Does Exercise Improve Fertility? What a Large 2026 Review Found

One of the most common questions I hear in my Ottawa practice is some version of this: should I be exercising more while we are trying to conceive, or is it going to work against me? It is a fair question, and the advice people receive is all over the place. Some are told to push harder and lose weight before treatment. Others are told to stop everything and rest. Very few are given a clear answer, because until recently the research was scattered across dozens of separate papers.

A new umbrella review published in the Journal of Global Health in 2026 pulls that scattered evidence together. An umbrella review sits one level above a normal study. Rather than looking at individual trials, it gathers the existing systematic reviews and meta analyses and summarises what they collectively show. This one included thirteen reviews built on randomised controlled trials, covering 32,538 people in total, roughly 24,470 women and 8,068 men. That makes it one of the largest attempts so far to answer whether structured exercise actually changes fertility outcomes.

What researchers observed in women

The reviews looking at women found that exercise was associated with favourable shifts in several hormones connected to ovulation, including sex-hormone binding globulin (SHBG) and DHEAs. In women with polycystic ovary syndrome (PMOS), changes in anti Müllerian hormone were also reported. These are the markers that often sit behind irregular or absent ovulation, so movement in these hormone levels is biologically meaningful.

Beyond bloodwork, exercise was linked to higher ovulation rates and higher pregnancy and clinical pregnancy rates compared with women who received minimal support or standard care. That is the finding most people will care about, and it is genuinely encouraging.

It is worth noting what did not move. Implantation rates and natural conception rates showed no clear improvement, and those two outcomes rested on a small number of participants. So the evidence is stronger for the steps that come before conception than for conception itself.

There is one detail that changes how this study should be read. Almost every review of women in this paper studied women with obesity, women with obesity and infertility, or women with polycystic ovary syndrome. This tells us very little about someone with a healthy weight and unexplained infertility, diminished ovarian reserve, or endometriosis. That is not a flaw in the research, it is simply the population that has been studied.

What researchers observed in men

The male side of the review was in some ways more consistent. Across several semen parameters, including concentration, count, total motility, morphology and semen volume, men who exercised showed better results than men who did not. Reduced sperm DNA fragmentation was also reported. Two of the reviews looked further down the line and found higher pregnancy rates among the female partners of men who took part in exercise programmes.

Combined aerobic and resistance training appeared to produce the broadest benefit, with steady cardiovascular exercise close behind. This matters because male factor contributes to roughly half of all infertility cases, and it is often the side of the equation that receives the least attention.

How much movement the studies actually involved

Across the reviews, most exercise programmes fell somewhere between 90 and 280 minutes per week, carried out over anywhere from four to fifty two weeks. That range lines up closely with general physical activity guidance, which is reassuring. Nobody in these trials was training like an athlete.

The "ceiling" on the optimal amount of exercise is important to keep in mind . The researchers noted that prolonged high-intensity training showed relatively limited improvement in male reproductive outcomes. When energy expenditure consistently outpaces energy intake, hormonal function can be suppressed rather than supported. In women this has been linked to loss of the menstrual cycle, and in men to reduced testosterone. More is not better here. Moderate and consistent appears to be the direction the evidence supports.

What this evidence does not establish

The authors were candid, and I will be too. Most of the outcomes were rated as moderate, low or very low certainty using standard grading tools, which means confidence in the size of these effects is limited. Seven of the thirteen reviews combined exercise with diet, medication or behavioural support, so it is difficult to separate the effect of movement itself from the effect of weight change. And an umbrella review can only show association. It cannot prove that exercise directly caused the improvement.

Where this fits in fertility care

What this research offers is that an intervention that is low cost, low risk, widely available and pointing consistently in a helpful direction across a large body of trial evidence.

The more useful conversation is rarely whether to exercise. It is what kind, how much, and whether your current level is supporting your fertility or actually working against it. That answer changes depending on your diagnosis, your treatment timeline, and where your energy is going already.

If you are trying to conceive or preparing for a cycle, this is worth talking through with a clinician who works in fertility regularly and can look at your full picture. There is no rush and no single right answer, but there is value in having someone help you interpret evidence like this in the context of your own situation.

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This article is provided for general educational purposes and is intended to raise awareness of emerging research. It does not constitute medical advice, diagnosis, or treatment, and it should not be used as a substitute for consultation with a qualified healthcare provider. Individual circumstances vary considerably, and any decisions regarding your health or fertility care should be made in partnership with a licensed clinician who is familiar with your full medical history.

About Dr. H. Singh, ND

Dr. H. Singh is a Fertility Naturopath based in Ottawa with over ten years of experience focusing exclusively on reproductive health.

He works with individuals and couples across Ontario and Quebec, supporting patients trying to conceive naturally or alongside treatments such as IUI and IVF.

Care focuses on evidence informed strategies to support egg quality, sperm health, hormonal balance, implantation, and early pregnancy.