FSH) injection and my embryo transfer. However, there were a lot of blood tests, pelvic ultrasounds and medication in that short period of time.

I anticipated on sticking to my normal work and training regime as usual. During my first week of IVF, I did not experience any symptoms. I managed to train as expected with no adjustments to my training volume or load. It wasn’t until 1 May 2023 that I started to feel incredibly bloated and highly emotional. One of the lovely nurses called me that day to give me an update on my cycle monitoring and to see how I was feeling. When I responded with “Fine!” she asked, “Are you sure? Your estrogen levels are above 16000 pmol/L so I would be very surprised if you’re feeling fine.” The normal range is between 100-1700 pmol/L for context. Well, at least that explained the tears and average training session a few hours earlier. The week prior (day 3 of hormone injections) I deadlifted 150kg x 2 reps at RPE 8 and could only manage 150kg x 1 rep at RPE 8.5 that day, and didn’t have it in me to do any down sets which were 130kg x 5 reps x 2 sets the week before.

Training Program: Hormone Injections

Below is a snapshot of a training week during the hormone injections. Day 2 purposefully only has two exercises due to time constraints on that training day.

Day 1Day 2 Day 3
Touch and Go Bench Press
72kg x 4 reps x 1 set
65kg x 8 reps x 2 sets
Low Bar Squat
107.5kg x 2 reps x 1 set
95kg x 5 reps x 3 sets
High Bar Paused Squat
87kg x 6 reps x 2 sets
Deadlift
150kg x 2 reps x 1 set
130kg x 5 reps x 2 sets
1ct Paused Bench Press
72.5kg x 2 reps x 1 set
67.5kg x 4 reps x 3 sets
3ct Paused Bench Press
60kg x 4 reps x 3 sets
Seated Cable Row
45kg x 8 reps x 2 sets
Feet Up Touch and Go Bench Press
55kg x 8 reps x 2 sets
Hamstring Curl
20kg x 15 reps x 2 sets
Single Arm Dumbbell Row
22.5kg x 10 reps x 2 sets
Bulgarian Split Squat
25kg x 10 reps x 2 sets

Deadlifting 150kg x 2 reps and Bench Pressing 72kg x 4 reps during hormone injections

The Egg Retrieval & Embryo Transfer

On 3 May 2023 I was booked in for my egg retrieval procedure. I took the day off work and training because I had to be there bright and early and the procedure was done under general anaesthesia. The egg retrieval was a success, with 19 eggs being collected. Later that day, I was in an incredible amount of pain to the point where my husband considered taking me to hospital. I cancelled work the following morning to get some rest, but worked the following afternoon with difficulty. I ended up taking the next day off work and training to rest and recover.

Before and after my egg retrieval procedure

That weekend, we were told that of the 19 eggs collected, 16 went through the ICSI process, 13 fertilised normally, 11 embryos matured normally, and 8 embryos were graded good enough to use or freeze. On 8 May 2023, I made the life changing decision to transfer an embryo and freeze the 7 remaining. The embryo transfer was pain-free, and I trained about an hour after the procedure. I was still feeling the effects of the egg retrieval procedure from 5 days earlier and I adjusted my training load to accommodate the discomfort I was experiencing. There was decrease in load in all exercises across the board, varying between a 2-23% drop. The most noticeable were deadlifts with a 23% decrease in load from 130kg x 5 reps to 100kg x 5 reps. Squats weren’t far behind with a 15% decrease in load from 95kg x 5 reps to 80kg x 5 reps.

Training Program: Post Egg Retrieval & Embryo Transfer

Below is a snapshot of a training week after the egg retrieval and embryo transfer. Day 2 purposefully only has two exercises due to time constraints on that training day.

