“], “filter”: { “nextExceptions”: “img, blockquote, div”, “nextContainsExceptions”: “img, blockquote, a.btn, a.o-button”} }”>

Heading out the door? Read this text on the brand new Outside+ app available now on iOS devices for members!
>”,”name”:”in-content-cta”,”type”:”link”}}”>Download the app.

Like most longtime yogis, I’ve ugly cried on my mat more times than I can count. However the day after my husband injected me with the ultimate hormonal shot of our in-vitro fertilization (IVF) cycle, I needed to take my overwhelming emotional outburst elsewhere because, in line with my medical team, I shouldn’t unroll my mat.

Prior to starting IVF back in June, I had 1,000,000 concerns. What would the every day injections feel like? Would the bloating be unbearable? Would the flood of hormones send my baseline emotional roller coaster flying off the tracks? Would I discover a Google seek for “annulment” in my latest husband’s browser history? All of those questions plagued me within the weeks leading as much as the exorbitantly expensive endeavor. But I used to be blissfully unaware of 1 particular IVF-specific source of stress until just before the beginning of my cycle: In accordance with my fertility team, yoga was strictly forbidden.

I used to be floored.

Before we began the cycle, I had (appropriately) assumed that I’d must put my more intense workouts on pause and that I’d probably must lay off the HIIT and heavy weights while going through the approximate two-week stimulation phase of every day hormone injections and the egg retrieval procedure that caps the cycle. But I had (incorrectly) expected to make use of the day off to dive deeper into my yoga practice.

I assumed possibly I’d finally have time to know the physics of Firefly Pose or persuade my impinged hips to recover from their loathing of Cow Face Pose (admittedly, a lofty goal). But to my surprise—and, frankly, my horror—my fertility clinic’s staff psychologist, of all people, informed me at the tip of our pre-cycle consultation that I used to be welcome to channel my IVF anxiety into meditation sessions and long walks. My most trusted coping skill—coming to my mat to practice yoga—was relegated, together with all types of other beloved things, to an inventory of banned activities.

My mat is my default go-to space for decompression, grounding, and the aforementioned ugly crying. Without it, I are inclined to struggle with probably the most basic on a regular basis challenges life throws at me. But being without it in the course of the hormonally-fueled, emotional tornado of IVF, I struggled with rather more than the baseline messiness of a nasty mood or anxiety attack. I felt foggy, sad, fatigued, and panicky about my impending egg retrieval, which was scheduled to happen 36 hours after that “trigger shot.”

The medical recommendations from my fertility team were enough to scare me away from my mat for a whole month during and after my IVF cycle. But I couldn’t shake the nagging suspicion that this overarching rule was rooted in a misunderstanding about what the practice of yoga actually is—or may be.

The Potential Complications of Practicing Yoga During IVF

Through continued conversations with my treatment team (I asked about it at literally every appointment during my 15-day cycle), I learned the very sound reasoning behind this widespread advice: Those undergoing IVF are at an increased risk of a rare but potentially serious complication often called ovarian hyperstimulation syndrome (OHSS). This condition could cause the ovaries to swell and leak fluids into the body, and in severe cases, can result in issues including severe abdominal swelling, difficulty respiration, and blood clots.

OHSS also increases the danger of one other scary scenario that can lead to the lack of an ovary. “Ovarian torsion is a really rare complication of IVF that may be a surgical emergency,” explains Bay Area-based fertility medicine specialist and reproductive endocrinologist Dr. Aimee Eyvazzadeh, MD, MPH.

A twisted ovary loses its blood supply, leading to extreme pain. “Women in danger for torsion typically have an ovarian cyst that makes the ovary unbalanced and twist on itself,” Eyvazzadeh says. “Women taking fertility meds are at a rather higher risk of ovarian torsion because fertility meds cause ovarian cysts to grow.”

Eyvazzadeh happens to disagree with the blanket advice to avoid yoga in any respect costs —and I learned through my research that she’s in good company. But she helped me understand the first reason a lot of her colleagues zero in on asana as a very dangerous practice during IVF: twisting the torso—a typical move in quite a few poses and flows—is strictly the style of motion one desires to avoid when trying to not torque an ovary.

Not All Yoga is Created Equal

“Doctors are saying ‘no yoga’ because their general impression of yoga relies on the form of yoga classes which can be pervasive within the U.S. right away, like ‘yoga-aerobics’ or ‘hot’ yoga, or ‘core-strengthening’ yoga,” says Seattle-based prenatal instructor and founding father of Yoga for Fertility, Lynn Jensen.“I’d agree that these aren’t secure for somebody undergoing IVF, and never even appropriate for somebody who’s just attempting to conceive naturally,” she says.

