IVF Preparation: Supplements and Lifestyle Changes to Improve Your Outcomes

Starting IVF can feel overwhelming. Between medical appointments, injections, and the emotional rollercoaster of an assisted conception cycle, it's easy to overlook the evidence-based steps you can take to meaningfully improve your chances. IVF preparation—through targeted supplementation and lifestyle optimisation—is one of the most impactful areas within your control.

This guide brings together the latest clinical evidence on IVF preparation, covering exactly which supplements have demonstrated benefits, how to optimise your lifestyle in the months before a cycle, and what both partners should be doing to maximise embryo quality.

Why IVF Preparation Matters

IVF success rates vary significantly based on factors within and outside your control. Age, ovarian reserve, and semen quality are major determinants—but so is the nutritional and lifestyle environment your eggs and sperm develop in during the 3–6 months before a cycle.

Egg development (folliculogenesis) takes approximately 90 days. The follicle that eventually ovulates in IVF has been growing for 3 months, responding to its nutritional environment throughout that time. Similarly, sperm take 72–90 days to mature. This means your IVF preparation begins not when your stimulation protocol starts, but 3–6 months before egg retrieval.

Optimising this developmental period can improve egg quality, sperm quality, fertilisation rates, embryo quality, and ultimately implantation and live birth rates.

Supplements That Have Clinical Evidence for IVF

CoQ10 (Coenzyme Q10)

CoQ10 is the most studied supplement for IVF preparation. It's a powerful antioxidant found in mitochondria—the energy factories of every cell, including eggs. As women age, CoQ10 levels in eggs decline, which is one reason egg quality decreases with age.

Multiple randomised controlled trials have shown CoQ10 supplementation (400–600mg daily) in the months before IVF improves ovarian response, increases the number of mature eggs retrieved, improves fertilisation rates, and in several studies, increases clinical pregnancy rates.

A landmark 2018 study in the Journal of Assisted Reproduction and Genetics found that CoQ10 supplementation before ovarian stimulation significantly improved outcomes in poor responders. The ubiquinol form (the reduced, active form) may have better bioavailability than standard ubiquinone for older women.

Recommended dose: 400–600mg daily, started 3 months before egg retrieval. Use the ubiquinol form if cost allows.

DHEA (Dehydroepiandrosterone)

DHEA is an androgen precursor that supports follicle development. In women with diminished ovarian reserve (DOR) or poor ovarian response, DHEA supplementation has shown benefits in multiple studies and meta-analyses, including increased antral follicle count, improved egg quality, higher fertilisation rates, and reduced aneuploidy (chromosomal abnormalities) in embryos.

Important: DHEA should only be used on medical supervision. It's not appropriate for all women—those with PCOS or normal ovarian reserve may not benefit and could be harmed by the additional androgen effect.

Recommended dose (if appropriate): 25–75mg daily, for at least 6 weeks before stimulation. Requires a GP or fertility specialist's approval.

Methylfolate (Active Folate/Vitamin B9)

Folate is essential for DNA synthesis and repair—critical in rapidly dividing embryonic cells. Women with the MTHFR gene variant (approximately 10–15% of the population) cannot efficiently convert synthetic folic acid to the active form. Methylfolate bypasses this conversion and is the preferred form for all women.

High folate status before and at conception significantly reduces the risk of neural tube defects and is associated with better embryo quality. Start methylfolate supplementation at least 3 months before IVF.

Recommended dose: 400–800mcg of methylfolate daily (or as directed by your doctor, who may prescribe higher doses).

Vitamin D

Vitamin D deficiency is extremely common—studies suggest 40–60% of women undergoing IVF are vitamin D deficient. Deficiency is associated with significantly reduced IVF success rates: a meta-analysis found that vitamin D-sufficient women had 34% higher live birth rates compared to deficient women.

Vitamin D receptors are present in the endometrium, ovaries, and placenta. Adequate vitamin D appears to support endometrial receptivity (essential for implantation) and immune tolerance of the embryo.

Recommended approach: Test your vitamin D level before starting IVF preparation. If below 75 nmol/L, supplement to reach and maintain optimal levels (75–125 nmol/L). This typically requires 2,000–4,000 IU daily, though higher doses may be needed under medical supervision for severe deficiency.

Omega-3 Fatty Acids (DHA and EPA)

Omega-3 fatty acids are essential for follicle development, hormone synthesis, and reducing inflammation. DHA is incorporated into egg cell membranes and is critical for embryo development. Studies show higher omega-3 intake is associated with larger follicle sizes, better embryo quality, and improved IVF outcomes.

Recommended dose: 1,000–2,000mg combined EPA+DHA daily from marine sources (or algae-based for vegetarians). Start 3 months before IVF.

Melatonin

Melatonin—best known as the sleep hormone—is also a potent antioxidant produced in follicular fluid. Follicular melatonin levels protect eggs from oxidative damage during the stimulation phase. Several randomised trials have shown melatonin supplementation (3mg at night) improves fertilisation rates and embryo quality in IVF, particularly in women with previous failed cycles.

Important: Discuss with your fertility specialist before starting. Melatonin affects sleep patterns and may interact with stimulation medications.

Inositol

Inositol—particularly myo-inositol and the combination of myo- and D-chiro-inositol—has strong evidence for IVF preparation, especially in women with PCOS. Benefits include improved insulin sensitivity, better oocyte quality, higher number of mature eggs, improved fertilisation rates, and better embryo quality.