Day 1Day 2 Day 3
Touch and Go Bench Press
70kg x 2 reps x 1 set
65kg x 5 reps x 2 sets
Low Bar Squat
80kg x 5 reps x 3 sets
High Bar Paused Squat
60kg x 6 reps x 2 sets
Deadlift
100kg x 5 reps x 3 sets
1ct Paused Bench Press
60kg x 5 reps x 3 sets
3ct Paused Bench Press
55kg x 4 reps x 3 sets
Seated Cable Row
40kg x 12 reps x 2 sets
Feet Up Touch and Go Bench Press
50kg x 8 reps x 2 sets
Hamstring Curl
15kg x 15 reps x 2 sets
Single Arm Dumbbell Row
20kg x 10 reps x 2 sets
Bulgarian Split Squat
20kg x 10 reps x 2 sets

Deadlifting 100kg x 5 reps and Bench Pressing 70kg x 2 reps after the egg retrieval and embryo transfer

IVF Cycle Monitoring

For anyone who might be interested, below is a summarised copy of my cycle monitoring data from IVF Australia.

DateFSH DoseAntagonist DoseTrigger DoseProgesterone DoseEstrogen LevelsNotes
22/04/2023250.00205
23/04/2023250.00
24/04/2023250.00
25/04/2023250.00
26/04/2023250.00250.004981
27/04/2023250.00250.007414
28/04/2023250.00250.00
29/04/2023250.00250.00
30/04/2023250.00250.00
01/05/2023250.0016429
02/05/2023
03/05/2023600.0019 Eggs Retrieved, 16 Eggs ICSI
04/05/2023600.0013 Eggs Fertilised Normally
05/05/2023600.00
06/05/2023600.00
07/05/2023600.0011 Embryos Matured Normally
08/05/2023600.001 Embryo Transferred, 7 Embryos Frozen

Training Throughout My First Trimester

First Trimester: Weeks 1 to 6

On 19 May 2023 I had a blood test at IVF Australia which confirmed that I was pregnant. Technically, I was already 4 weeks pregnant at this point. My abdomen was still feeling quite sensitive after the egg retrieval procedure, so I decided to stop using my belt in training and some adjustments to exercise selection were made. Low bar squats were swapped for safety bar squats with an increase in rep range. The other modifications were mainly to my supplementary exercises. These modifications were made because it was time to update my training program, not because I was suddenly pregnant.

It felt great to continue training. Thankfully, I didn’t experience any nausea or morning sickness. My motivation to train was still high, and I didn’t struggle completing all of my sessions.

Training Program: Weeks 1 to 6

Below is a snapshot of a training week during weeks 1 to 6.

Day 1Day 2 Day 3
Feet Up Touch and Go Bench Press
55kg x 10 reps x 2 sets
Safety Bar Squat
67.5kg x 8 reps x 3 sets
Paused Incline Dumbbell Bench Press
35kg x 10 reps x 3 sets
Tempo Bench Press
55kg x 5 reps x 2 sets
Touch and Go Bench Press
67.5kg x 4 reps x 2 sets
60kg x 6 reps x 2 sets
Heels Elevated Goblet Squat
27.5kg x 12 reps x 3 sets
Deadlift
105kg x 6 reps x 2 sets
Paused Dumbbell Romanian Deadlifts
40kg x 12 reps x 3 sets
Tempo Single Leg Leg Press
40kg x 10 reps x 3 sets
Single Leg Hip Thrusts
Body weight x 10 reps x 3 sets
L-Sit Dumbbell Shoulder Press
20kg x 10 reps x 3 sets
Single Arm Supinated Grip Pulldown
22.5kg x 10 reps x 3 sets
Neutral Grip Seated Row
40kg x 12 reps x 3 sets
Tricep Pushdown
15kg x 15 reps x 2 sets

Incline Bench Pressing 35kg x 10 reps and Tricep Pushdowns for 15kg x 15 reps while 4 weeks pregnant

First Trimester: Weeks 7 to 12

Prior to IVF treatment and falling pregnant, my husband and I had booked a long-overdue trip overseas. We travelled to Texas, Florida, The Bahamas and Mexico.