After dealing along with her own reproductive challenges, Jensen launched her fertility-focused program of classes, retreats, and workshops in 2002. She later co-authored the book Yoga and Fertility: A Journey to Health and Healing and started offering specific Yoga for Fertility teacher trainings to coach instructors on secure practices which can be compatible with infertility diagnoses and designed for anyone attempting to conceive.

Jensen understands the hesitation many medical professionals have around recommending yoga in any form to fertility patients. “Prenatal yoga teachers are rarely trained to work with fertility patients or anyone attempting to conceive,” Jensen says. “I’m a registered prenatal yoga teacher, have been a registered yoga teacher for 20 years, and I’m also an authorized yoga therapist—none of those certifications included any training about fertility issues, and definitely no training for working with someone going through assisted reproductive treatments.”

Los Angeles-based yoga and meditation instructor and licensed prenatal instructor Kala MacDonald believes the strict no-yoga policy set forth by many fertility experts speaks to a broader disconnect between Western medicine and evidence-based Eastern or holistic practices. “While I understand a Western medical doctor’s all-encompassing ‘no yoga’ policy, what they’re really doing is eliminating an important, accessible, stress-relieving, sleep supporting, whole mind-body practice that might offer a lot profit to an individual going through this difficult process.”

MacDonald believes an appropriate, secure yoga practice has the potential to mitigate a few of the frustration, stress, and confusion inherent in the method. “A health care provider tells their patient ‘no yoga’ but what they really mean is ‘no intensive, acrobatic, overreaching, uncontrolled, too-advanced yoga,” she says. “Those doctors understandably aren’t co-trained in yoga practices and, with their advice, could also be eliminating practices that will not only not be harmful to a patient going through IVF, but could possibly be so useful.”

While many  gentle, restorative flows still include some twisting elements, MacDonald says there are still dozens postures which can be generally secure, supportive, and value practicing through IVF.

Research has shown that yoga and movement typically can actually help fend off the psychological uncomfortable side effects of infertility and IVF. Studies have also shown that IVF, in addition to infertility itself, could cause a serious increase in the danger for mental health conditions equivalent to depression and anxiety—the identical ones that yoga and movement may thoroughly help.

The most important risk of ovarian torsion in the course of the IVF process comes after the egg retrieval procedure, with an incidence of 0.024%–0.2%. The common incidence of ovarian torsion in all women over a one-year period is about 0.0059% (about 5.9 out of each 100,000 women) of all ages. Incidences of OHSS are much higher, affecting between 3.1% and eight% of people going through IVF, but rates may be as high as 20% in high-risk women like those that have polycystic ovarian syndrome (PCOS). While the chances of those complications are statistically low, they’re very much real and devastating and I’ve known women who’ve experienced the excruciating pain of OHSS. Anyone going through the IVF process should, due to this fact, be explicitly forewarned by their fertility teams in regards to the early symptoms of those issues and be vigilant for signs of trouble.

But given my emotional reliance on yoga, had I not been explicitly instructed to avoid it, I think I’d’ve been in a position to navigate things a little bit less messily by Downward Dogging my way through those days.

What I Know Now

I’ve experienced the calming effects of yoga first-hand over and yet again throughout the many years. But I took the recommendation of my fertility treatment team seriously. My husband and I were investing near $20,000 in a likelihood at potential parenthood (the obscene lack of infertility health coverage on this country is an entire other story…). I wasn’t about to screw this up for us simply because I missed my Sun Salutations. I dutifully sat out my regular practices, focused on meditation, and avoided any body positions that might in any way, shape, or form, be construed as a “twist.”

Ultimately, even with all that precaution, our IVF cycle wasn’t successful. Out of 14 retrieved eggs and 6 resulting embryos, only two made it to maturity, and none were deemed genetically healthy. It was heartbreaking but by no means unusual. In reality, I learned that based on my age, medical history, and various other aspects, I only stood a few 30% likelihood of ultimately having a baby with one IVF cycle.

I knew we’d at the least given it our greatest shot (pun very much intended given the variety of injections I endured), however it was an emotional minefield to navigate. I jumped back into my yoga routine as soon as I used to be given the green light to twist my heart out two weeks post-retrieval, but I had already began to wonder if the no-asana advice was needed or if I’d have mentally benefited from a toned-down version of my typical practice.

