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The role of maternal physical activity on in vitro fertilization outcomes: a systematic review and meta-analysis

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This systematic review is designed to summarize the evidence concerning the impact of maternal physical activity on the reproductive outcomes following assisted reproduction techniques (ART), namely in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).


We searched for eligible studies on PubMed, EMBASE databases and the Cochrane Library from their inception until September 2021. Our primary outcomes were live birth rate and miscarriage, while secondary ones included clinical pregnancy and implantation rates. The quality of the evidence was evaluated using a study-specific adaptation of the Robins I tool.


Quantitative data from 10 cohort studies (CS) and 2 randomized control trials (RCT), involving 3431 women undergoing ART treatments, were included in the analyses. The pooled results exhibited uncertainty regarding the effect of physical activity on live birth rate per woman (OR 1.15, 95% CI 0.92–1.43, p = 0.23, I2 = 61%, 9 studies) and miscarriage rates (OR 0.79, 95% CI 0.44–1.43, p = 0.43, I2 = 44%, 6 studies). However, physical activity was associated with significantly improved clinical pregnancy rate after ART (OR 1.39, 95% CI 1.08–1.79, p = 0.0009, I2 = 68%, 10 studies), whereas implantation rate after ART almost reached statistical significance (OR = 1.95, 95% CI 0.99–3.82, p = 0.05, I2 = 77%).


The current evidence is still insufficient to firmly conclude on the effect of maternal physical activity on live birth, miscarriage and implantation rates. Although clinical pregnancy rates favored physical activity in this group of patients, these results must be undertaken with caution due to the low quality and the high heterogeneity of the studies included.

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The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by EK, EM, MF and EA. The first draft of the manuscript was written by EK and all authors commented on previous versions of the manuscript. CS supervised and guided the whole initiative. All authors read and approved the final manuscript.

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Correspondence to Eleftheria Kakargia.

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The authors declare that the present manuscript is not a result of original research on human subjects but a review of the current literature thus an ethics approval is not required.

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Kakargia, E., Mamalakis, E., Frountzas, M. et al. The role of maternal physical activity on in vitro fertilization outcomes: a systematic review and meta-analysis. Arch Gynecol Obstet 307, 1667–1676 (2023).

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