In addition to travelling, there were a few hiccups that disrupted my training from Weeks 7 to 12. Unfortunately I tested positive to COVID as soon as we landed in Florida. I experienced sciatica (apparently quite common during pregnancy), but walking and training seemed to improve my symptoms. I was also pretty damn tired. My husband caught me napping throughout all hours of the day if my head hit a pillow. I was a bit concerned that the dreaded nausea would start while we were overseas, but it never came!

I had intended on getting in as much training as possible while travelling, but this ended up only being 1 or 2 sessions per week.

Training Program: Weeks 7 to 12

Below is a snapshot of a training week during weeks 7 to 12.

Day 1Day 2 Day 3
Feet Up Touch and Go Bench Press
57.5kg x 6 reps x 2 sets
Safety Bar Squat
70kg x 8 reps x 3 sets
Paused Incline Dumbbell Bench Press
32kg x 10 reps x 3 sets
Tempo Bench Press
55kg x 5 reps x 2 sets
Touch and Go Bench Press
67.5kg x 4 reps x 2 sets
60kg x 6 reps x 2 sets
Heels Elevated Goblet Squat
20kg x 12 reps x 3 sets
Deadlift
110kg x 6 reps x 2 sets
Paused Dumbbell Romanian Deadlifts
40kg x 12 reps x 3 sets
Tempo Single Leg Leg Press
20kg x 10 reps x 3 sets
Single Leg Hip Thrusts
Body weight x 10 reps x 3 sets
L-Sit Dumbbell Shoulder Press
20kg x 10 reps x 3 sets
Single Arm Supinated Grip Pulldown
20kg x 10 reps x 3 sets
Neutral Grip Seated Row
35kg x 12 reps x 3 sets
Tricep Skullcrushers
15kg x 15 reps x 2 sets

High Bar Squatting (in lieu of the Safety Bar) 70kg x 8 reps and Paused Dumbbell Romanian Deadlifting 40kg x 12 reps while 10 weeks pregnant in Mexico

Training Throughout My Second Trimester

Second Trimester: Weeks 13 to 19

By this point in my pregnancy I was fully recovered from the egg retrieval procedure and back into routine after travelling. Aside from a growing bump, I had zero pregnancy-related symptoms.

Training continued to feel great and no adjustments were made to exercise selection due to being pregnant. I use the RPE (Rate of Perceived Exertion) scale with my training which allowed me to auto-regulate training load depending on how I was feeling on the day.

There was a slight decrease in load for some exercises, however this was mainly due to returning to regular training after being inconsistent while travelling. There were also some changes to my supplementary exercises, but again this wasn’t pregnancy-related.

Training Program: Weeks 13 to 19

Below is a snapshot of a training week during weeks 13 to 19.

Day 1Day 2 Day 3
Feet Up Touch and Go Bench Press
55kg x 6 reps x 2 sets
Safety Bar Squat
62kg x 8 reps x 3 sets
Paused Incline Dumbbell Bench Press
35kg x 10 reps x 3 sets
Tempo Bench Press
52.5kg x 5 reps x 2 sets
Touch and Go Bench Press
65kg x 5 reps x 2 sets
60kg x 6 reps x 2 sets
Heel Elevated Goblet Squat
25kg x 12 reps x 3 sets
Deadlift
100kg x 6 reps x 2 sets
Paused Dumbbell Romanian Deadlifts
40kg x 12 reps x 3 sets
Tempo Single Leg Leg Press
30kg x 10 reps x 3 sets
Assisted Pull-Ups
Green band x 8 reps x 3 sets
L-Sit Dumbbell Shoulder Press
20kg x 10 reps x 3 sets
B-Stance Hip Thrusts
50kg x 10 reps x 3 sets
Neutral Grip Seated Row
35kg x 12 reps x 3 sets
Tricep Skullcrushers
15kg x 12 reps x 3 sets

Safety Bar Squatting 62kg x 8 reps and Bench Pressing 65kg x 5 reps while 15 weeks pregnant

Second Trimester: Weeks 20 to 26

At 23 weeks pregnant, I had heartburn for the very first time in my life. Little did I know that this heartburn would continue throughout the rest of my pregnancy. Apparently it’s an old wives’ tale that heartburn is an indicator that your baby will be born with a full head of hair. We will find out whether this is true or not in late January when the baby is born!

