I Was Afraid Running Caused My Infertility | Running and Pregnancy – runnersworld.com

The night before the 2018 Boston Marathon (my 15th 26.2-miler and sixth time running this race), I lined up my medications—hormone therapy for my unexplained infertility—beside my race uniform.

For the past year, my husband Ben and I had been trying unsuccessfully to have a baby. In the fall I had stopped running—a sport that is part of my life and my identity — at the recommendation of my ob-gyn. She was worried that my exercise might have been sending signals to my brain that my body wasn’t a safe environment for a baby. But six months later, when I still hadn’t conceived, I felt defiant. I decided to train for Boston. I craved one more long run through the city. I needed running to keep me sane.

As an athlete and running coach, I’ve always viewed my body as somewhat at my service. My body and I have gone far and fast together, achieving things I never could have imagined. Infertility felt like an outright betrayal, like my body was failing to perform what I felt was its most essential, most female function. It was letting me down in a way that was deeply personal. It made me question what it meant to be an athlete and what it meant to be a woman.

Worse, I wondered: As a lifelong runner, was this all my fault?

To be clear, moderate exercise is essential for maintaining a healthy body weight and reducing stress—things that have been shown to help with fertility—when trying to conceive. But what’s murky is what ‘moderate’ looks like for those of us who are especially active or seasoned athletes. Whether you run ten or 50 miles per week, there aren’t many reliable parameters out there for how much to exercise — or not — during this critical time.

I found my doctor’s definition of moderate—‘no more marathons for a while’ and ‘keep it easy’ —to be unhelpful. Did that clear me to run a half marathon? Should I skip distance and focus on the 5K? Do I go from 80 miles per week to 40? She couldn’t say.

Taking to the internet was similarly unhelpful. Some resources recommended “vigorous-intensity aerobic activity” for women who regularly engage in it before becoming pregnant, but other resources warned about over-exercising.

I decreased my mileage from 50 to 80 miles a week to around 10, keeping my heart rate under 140, which was the rate my doctor suggested would allow for adequate blood flow to my reproductive system before and during pregnancy. When I wasn’t running, I walked, did light yoga, and barre. Light exercise worked wonders for my sanity but I was embarrassed by slower splits, lighter mileage, and frequent rest days. I couldn’t help but see what I was doing as anti-training. When my teammates at my local running club, Heartbreak Hill Running Company, asked which races I had coming up, I’d change the subject.

My first round of IVF ended with a chemical pregnancy [a positive test that quickly turns negative]. I was out to lunch with my best friend and her then three-month-old daughter when I got the call from my doctor, telling me that my HCG count [a hormone used to indicate a pregnancy’s progression] was lower than she expected. A moment later, a woman stopped to admire my friend’s beautiful little girl, turned to me and said: “Doesn’t it make you want one of your own?” I had to excuse myself to cry.

Later, I crawled into bed and sobbed with my husband holding me, my dog’s head in my lap. It was one of the darkest days of my life.

We began a second cycle of IVF four weeks later. This time, my doctor suggested a more holistic look at all the stresses on my body. I needed to learn balance — not in running, but in life.

My first assignment was to get my BMI up. Like many runners, mine was low (around 15). I also checked two of the boxes for Female Athlete Triad [a condition linked to infertility which is common in runners; it is marked by menstrual dysfunction, low energy availability, and low bone mineral density]. While my training volume exacerbated these issues, I’ve talked with other women I coach and found them to be present among recreational runners, too. The hard truth is that women’s bodies are carefully calibrated for reproduction, and it can take surprisingly little to throw those elements out of balance.

My period almost always disappeared for months while training; my weight would go down a bit. That seemed normal: Many of my distance-runner friends lost their periods while training and seemed unconcerned about it. Same for low weight: It only makes sense to be on the lighter end of the scale when you’re running 50 to 80 miles per week, right?

