The Link between Fitness & Fertility: Why Getting Strong Before Pregnancy Matters

While women typically prepare for pregnancy by stocking up on prenatal vitamins and cutting back on coffee, the powerful role that fitness and overall health play in fertility, a smoother pregnancy and a quicker recovery is often overlooked.

When you’re strong, fit, and healthy, you lay the groundwork for improved fertility, increasing your chances of conceiving while also lowering risks of complications.

You’ll also benefit from a quicker rebound once your baby arrives, whether you have a natural birth or an elective C-section. This is particularly relevant for South Africans, as the country has one of the highest elective C-section rates in the world at 52.9% in the private sector¹.

The connection isn’t just anecdotal. Research consistently shows that women with healthy body composition and good cardiovascular fitness have higher conception rates, both naturally and through assisted reproductive methods.

Whether you’re planning to start trying in six months or beginning your fertility journey now, building a strong, balanced fitness foundation is one of the most valuable investments you can make in your future family’s health.

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A Fit Body Boosts Conception

Our bodies are built with a simple survival-first principle: when energy is scarce or stress is high, reproduction takes a back seat. That’s why poor sleep, chronic stress, and unhealthy lifestyle habits can make it harder to fall pregnant.

Being overweight (or underweight) can disrupt hormone balance and ovulation cycles. By getting fit and nourishing your body before trying to conceive, you’re essentially telling your body that it is safe, healthy, and ready to support new life.

That’s why women who are physically fit and metabolically healthy often find it easier to conceive.

Research shows that women with a healthy body mass index (BMI)²  – between 18.5 and 24.9 – and good cardiovascular health³ often have higher conception rates, both naturally and through assisted methods like IVF.

Strength training is particularly effective at lowering your weight by boosting your resting metabolic rate, while cardio exercise, like walking, running and cycling, is great for improving your cardiovascular health.

Whether you’re planning to start trying in six months or beginning your fertility journey now, building a strong, balanced fitness foundation is one of the most valuable investments you can make in your future family’s health.

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Hormonal Balance

Regular exercise, including strength training and cardio, helps regulate hormones such as oestrogen and progesterone, which are essential for a healthy menstrual cycle and ovulation.

Exercise also improves insulin sensitivity, which can be particularly beneficial for conditions like polycystic ovary syndrome (PCOS) – a condition that often involves hormonal imbalances affecting up to 10% of women of reproductive age.

Studies⁴ confirm that both vigorous aerobic exercise and resistance training can significantly improve conception rates in overweight and obese women with PCOS.

Furthermore, physical activity helps to reduce the stress hormone, cortisol, which can otherwise disrupt the delicate hormonal signals needed for ovulation and overall reproductive health.

Research⁵ shows that exercise works at the deepest level of reproductive health – the hypothalamic-pituitary-gonadal axis (essentially your body’s fertility control centre). This means better hormone production, improved egg quality, reduced inflammation, and stronger immune function.

This effect improves hormonal levels (specifically gonadotropins like luteinizing hormone and follicle-stimulating hormone), crucial for stimulating sex hormone production and the maturation of eggs, while also improving immune function and reducing inflammation and oxidative stress.

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The Goldilocks Principle

However, it’s important to find a balance – not too much and not too little, just right. For instance, excessive, high-intensity exercise can sometimes leading to an absence of menstruation and a disruption of the hormonal cycle.

Women who engage in high-intensity workouts may experience irregular periods or amenorrhea (absence of menstruation). Very low body fat resulting from excessive exercise can lead to hormonal imbalances, further affecting ovulation.

Additionally, overtraining can elevate cortisol levels, which negatively impact reproductive hormones, while inadequate nutrition can lead to low energy levels and nutrient deficiencies that negatively impact reproductive health.

Championing Conception

If motherhood is on the horizon, fitness is about more than just looking and feeling good; it’s about giving yourself and your future baby the healthiest possible start.

Whether it’s boosting your fertility, reducing risks during pregnancy, or bouncing back with confidence afterwards, building a strong, fit body before you fall pregnant is one of the best investments you can make in yourself and your family.

References:

1. Sandie AB, Mutua MK, Sidze E, Nyakangi V, Sylla EHM, Wanjoya A, Njom Nlend AE, Faye C. Epidemiology of emergency and elective caesarean section and its association with early neonatal mortality in sub-Saharan African countries. BMJ Open. 2023 Oct 12;13(10):e074995. doi: 10.1136/bmjopen-2023-074995. PMID: 37827732; PMCID: PMC10582852.
2. Zhu L, Zhou B, Zhu X, Cheng F, Pan Y, Zhou Y, Wu Y, Xu Q. Association Between Body Mass Index and Female Infertility in the United States: Data from National Health and Nutrition Examination Survey 2013-2018. Int J Gen Med. 2022 Feb 19;15:1821-1831. doi: 10.2147/IJGM.S349874. PMID: 35221716; PMCID: PMC8865871.
3. Yan Yang , Chen Jiajia , Qin Jinlong , Yu Min , Du Meirong; Association of cardiovascular health with reproductive lifespan and pregnancy loss: insights from NHANES 2005–2018; Frontiers in Endocrinology; Volume 16. 2025. 10.3389/fendo.2025.1597097. ISSN=1664-2392.
4. Mussawar M, Balsom AA, Totosy de Zepetnek JO, Gordon JL. The effect of physical activity on fertility: a mini-review. F S Rep. 2023 Apr 14;4(2):150-158. doi: 10.1016/j.xfre.2023.04.005. PMID: 37398617; PMCID: PMC10310950.
5. Xie, F., You, Y., Guan, C. et al.Association between physical activity and infertility: a comprehensive systematic review and meta-analysis. J Transl Med 20, 237 (2022). https://doi.org/10.1186/s12967-022-03426-3.