At 25 weeks pregnant I experienced my first nosebleed. Having never had a nosebleed before, it came as quite a shock. Apparently this is another pregnancy-related symptom due to increased blood volume and hormonal changes. I have since had another two nosebleeds, so I guess you can call me an expert at managing them now.

The biggest adjustment to my training program during the latter part of my second trimester was swapping conventional deadlifts for Romanian deadlifts. There was no specific pregnancy-related reason for this. I wanted to continue doing some deadlift or hip-hinge variation throughout the duration of my pregnancy. Romanian deadlifts are a great exercise that still allows me to work my posterior chain. I also saw the return of low bar squats after doing safety bar squats for 10 weeks.

Training Program: Weeks 20 to 26

Below is a snapshot of a training week during weeks 20 to 26.

Day 1Day 2 Day 3
Touch and Go Bench Press
65kg x 3 reps x 1 set
60kg x 5 reps x 2 sets
55kg x 6 reps x 1 set
Low Bar Squat
77kg x 5 reps x 3 sets
High Bar Paused Squat
55kg x 8 reps x 3 sets
High Stance Leg Press
140kg x 15 reps x 3 sets
Incline Bench Press
45kg x 6 reps x 3 sets
Paused Dumbbell Bench Press
40kg x 8 reps x 3 sets
Bent Over Barbell Row
40kg x 10 reps x 3 sets
Barbell Romanian Deadlifts
60kg x 10 reps x 3 sets
Supinated Grip Lat Pulldown
35kg x 12 reps x 3 sets
Single Arm Dumbbell Press
10kg x 10 reps x 3 sets
Single Arm Cable Row
10kg x 12 reps x 3 sets
Step-Ups
15kg x 10 reps x 3 sets
Tricep Skullcrushers
15kg x 12 reps x 3 sets

Low Bar Squatting 77kg x 5 reps and Incline Bench Pressing 45kg x 6 reps while 22 weeks pregnant

Training Throughout My Third Trimester

Second Trimester: Weeks 27 to 32 weeks

I am currently 32 weeks pregnant at the time of writing this blog, so I can only write about training throughout pregnancy to this point. I will revisit this section once we’ve welcomed our new family member into the world.

Not much has changed on the pregnancy symptom front. I am still experiencing heartburn on an almost daily basis. The heartburn affects my appetite more than anything else. Training is still feeling great. I also feel a bit of rib pain occasionally, but haven’t felt any discomfort during training. Surprisingly, I am low bar squatting more weight than I was in my second trimester. We will have to wait and see what the trajectory is for the rest of my pregnancy, though!

There have been some pregnancy-related exercise modifications. The first was removing the paused dumbbell bench press. The movement itself felt fine, however both getting into position and dismounting felt uncomfortable. Incline bench press has taken its place for now. The second was swapping the high stance leg press for single leg leg press. With a growing bump I simply wasn’t getting the most out of the movement due to the limited range of motion.

Training Program: Weeks 27 to 32 weeks

Below is a snapshot of a training week during weeks 27 to 32.

