Pilates guide
No Pilates move has been shown to boost fertility, and no study has tested Pilates on getting pregnant. What the evidence does show is that being active and a healthy weight help a little, that very large amounts of hard exercise without enough food can get in the way, and that Pilates is safe to keep doing while you try, through IVF (in vitro fertilisation) with some changes, and into early pregnancy.
This guide covers exercise and fertility for women and men, weight and polycystic ovary syndrome (PCOS), now called polyendocrine metabolic ovarian syndrome (PMOS), what to change at each stage of IVF and in the two-week wait, stress, the claims about blood flow and fertility poses, a gentle routine, and the warning signs to know. Your GP and fertility clinic come first for any fertility question; Pilates sits alongside their care.
We found no trial of Pilates, or of any single move, on getting pregnant, ovulation, egg quality, sperm or IVF results. NICE (the National Institute for Health and Care Excellence) says complementary therapies for fertility have not been properly evaluated.
In studies following hundreds of thousands of people, the most active had less infertility than the least active. Only very large amounts of hard exercise were linked with taking longer to conceive, mostly in lean women, and these studies can't prove cause and effect.
With a BMI (body mass index) of 30 or more, it's likely to take longer to conceive, and a group programme of exercise and diet advice leads to more pregnancies than weight-loss advice alone. With PMOS, any exercise counts: no type is better than another.
There's no trial of exercise during IVF stimulation; NHS clinics advise against sudden or jerky movements because enlarged ovaries can twist, and against strenuous exercise for 2 weeks after transfer. Bed rest after transfer doesn't help.
Across 14 studies, women's distress before treatment wasn't linked to the result, and the Human Fertilisation and Embryology Authority (HFEA), the UK fertility regulator, agrees. Pilates may help you feel calmer; it won't change your chances.
The NHS says exercise is safe in pregnancy. Skip hot Pilates, and from the end of the first trimester keep spells lying flat on your back short.
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NICE says over 80% of heterosexual couples conceive within a year if the woman is under 40 and they have regular sex without contraception, and about half of the rest in the second year. The NHS: "If you're aged 39 or under and have sex without contraception every 2 to 3 days, it's likely you'll get pregnant within a year."
Weight, smoking and alcohol for both partners, and heat for men. The NHS says being overweight reduces fertility, and "in women, being overweight or severely underweight can affect ovulation". Stress can lower sex drive, and "in severe cases, stress may also affect ovulation and sperm production".
Regular activity helps weight and how the body handles insulin, which matter most with PMOS and obesity. At the other end, a lot of hard training without enough food can switch off ovulation: the Endocrine Society says this kind of missed period is "often associated with stress, weight loss, excessive exercise, or a combination thereof".
"PMOS used to be called polycystic ovary syndrome (PCOS)." The NHS advises eating a healthy, balanced diet, exercising regularly and trying to lose weight if you're overweight. The first medicine to help ovulation is letrozole, prescribed by your doctor.
Injections stimulate the ovaries, which enlarge; then come egg collection, embryo transfer and about two weeks' wait before the test. Ovarian hyperstimulation syndrome (OHSS) is when "Your ovaries can become large and painful", usually in the week after egg collection. Enlarged ovaries can rarely twist.
It can be the muscle-strengthening part of the activity the guidelines ask for, prepare your trunk and pelvic floor for pregnancy, and help you feel calmer. It can't change your hormones, blood flow to the womb or ovaries, egg quality or implantation.
We found no trial of Pilates with pregnancy, ovulation, live birth, sperm or IVF results. NICE says complementary therapies haven't been properly evaluated, the NHS says there's no evidence they work for fertility problems, and European fertility specialists list yoga among therapies that are not recommended for improving results.
In 10 studies of 708,965 people, the most active had about 40% less infertility than the least active. In the Nurses' Health Study II, each weekly hour of vigorous activity went with 7% less infertility from ovulation problems. These are observational studies, which can't prove cause and effect, and an umbrella review rated most of the evidence low or very low certainty.
