If you’re trying to get pregnant in 2026, chances are you’ve already been exposed to a lot of advice — some helpful, some outdated, and some flat-out confusing.
As an exercise researcher and pelvic health physical therapist, I want to stay firmly in my lane and talk about health promotion, exercise, and fertility — especially the areas that tend to be misunderstood for active individuals.
This post breaks down what we actually know about fertility optimization, menstrual cycles, energy availability, and exercise intensity — and where nuance matters more than fear.
One of the most important first steps when trying to conceive is understanding your menstrual cycle.
Many fertility recommendations are based on the “average” 28-day cycle. If that’s you, great — estimated ovulation typically occurs around days 12–14. But not everyone has a 28-day cycle, and applying that framework blindly can be misleading.
If you’ve been trying for a few months without success, additional tracking tools can be helpful:
The key takeaway: calendar counting alone isn’t personalized care.
If you’re not cycling regularly, that’s a signal worth paying attention to — and one that deserves medical support.
Conditions commonly associated with cycle irregularity and fertility challenges include:
From a health-promotion and exercise perspective, one of the most common and overlooked contributors to menstrual dysfunction is low energy availability.
Low Energy Availability and RED-S: A Critical (and Often Missed) Fertility Factor
Low energy availability occurs when the calories you consume are insufficient for the combined demands of daily life, exercise, and basic physiological function.
This can happen in:
When prolonged, low energy availability can progress into Relative Energy Deficiency in Sport (RED-S) — previously referred to as the Female Athlete Triad.
One of the earliest and most common consequences? Menstrual cycle disruption and anovulation (not releasing an egg).
If ovulation isn’t happening, pregnancy can’t occur — regardless of how well-timed intercourse is.
Lifestyle factors like physical activity, nutrition, sleep, and stress management do matter — but fertility is multifactorial, not a personal morality test.
Importantly, research shows:
This is where I want to actively remove shame and blame from the conversation.
You didn’t fail your fertility because you didn’t optimize hard enough.
About 30–50% of fertility challenges involve male factors, yet fertility optimization conversations disproportionately target women.
One key difference:
This means health behavior changes (sleep, nutrition, alcohol, activity) can produce more rapid improvements in sperm parameters than in egg quality.
Fertility is a team sport — and both partners matter.
When researchers look at physical activity and fertility, a consistent pattern emerges: a J-shaped curve.
What does that mean?
Most studies:
This matters — because exercise itself may not be the issue.
In endurance and high-volume athletes, estimates suggest 50–58% may experience low energy availability.
Here’s why that matters physiologically:
This is a protective mechanism. If your body doesn’t have enough energy to sustain basic function, it won’t initiate pregnancy — which requires a massive metabolic investment.
When researchers control for energy availability and ovarian function, training volume alone does not appear to increase infertility risk.
That’s a crucial distinction.
Clinically, I’ve worked with many athletes told to stop exercising entirely during fertility treatment.
What often happens?
In some cases, people conceive without needing ART for subsequent pregnancies.
This doesn’t mean IVF was unnecessary or that exercise caused infertility — it highlights how fueling and energy balance are often the missing pieces.
Before removing something that supports mental health and identity, nutrition deserves first attention.
The REFUEL study looked at highly active individuals with secondary amenorrhea (loss of a previously regular period).
Instead of reducing exercise, researchers:
Results:
Follow-up research showed:
Weight gain was common — and that reality deserves honest, compassionate discussion, especially for those with complex relationships with food or body image.
In 2026, we understand more than ever that the menstrual cycle is a powerful snapshot of overall health.
Knowing:
…can change the trajectory of both performance and fertility.
If pregnancy is a goal, starting these conversations earlier — not later — matters.
Fertility is complex.
Exercise is not the villain.
Fueling matters more than most people realize.
And your body isn’t broken — it’s communicating.
If you’re navigating this space, you deserve evidence, nuance, and support — not fear-based rules.
By Dr. Christina Prevett, PT, PhD | Barbell Mamas
Christina Prevett is a pelvic floor physiotherapist who has a passion for helping women with different life transitions, including postpartum care and menopause.