Day 1Day 2 Day 3
Touch and Go Bench Press
65kg x 3 reps x 1 set
60kg x 5 reps x 2 sets
55kg x 8 reps x 1 set
Low Bar Squat
80kg x 5 reps x 3 sets
High Bar Paused Squat
55kg x 6 reps x 3 sets
Bulgarian Split Squat
15kg x 10 reps x 3 sets
Barbell Overhead Press
30kg x 6 reps x 3 sets
Incline Bench Press
45kg x 6 reps x 3 sets
Seated Dumbbell Press
25kg x 10 reps x 3 sets
Barbell Romanian Deadlifts
70kg x 8 reps x 3 sets
Single Leg Leg Press
30kg x 10 reps x 3 sets
Incline Single Arm Dumbbell Row
20kg x 10 reps x 3 sets
Single Arm Cable Row
45kg x 8 reps x 3 sets
Tempo Dumbbell Lateral Raise
5kg x 12 reps x 3 sets
Tricep Skullcrushers
15kg x 12 reps x 3 sets
Seated Dumbbell Overhead March
10kg x 20 reps x 2 sets

Low Bar Squatting 80kg x 5 reps and Overhead Pressing 30kg x 6 reps while 30 weeks pregnant

Strength Training Throughout Fertility Treatment and Pregnancy in a Nutshell

It’s likely no secret that I am a huge advocate for training throughout all phases of life, and that includes pregnancy. I have trained plenty of pregnant women in the past, but it has been a different experience going through the different stages of pregnancy myself. What I have learnt is that no pregnancy is the same. Modifications are specific to each individual and pregnancy, and what works for one person may not work for another.

One of my goals was to continue strength training as close to labour as possible, only making adjustments when needed. The most substantial change to load was after my egg retrieval procedure, but since then I have managed to keep my training load much the same. The main changes to my exercise selection due to pregnancy were the removal of the paused dumbbell bench press and high stance leg press. I haven’t felt any discomfort whilst performing specific movements. Rather, adjustments were made due to the awkwardness of setting up or because of the limited range of motion (thanks to the bump)!

If you’ve made it this far, I hope this inspires you to continue training throughout pregnancy – whether that be now or in the future. I also suggest checking out our A Brief Guide to Training During Pregnancy blog to learn more about the benefits of training throughout pregnancy, safety considerations and training recommendations. If you’re currently trying to conceive or pregnant and would like to work with a Pre/Post Natal qualified trainer, you can get in contact with us here.

Bench Pressing 65kg x 3 reps and Bulgarian Split Squatting 15kg x 10 reps while 32 weeks pregnant

A Brief Guide to Training During Pregnancy

The topic of exercising during pregnancy is often a contentious one, full of conflicting information and personal opinions. This article will explore some of the latest research and guidelines to help individuals understand the safety considerations of exercising during pregnancy, the potential benefits of doing so, and the recommended types of training.

Before we get into the details, there are two important disclaimers we need to make:

  1. We are not doctors. The information in this article is not advice about training during pregnancy, nor should it supersede any specific information or advice given to you by your doctor.
  2. This article intends to provide information for pregnancies without complications. If you are experiencing any sort of complications, please consult your doctor before engaging in exercise.

With those caveats in mind, let’s dive into the topic of training during pregnancy.

Is It Safe to Train During Pregnancy?

The main concern when discussing the topic of exercising during pregnancy is usually safety. For this reason, physical activity was historically not recommended for pregnant women. However, as more research has emerged on the topic, this narrative has shifted in the opposite direction. Many modern national guidelines now recommend exercise as both safe and beneficial to undertake during an uncomplicated pregnancy.1

However, if you plan to exercise during pregnancy, it’s important to consider specific safety aspects. As the body undergoes regular and anticipated changes during gestation, you may need to adjust exercise selection and intensity to accommodate these changes.2 For example, push-ups might become a bit difficult as the baby gets bigger, so substituting them for a bench press variation will achieve the same outcomes in a more comfortable position.

