Why elite and professional athletes may face unique fertility challenges
Did you know that being a top athlete can sometimes make it harder to have kids? When we think of professional athletes, we often picture peak physical fitness, discipline and the relentless pursuit of excellence. However, behind the scenes, many athletes face significant fertility challenges that often remain hidden from the public eye.
You don’t have to be a pro to be concerned how athletic pursuits can affect fertility. Here’s what you need to know about fertility challenges and how to tackle them.
Why are many athletes infertile?
High-level athletes, particularly those in endurance sports or with very intense training regimens, can face unique fertility challenges. A recent study of pregnant Olympic athletes highlighted the complex issues women face when trying to train while also conceive. Some of these issues follow.
Intense training
Intense physical training, especially at elite levels, can significantly affect hormonal balance. In women, rigorous training can lead to a condition known as hypothalamic amenorrhea, where the hypothalamus, the part of the brain that regulates reproductive hormones, reduces its signaling to the pituitary gland. This results in decreased levels of reproductive hormones such as estrogen, leading to irregular or absent menstrual cycles (amenorrhea).
Similarly, excessive training and physical activity can lower testosterone levels, which can negatively impact sperm production and overall reproductive health in men. Lowered testosterone levels are associated with reduced libido and sperm count.
On becoming pregnant while training at an elite level, athletes said they received messages such as ‘happy retirement’ or ‘congratulations you’re done (competing) now’. As such, athletes found themselves questioning what was possible. ‘Nicola’ said, ‘…do I compete at Nationals or do I try and get pregnant? Because I can’t do both’.
Low body fat
Many athletes have very low body fat. For female athletes, very low body fat can disrupt the production of estrogen and other hormones crucial for regular menstrual cycles and ovulation.
High stress
Competing at a high level is stressful. Rigorous training, competition and performance pressure can lead to elevated levels of cortisol, a stress hormone. High cortisol levels can interfere with the function of reproductive hormones and lead to issues such as anovulation (lack of ovulation) in women and decreased sperm quality in men.
Chronic stress can also have psychological effects that impact fertility, including reduced libido and impaired sexual function, which can further complicate efforts to conceive.
Heat exposure
Of particular concern for men is prolonged exposure to heat, such as in cycling or prolonged physical activity. This can raise scrotal temperature and negatively affect sperm production.
Diet and energy
Athletes need a lot of energy. If they don’t eat enough, their bodies might not have what they need to support reproduction or a resulting pregnancy for female athletes.
Did you know? Famous infertile athletes who have shared their stories
Carly Patterson
A Texas-native and Olympic gold medalist, Carly Patterson was the women’s gymnastics all-around champion at the 2004 Summer Olympic Games in Athens. Carly has been open about her infertility journey and is now a proud mother of three boys.
Tara Lipinski
The Olympic gold medalist figure skater experienced significant fertility struggles. She went through multiple miscarriages, in vitro fertilization (IVF) and surgeries for endometriosis before having her daughter via a surrogate.
Hope Solo
The famous soccer goalie also used IVF. She shares her story to help others who might be going through the same thing.
Dwyane Wade
The NBA star and his wife, Gabrielle Union, faced multiple miscarriages and failed IVF cycles before welcoming their daughter via surrogacy. Wade has been open about the emotional and physical toll these struggles took on their journey to parenthood.
Kaillie Humphries
In addition to being an Olympic gold medalist in bobsledding, Kallie was diagnosed with endometriosis, a common cause of female infertility. She and her husband went on to have a child with the help of IVF.
Gigi Fernandez
Gigi Fernandez, a renowned former professional tennis player, has been open about her infertility after retiring from her tennis career. Eventually, Fernandez gave birth to twins, Karson and Madison. Fernandez emphasizes the importance of freezing eggs for fertility preservation.
J.R. Smith
While the specifics of their fertility struggles are less documented, this basketball player and his wife have been open about issues when starting a family.
How can infertile athletes improve their fertility?
Infertile athletes face a unique set of challenges that can impact fertility, including intense training, low body fat, chronic stress and overtraining. But there are effective strategies to manage them.
- Balance training. Modifying training intensity and incorporating sufficient rest can help balance hormone levels and improve reproductive health.
- Eat well. Infertile athletes should eat a balanced diet to get all the nutrients they need. This helps their bodies work properly.
- Manage stress. Finding ways to relax, like meditation or talking to a therapist, can help reduce stress.
- Monitor health. Pay attention to menstrual cycles. Irregular periods can signal hormonal imbalances. For men, maintaining a healthy lifestyle supports sperm health.
When infertile athletes should see a fertility doctor
What all these stories and research tells us is that athletes performing at advanced levels, whether pros or not, can face greater fertility challenges. The important thing is to seek help when issues arise.
- For women: If there are irregular periods or if trying to get pregnant for six months to a year hasn’t worked, it’s time to consult a fertility specialist.
- For men: If pregnancy hasn’t happened after six months to a year of trying, it’s a good idea to see a doctor for a semen analysis.
Removing the stigma around the infertile label
Fertility challenges can affect anyone, regardless of their physical condition or public success. Facing infertility is not a reflection of one’s strength or worth but rather a challenge that can be addressed with the right support and resources. By balancing training, eating well, managing stress and seeking medical help, athletes of all levels can improve their chances of becoming parents.
Beyond this, professional sports organizations are beginning to recognize the unique fertility challenges faced by women athletes. For instance, the WNBA’s latest collective bargaining agreement includes substantial family planning benefits, such as reimbursements for fertility treatments. Teams in the NWSL, like the Portland Thorns, have partnered with fertility clinics to support players in preserving their reproductive options.
These advancements reflect a growing understanding that athletes should not have to choose between their careers and starting a family, and they highlight the importance of addressing fertility issues openly and proactively.
About the author Dr. Sara Mucowski
Fertility specialties
- LGBTQIA+ family planning and third-party reproduction.
- Fertility preservation/ Egg freezing.
- Recurrent pregnancy loss.
- IVF.