My doctor instructed me to boost my daily calorie intake by about 500 calories, sleep more, and cut back on work (at the time I was regularly putting in 60-hour weeks) and my workouts. I made a rule where I could do either a morning or a nighttime activity, not both. I also started seeing a therapist who encouraged me to develop healthy coping tools that had nothing to do with running, including asking for help.

At first, I felt guilty and antsy about these changes, but I soon realized I felt more rested.

Yet, I was so emotionally distraught and physically beat up from the surgical procedures I needed (including an egg extraction and two embryo transfers), plus the hormones I was taking that I had stopped running almost completely. I was worried that any wrong move would result in another failure.

I wanted to reach out to others who might be going through something similar—something my therapist had suggested—but I was too scared. By this time, we were about two years in. That’s 24 months. Twenty-four full menstrual cycles. Twenty-four opportunities to get our hopes up—and 24 moments of being crushed by the full weight of that hope. Twenty-four mornings spent crying in my office, the back of my head to the door so no one would open it, so no one would see. Twenty-four months of barely running.

My hope was waning. It was too much for me to go through the daily injections (which triggered my body to release an egg at exactly the right time each month) and tests and try to remain positive, too.

Weeks later, we let ourselves feel excited by good news: An ultrasound tech brought up the baby — our baby — on the screen at our eight-week appointment. Our second round of IVF had worked.

Those early weeks were one long walk on eggshells, getting in and out of the car gingerly, careful not to tighten the seat belt too tightly over my abdomen. Although I was cleared by my doctor to do so, I was too afraid to run.

But as the weeks went on and our baby continued to grow, I slowly started jogging again about two days a week. By the time we hit 20 weeks, I was running three days a week. Running helped clear pregnancy fog and made me feel more normal as my body was changing. I ran two 5Ks while I was pregnant, the second one at 38 weeks.

More importantly, I finally started to open up — and I was blown away by how many other women in my community, many with whom I had spent significant time running and socially, had struggled with reproductive issues of their own. Many of my clients and teammates had also been advised to “cut back” on running — but, like me, were given no clear parameters for what that looked like. They were frustrated at the lack of resources. They were ashamed, feeling, like I had, that somehow they had brought infertility upon themselves through running. But they were also relieved, as I was, to finally have a space to talk about it.

On July 5, 2019, our beautiful daughter Aurora was born. Our greatest hope came true. But now I hope for something else, too: to start a dialogue about the complicated intersection of fitness and femininity.

Through infertility I learned that sometimes life calls for taking a step back from what we love so that we can pursue a higher, more worthy cause—but those two things don’t need to cancel each other out. I can be a runner and an IVF patient. I can be a runner and nine-months pregnant. I can be a runner and a mom. I don’t have to be racing, training, or even running to be a runner.

Recently, I worked with the head coach of my running club to start a women’s event series called Ladies Lead, which brings together inspiring panelists and female runners to discuss issues at the intersection of sport and womanhood. Our very first panel featured Olympian Emily Infeld, who talked about body image and coming back from injury. It was here at this panel that I first publicly shared my own story. My inbox was flooded in the days and weeks following with notes from teammates and other women sharing their own pregnancy hopes and stories, and asking for advice about how and when to exercise while trying to conceive.

In April, Kara Goucher posted an adorable photo of her with her son Colt on Instagram with the hashtag #inferilitysucks. She talked about that shame and reminded her followers who may have been struggling that they were not alone. I was grateful to Kara for being so open. Through the comments on that post, I discovered a new community of female runners who were going through what I had. She provided a space for us to connect, commiserate, and share stories.

I hope that my sharing my story empowers other runners to ask for help and support and gives them hope that they don’t have to struggle in silence. This year, I’m running the 2020 Boston Marathon to raise funds for Brigham and Women’s Hospital—a thank-you for helping us, at long last, to have our family. I can’t wait to greet our little girl at the finish line. It won’t be me showing her what strength looks like, but the other way around.