After my experience, I reached out to dozens of fertility specialists and was hard-pressed to seek out a single expert who was adamantly against practicing yoga during IVF. I even reached out to the American Society for Reproductive Medicine (ASRM) and was told they don’t have any members who’re “against” yoga during IVF.

Still, the problem is complicated. And so is the practice of yoga, which might tackle myriad shapes and forms, with physical twists only one small a part of that big picture Although I couldn’t find any specialists who would go on the record against yoga, many—like my treatment team—proceed to steer patients away from asana because there are real risks related to specific postures.

Eyvazzadeh is hopeful more fertility experts will begin to expand their knowledge of the secure, supportive elements of the practice. “Yoga may also help renew your mind,” she says. “It will probably release each physical and mental tension all while constructing strength. It will probably help with higher sleep and improve your mindset from stress. My patients are advised to maneuver their bodies throughout treatment and I be sure all of them have built their fertility T.E.A.M.—Therapy, Exercise (especially encouraging yoga), Acupuncture, and Mindfulness—before they begin treatment.”

If only I had known.

(Photo: Westend61 | Getty)

So Which Yoga Poses Are Considered Secure to Practice During IVF?

Yoga, as practiced in lots of contemporary Western studios, really isn’t secure in the course of the IVF process. As someone who tends toward the spicy, twisty, inversion-filled vinyasa style, I can say that my fertility team wasn’t fallacious in putting me on timeout. However the hope is that more medical professionals will understand that yoga isn’t all arm balances and inversions.

“It’s a protracted journey ahead, but the reply really is more education in order that doctors have a network of execs, like myself, who concentrate on gentle, restorative, subtle body, focus practices, alongside their existing network of chiropractors, physical therapists, and so forth,” MacDonald says.

Eyvazzadeh considers movement an integral part of creating it through the IVF process. “I believe patients are made to think that they should stop exercising after they’re going through fertility treatment; that’s a really harmful advice,” she says. “Gentle stretching and respiration and poses that don’t involve intense backbends are secure.”

With regards to which traditional poses are considered secure, Jensen and MacDonald have an inventory of vetted postures that don’t involve twisting, contorting, or overworking the nervous system—all legitimate IVF no-nos. Along with gentle respiration practices, Jensen generally endorses resting poses equivalent to Legs up the Wall (Viparina Karani) and Resting Certain Angle (Supported Supta Baddha Konasana). “The secret’s that even these poses shouldn’t be done in the event that they feel uncomfortable,” she says. “And in fact, meditation, use of affirmations, chanting, and visualization are all the time effective to do.”

MacDonald advocates for practicing deep respiration to bring on the calming effects of the parasympathetic nervous system. Included in her list of “secure” poses is Savasana, specifically with support under the knees.

Eyvazzadeh advises all of her patients to read the book Finding Calm for the Expectant Mom: Tools for Reducing Stress, Anxiety, and Mood Swings During Your Pregnancy. And he or she, along with MacDonald and others in the sphere, advises patients to hunt individualized, expert-guided care. Regardless of which way you lean, it’s essential to seek the advice of your physicians and work together with your fertility team to give you an exercise plan you all agree on and feel comfortable with.

While I wasn’t armed with this information once I went through my very own IVF journey, my intuitive response to my doctor’s no-yoga policy was to lean into breathwork, meditation, and gentler, more intentional movement. I continued my every day ritual with non-asana-focused practices and even once I was within the clear after my retrieval, I opted for shorter slow flows, yin yoga classes, and even a couple of pre- and postnatal flows.

And truthfully? Re-learning the true tenets of yoga and all that the practice entails inspired me to include an entire lot more of the non-asana facets into my life. And I believe my dear, patient husband appreciates how slowing down has kept my typical emotional rollercoaster rides safely on the rails.

About Our Contributor

Michelle Konstantinovsky is a San Francisco-based independent journalist, author, editor, and UC Berkeley Graduate School of Journalism alum. She’s written extensively on health, body image, entertainment, lifestyle, design, and tech for outlets including Vogue, Vanity Fair, Scientific American, Glamour, Shape, Self, WIRED, Cosmopolitan, Marie Claire, Teen Vogue, and lots of more. She has also served because the health and wellness editor at Fitbit, senior health author at One Medical, and contributing editor at California Home + Design. She accomplished 200 hours of yoga teacher training in 2018 and continues to be trying to know the physics of hand balancing. Follow her at @michellekmedia.