In 3,628 Danish women, 5 or more hours a week of vigorous activity went with taking longer to conceive, but not in women with a BMI of 25 or more. In Norway, the small group who exercised most often and hardest had more fertility problems. Very heavy exercise of more than an hour a day went with not ovulating. This evidence is observational, from single cohorts and mostly lean women, and the Nurses' Health Study II found the opposite for moderate amounts of vigorous activity.
NICE says that if you've stopped ovulating and do high levels of exercise, cutting back may improve your chance of regular ovulation and conception. The NHS lists "doing too much exercise" among causes of missed periods.
In a trial of 168 women, a 10-week mind and body programme didn't change pregnancies or births; both groups had the yoga sessions, so it couldn't test yoga. A 2026 review of yoga in infertility found no study that measured pregnancy.
We found no study of any Pilates or yoga move on blood flow to the womb or ovaries in people trying to conceive. In women with period pain, exercise reduced uterine artery blood flow afterwards. A review says there's no evidence fertility massage helps, and activity didn't change the number of eggs collected in IVF.
NICE: with a BMI of 30 or more, losing weight improves your chance of conceiving if you aren't ovulating, and a group programme of exercise and diet advice leads to more pregnancies than weight-loss advice alone. With a BMI under 18.5 and irregular periods, gaining weight helps. Before IVF, weight loss led to more pregnancies, mostly natural ones, but not clearly more births.
The 2023 international guideline says no type or intensity of exercise has been shown to be better than another, and asks for 150 to 300 minutes of moderate activity a week (or 75 to 150 vigorous) plus muscle strengthening on 2 non-consecutive days. The Cochrane review of lifestyle changes found no trial that measured live births.
In one trial in women with PCOS and overweight, 6 weeks of structured exercise and diet before the fertility drug clomiphene raised ovulation to 37.5%, against 12.5% without them.
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The only Pilates study in PCOS had 26 women and no comparison group; period pain fell, and ovulation wasn't measured. Pilates can be your strength sessions; it isn't a PMOS treatment.
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Aim for 150 minutes of moderate activity a week, such as brisk walking, with strength work on 2 days. Pilates can be one or both of those strength days.
Pelvic floor squeezes prepare you for pregnancy and help prevent leaking later (our Pilates for your pelvic floor guide has the detail). If you have pelvic pain or pain with sex, start with relaxing the pelvic floor instead, as our trying to conceive guide says.
The NHS advises losing weight if you're overweight, drinking less alcohol, stopping smoking and wearing loose underwear. Activity overall wasn't linked with sperm or time to pregnancy in cohorts, but cycling 5 or more hours a week went with lower sperm concentration in one, and regular saunas lowered sperm counts for months in a small study. No study has tested Pilates.
There are no trials of exercise at each stage of IVF, so this is caution rather than evidence: follow your own clinic's advice first.
Gentle Pilates is fine: breathing, side-lying hip work, small pelvic tilts and standing moves. An NHS clinic leaflet says "Avoid sudden or jerky movements, as enlarged ovaries can twist", so leave out jumping, running, fast or deep twists, heavy lifting and high-intensity classes until your clinic says your ovaries have settled, as our IVF guide says.
Rest that day and walk gently from the next day if you feel well, keeping to gentle activity until your period or your clinic says you can do more (our IVF guide). OHSS symptoms usually come in the week after collection, and with OHSS the RCOG (Royal College of Obstetricians and Gynaecologists) says avoid strenuous exercise but stay active to lower the risk of a blood clot.
An NHS clinic advises living normally but avoiding strenuous exercise for 2 weeks, and another says "Walking, running, coughing, going to the toilet and sneezing does not cause an embryo to fall out". NICE says bed rest of more than 20 minutes after transfer doesn't help, and reviews agree. Skip hot classes, as NHS clinics advise against saunas and hot baths after transfer.