There are also certain types of activities that are not recommended if pregnant. Activities involving risk of contact/collision, risk of falling, changes in air pressure (e.g. scuba diving), or high temperatures are recommended to avoid completely.3

The guidelines also list a number of warning signs to stop physical activity and consult a healthcare provider. Examples include severe chest pain, severe shortness of breath that does not resolve with rest, regular and painful uterine contractions, persistent dizziness, or vaginal bleeding.4

Individuals experiencing pregnancies involving complications should refrain from exercising until consulting with a healthcare specialist. This caution also applies to individuals with a history of certain medical conditions.

In general, healthcare professionals recommend engaging in physical activity throughout most uncomplicated pregnancies. Comprehensive guidelines exist to optimize safety. It’s always advisable to seek advice from a healthcare professional familiar with your specific circumstances.

For more information, we recommend having a look at the Australian Guidelines for Physical Activity During Pregnancy.

The Benefits of Exercising During Pregnancy

Now that we know that it’s safe to train during pregnancy, we should look at whether or not there are any benefits to doing so. Research shows that there are a number of positive outcomes unique to pregnancy, including:5

  • Decreased gestational diabetes.
  • Reduced incidence of caesarean delivery.
  • Reduced incidence of delivery requiring operative intervention.
  • Decreased postpartum recovery time.
  • Prevention of postpartum depressive disorders.
  • Reduced gestational hypertension (high blood pressure).
  • Less body pain and reduced physical capability due to pain.
  • Reduced gestational weight gain compared to not exercising.

Additionally, all of the regular benefits of exercise still apply. These include increased muscular strength and size, increased bone density, stronger connective tissue, greater coordination, better aerobic fitness, and improved management of various health conditions.6

Upon examining these outcomes, it becomes evident that encouraging exercise before, during, and after an uncomplicated pregnancy can provide immense benefits.

Training Recommendations During Pregnancy

We’ve talked about the safety of training during pregnancy, and what the benefits are. The last thing to look at is the actual training recommendations. If previously active, continuing to exercise within existing capabilities is a good place to start. If inactive prior to pregnancy, it is recommended to start slow, and gradually increase duration and intensity over time.7

In terms of the specifics, the activity guidelines are actually very similar to those for non-pregnant people:8

  • 2.5-5 hours of moderate aerobic activity per week or;
  • 1.25-2.5 hours of vigorous aerobic activity per week, or a combination thereof.
  • Resistance training at least twice per week.
  • Aim to be active most, if not all days.
  • Do pelvic floor strengthening exercises.

It’s important to keep in mind that as gestation continues and the mother’s body changes, modifications may need to be made to the type, intensity, and duration of exercise. As always, consult with a healthcare specialist to make sure that the activity you do is suitable for your individual circumstances.

Conclusion

In summary, being physically active is safe, beneficial, and recommended to do during pregnancy. For uncomplicated pregnancies, there are guidelines available to provide general advice on how that physical activity might look. However, you should not consider either these guidelines or anything we’ve discussed in this article as specific advice. Before undertaking any sort of exercise during pregnancy make sure to consult with your healthcare specialist to make sure that what you plan to do is appropriate for your specific condition.

Keep an eye out for our next article, where Rachael will be doing an in-depth look at her experience of training throughout her pregnancy!

References

  1. Guidelines for exercise during normal pregnancy and gestational diabetes: a review of international recommendations ↩︎
  2. Guidelines for Physical Activity During Pregnancy ↩︎
  3. Guidelines for Physical Activity During Pregnancy; 2019 Canadian Guideline for Physical Activity Throughout Pregnancy ↩︎
  4. Guidelines for Physical Activity During Pregnancy; 2019 Canadian Guideline for Physical Activity Throughout Pregnancy ↩︎
  5. Physical Activity and Exercise During Pregnancy and the Postpartum Period ↩︎
  6. Resistance Training for Health ↩︎
  7. Guidelines for Physical Activity During Pregnancy; 2019 Canadian Guideline for Physical Activity Throughout Pregnancy ↩︎
  8. Guidelines for Physical Activity During Pregnancy; 2019 Canadian Guideline for Physical Activity Throughout Pregnancy ↩︎