In two studies that measured activity with devices, activity before and during treatment wasn't linked to the result. Women who recalled 4 or more hours of exercise a week for years had fewer live births in one older study. Gentle Pilates during treatment hasn't been tested.
In French national data, ovarian torsion after egg collection happened about 14 times per 10,000 months of follow-up. It's a rare emergency: sudden severe tummy pain with being sick needs urgent help.
Lying still for 15 minutes after intrauterine insemination (IUI) helped in one trial of 391 couples but not in a larger trial of 498 couples. No study has tested lying with your legs up the wall after sex.
Distress before IVF wasn't linked to the result in 14 studies of 3,583 women, or in a later review of 20 studies. The HFEA says "there is no conclusive evidence that stress impacts on fertility treatment outcomes".
Slow breathing and a gentle class may help you cope with the waiting. NICE says counselling should be offered before, during and after fertility treatment: ask your clinic.
The HFEA doesn't regulate complementary therapies, and they "are not usually offered in an HFEA licensed fertility clinic". Be wary of fertility classes that promise better results.
"Exercise is safe for you and your baby in pregnancy." The NHS says don't start a new vigorous activity, and "In later pregnancy, try to avoid any activity that involves lying flat on your back for more than a few minutes". The UK Chief Medical Officers say there's "No evidence of harm". Exercise in pregnancy hasn't been linked with miscarriage.
Skip hot Pilates, keep spells on your back short from the end of the first trimester, and swap planks and the Pilates push-up for wall push-ups. Our Pilates in pregnancy guide has the details.
Our editorial starting point:
A small trial used mat Pilates for 50 minutes twice a week for 12 weeks, and period pain fell. Exercise in general eases period pain, from low-quality trials.
2 minutes of slow breathing is from our pelvic floor relaxation routine; 5 to 8 lateral breaths, 5 breath reaches and 5 to 10 slow pelvic floor relaxation breaths are the move pages' doses; 2 minutes of supported bound angle sits within its page dose; 3 minutes of rest is from our endometriosis class. Once pregnant, prop yourself up or lie on your side to rest.
3D demoSlow breathing (6 breaths a minute)Beginner · No equipment
3D demoLateral breathing (Pilates breathing)Beginner · No equipment
3D demoPelvic floor relaxation (reverse Kegel)Beginner · No equipment
3D demoBreath reachBeginner · No equipment
3D demoReclining bound angle pose (Supta Baddha Konasana)Beginner · Firm cushion
3D demoCorpse pose (Savasana)Beginner · No equipmentSafe in early pregnancy. 8 slow pelvic floor squeezes held up to 10 seconds and 8 quick ones, and up to 10 side-lying tummy draw-ins held up to 10 seconds, are the move pages' doses; 6 to 8 bridges is from our pelvic floor class; 5 knee folds and 5 knee fall-outs each side are from our endometriosis and somatic classes; 10 clams and 8 side-lying leg raises each side, 4 single-limb and 4 to 6 full bird dogs, and 8 to 10 sit-to-stands and wall push-ups are from our pregnancy Pilates class; 10 side leg lifts each side sits within its page dose.
3D demoPelvic floor exercise (Kegel)Beginner · No equipment
3D demoSide-lying tummy draw-inBeginner · No equipment
3D demoPelvic tilt into bridgeBeginner · No equipment
3D demoKnee foldBeginner · No equipment
3D demoBent-knee fall-outBeginner · No equipment
3D demoClamshellBeginner · No equipment
3D demoSide-lying leg raiseBeginner · No equipment
3D demoBird dog, one limb at a timeBeginner · No equipment
3D demoBird dogBeginner · No equipment
3D demoSit to stand from a chairBeginner · A bench or box
3D demoWall push-upBeginner · A wall
3D demoWall side leg lift (standing side kick at the wall)Beginner · A wall8 slow cat-cows and 3 mermaid stretches each way are the move pages' doses; 6 to 8 standing pelvic tilts, 6 to 8 wall angels and 5 open-book rotations each side are from our pregnancy Pilates class (leave the open book out while your ovaries are enlarged); keep seated rotations small during stimulation.
Leave out jumping (march instead), deep or fast twists such as the saw and criss-cross, moves that press on your tummy such as child's pose and lying face down, hard tummy work such as the hundred and roll-ups, and anything that pulls on your tummy.
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The roll-over, jack knife, control balance and boomerang aren't needed: their own pages say avoid them in pregnancy.
From the end of the first trimester, keep time flat on your back to a few minutes, swap planks and the Pilates push-up for wall push-ups, and don't start new jumping.
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Fine as a rest, never as a fertility treatment.
Leave hot classes for now. If your periods have become irregular, cut back hard training and eat enough for it.
The pregnancy Pilates class is the gentle routine: no lying on your back and no jumping, safe in any trimester; during stimulation, skip its open book and child's pose. The pelvic floor workouts suit women and men; the others are for before treatment and between cycles.
A 20-minute Pilates workout for any trimester: seated, standing, all-fours and side-lying moves, with no lying on your back or front and no jumping.
20 minBeginner15 movesA wall, A bench or boxA 20-minute Pilates workout for your pelvic floor, built on UK pelvic health physiotherapists' booklet: squeeze as you breathe out, move, then fully release.
20 minBeginner18 movesA wall, A bench or boxA 5-minute daily pelvic floor workout for women and men: slow holds and quick squeezes, three times a day, with how to find the right muscles.
5 minBeginner2 movesNo equipmentAn 8-minute routine for a tight pelvic floor: slow breathing and comfortable positions to help the muscles let go, with no strengthening squeezes.
8 minBeginner5 movesFirm cushionA slow, 20-minute Pilates class with time to notice your breath and how each move feels. Every move is optional and you can pause or stop at any point.
20 minBeginner12 movesNo equipmentA slow 15-minute Pilates wind-down for the last hour before bed: slow breathing, small lying moves and a few minutes of stillness, with no effort or holds.
15 minBeginner9 movesFirm cushionA 20-minute mat Pilates workout for complete beginners. It covers breathing, spine position and the foundation moves, each with an easier option.
20 minBeginner13 movesNo equipmentA 45-minute session for weight loss and health: a 20-minute brisk walk, which does more for the scales, then a short-rest Pilates circuit for strength.
45 minBeginner11 movesCardio machineA gentle 20-minute Pilates class for endometriosis, based on Endometriosis UK's pelvic exercises: breathe, let go, then light control work and stretches.
20 minBeginner14 movesNo equipmentThe walking plan builds the aerobic activity; the pregnancy plan is for once you're pregnant.
A free 8-week walking plan for beginners: build to 150 minutes of brisk walking a week, with intervals, hills and two short strength sessions.
6 training days40 minBeginner5 days a weekA pregnancy workout plan for each trimester: walks or swims, two strength sessions a week off your back, daily pelvic floor work and when to stop.
5 training days30 minBeginnerThese are the same warning signs as our trying to conceive, IVF and endometriosis guides. In the US, call 911 where this page says 999.
Call 999 if:
If you have pelvic pain and any of these. Don't drive yourself to A&E.
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If you have pelvic pain and any of these.
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If pelvic or period pain is severe or worse than usual, and painkillers haven't helped.
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The NHS says these could be severe symptoms of OHSS or of an ectopic pregnancy. Don't drive yourself to A&E.
One NHS trust's leaflet adds that sudden severe tummy pain with vomiting and feeling unwell can mean a twisted ovary, a rare emergency that needs urgent help.
Stop and contact your clinic if you get tummy or pelvic pain, a heavy, dragging or bloated feeling, feel sick or faint, or become breathless (our suggestion, from the OHSS and twisted ovary signs).
Call 999 if you have vaginal bleeding with severe tummy pain, pain in your shoulder, feeling sick, faint or dizzy, or heavy bleeding (soaking a period pad soon after putting it on). For light bleeding or spotting, or unusual discharge, get urgent help from your maternity unit, an early pregnancy unit or NHS 111.
The NHS says stop if you feel uncomfortable, too hot or unwell. Our Pilates in pregnancy guide lists the signs to stop and call your midwife or maternity unit.
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Fertility problems and treatment can be hard, and NICE says counselling should be offered. Talk to your GP or clinic. If you're having thoughts of harming yourself, call Samaritans free on 116 123 at any time, or 988 in the US.
You feel any pain or become unwell, as the NHS advises for its Pilates videos, and especially for chest pain or pressure, unusual breathlessness, dizziness or fainting. If you have a health problem, an injury or any symptoms, get advice from a healthcare professional, such as a GP, before you start.
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No move has been tested on fertility, and guidelines say complementary therapies haven't been shown to help.
No study in people trying to conceive has shown it; in women with period pain, exercise reduced uterine artery flow afterwards.
No trial has shown either, and activity didn't change the number of eggs collected in IVF.
The most active people had less infertility. Only very large amounts of hard exercise, mostly in lean women, and training without eating enough are linked with slower conception or missed periods.
Activity during IVF wasn't linked to the result and bed rest doesn't help; clinics ask for gentle exercise while your ovaries are enlarged and no strenuous exercise for 2 weeks after transfer.
The real concern is rare twisting of an enlarged ovary during stimulation. Gentle twists are fine at other times.
No study has tested it, and lying still after insemination helped in one trial but not in a larger one.
Distress before IVF isn't linked to the result. Feeling calmer is worth having for its own sake.
No study has tested Pilates on getting pregnant, and no move has been shown to boost fertility. Being active and a healthy weight help a little, and Pilates can be part of that as strength work.
Yes. Exercise is safe even if you're newly pregnant, and the NHS says keep active in pregnancy. Skip hot Pilates for now, and if you could be pregnant, keep spells lying on your back short from the end of the first trimester.
It's best left for now, because overheating matters most in the early weeks of a pregnancy. For men, regular heat such as saunas lowered sperm counts for months in a small study.
Gentle Pilates, yes: breathing, side-lying hip work and standing moves. NHS clinics advise against sudden or jerky movements because enlarged ovaries can twist, so leave out jumping, deep or fast twists, lying on your front and hard tummy work until your clinic says your ovaries have settled.
Gentle activity is fine, and bed rest doesn't help. Clinics advise avoiding strenuous exercise for 2 weeks after transfer, and hot baths and saunas; one says walking, coughing and sneezing don't cause an embryo to fall out.
Before treatment, yes. During stimulation and after egg collection, keep springs light and leave out jumping, rolling and twisting work, as for the mat, and follow your clinic's advice.
As strength work, yes: the PCOS guideline asks for 150 to 300 minutes of activity a week plus strength work on 2 days, and says no type is better than another. The only Pilates study in PCOS was small, had no comparison group and didn't measure ovulation.
Very large amounts can: 5 or more hours a week of vigorous exercise went with slower conception in lean women in one study, and training hard without eating enough can stop periods. A few Pilates classes a week isn't that kind of training. See a GP if you've missed 3 periods in a row.
There aren't any special ones. The useful moves are the ones that keep you active and strong, such as pelvic floor squeezes and hip and back strength, plus some slow breathing for the waiting.
Neither has been shown to help you conceive. Choose the one you enjoy; both can help you feel calmer.
No good evidence links exercise to miscarriage: across many studies, exercise in pregnancy wasn't linked to it. The NHS says miscarriage is often caused by a problem with the way the pregnancy develops.
It hasn't been tested. For men, the NHS advises a healthy weight, less alcohol, no smoking and loose underwear; very long weekly cycling and regular saunas have been linked with lower sperm counts.
Exercise education, not a personal prescription, and clinical review of these guides is pending. If you are pregnant, have a health condition or have had recent surgery, check with a doctor, midwife or physiotherapist before starting, and stop for sharp or increasing pain. Health disclaimer.