In women without PCOS, the evidence is less robust but still encouraging for overall egg quality improvement.

Recommended dose: 4g myo-inositol daily, or 3.6g myo-inositol + 400mg D-chiro-inositol. Start 3 months before IVF.

Male Partner Preparation for IVF

Even for IVF with ICSI (where a single sperm is injected directly into an egg), sperm quality significantly affects outcomes. DNA fragmentation in particular—not measured in a standard semen analysis—is a key determinant of fertilisation and embryo quality.

For Men: The Essential Supplement Stack

• CoQ10: 200–600mg daily — reduces oxidative damage to sperm DNA
• Zinc: 15–25mg daily — essential for testosterone and sperm maturation
• Selenium: 55–200mcg daily — structural component of the sperm tail
• Vitamin C: 500–1,000mg daily — antioxidant protection for sperm DNA
• Vitamin E: 400 IU daily — antioxidant, synergistic with selenium
• L-carnitine: 2–3g daily — primary fuel for sperm motility
• Folate (methylfolate): 400–800mcg daily — sperm DNA integrity

An all-in-one male fertility formula providing these nutrients in appropriate doses is the most practical approach. Conceive Plus offers a comprehensive male fertility supplement available at conceiveplus.hk/collections/fertility-supplements.

Lifestyle Optimisation Before IVF

Stop Smoking

Smoking before IVF reduces ovarian reserve, impairs egg quality, reduces fertilisation rates, and significantly lowers clinical pregnancy and live birth rates. Some clinics require cessation for 3 months before commencing treatment. This is non-negotiable for both partners.

Minimise Alcohol

Even moderate alcohol consumption (more than 4–5 units per week) is associated with reduced IVF success. A study of 2,500 IVF cycles found that women drinking more than 4 drinks per week had significantly lower live birth rates. Both partners should minimise alcohol for at least 3 months before treatment.

Achieve a Healthy BMI

Both underweight (BMI below 18.5) and overweight (BMI above 25) are associated with worse IVF outcomes. Obesity particularly impairs ovarian response to stimulation and reduces implantation rates. Even a 5–10% reduction in body weight before IVF can meaningfully improve outcomes for overweight women.

Manage Stress

The relationship between stress and IVF outcomes is complex and somewhat contested, but evidence suggests high cortisol levels can impair embryo implantation. More practically, IVF is an intensely stressful process, and having robust stress management tools in place before starting protects both your mental health and potentially your outcomes.

Evidence-supported stress reduction approaches: acupuncture (may improve IVF outcomes through stress reduction and blood flow improvement), mindfulness-based cognitive therapy, regular moderate exercise, and professional psychological support.

Optimise Sleep

Growth hormone and melatonin—both important for follicle development—are predominantly secreted during sleep. Women who sleep fewer than 7 hours per night show worse IVF outcomes in some studies. Prioritise 7–9 hours of quality sleep during IVF preparation.

Moderate Exercise

Moderate exercise during IVF preparation is beneficial for insulin sensitivity, stress management, and general health. However, high-intensity or excessive exercise (particularly running and cycling) before egg retrieval may impair ovarian blood flow. Transition to lower-impact activities like walking, yoga, and swimming as stimulation begins.

Reduce Endocrine Disruptor Exposure

BPA (from plastic containers), phthalates (from synthetic fragrances), and parabens (from personal care products) all act as endocrine disruptors that can impair egg and sperm quality. Switch to glass or stainless steel containers, choose paraben-free and fragrance-free personal care products, and avoid heating food in plastic containers.

Acupuncture and IVF

Acupuncture during IVF cycles remains a topic of active research. The largest individual RCT (the ACUTrial, 2018) found no significant benefit from standardised acupuncture. However, meta-analyses including smaller, positive studies suggest a potential benefit—particularly for stress reduction, uterine blood flow, and embryo transfer procedure relaxation. Many fertility clinics offer or recommend acupuncture support. If it's available and affordable, it's unlikely to harm and may help.

During the Stimulation Protocol

Once stimulation begins:

• Continue all approved supplements unless your doctor advises otherwise
• Stay well hydrated — important for follicle development and reducing OHSS risk
• Reduce exercise intensity — stick to gentle walking, yoga, swimming
• Monitor for OHSS symptoms — bloating, abdominal pain, reduced urination—and contact your clinic immediately if significant
• Follow medication schedule exactly — timing of trigger shot is critical

Frequently Asked Questions About IVF Preparation

Q: How far in advance should I start IVF preparation?

Ideally 3–6 months before egg retrieval to allow a full spermatogenesis/folliculogenesis cycle of nutritional improvement.

Q: Can supplements improve outcomes for poor responders?

Yes—particularly CoQ10 and DHEA (under medical supervision) have the strongest evidence for poor responders and diminished ovarian reserve. Vitamin D optimisation is also important.

Q: Should I continue supplements after embryo transfer?

Folate and vitamin D should definitely continue. CoQ10, omega-3, and other supplements can generally continue through the first trimester, but discuss with your fertility team. Some supplements are not recommended in pregnancy.

Q: Does diet matter during IVF stimulation?

Yes. A Mediterranean-style diet during stimulation may improve follicle development and reduce inflammation. Avoid alcohol, limit caffeine, and stay well hydrated.

Q: Can the male partner take supplements even if we're doing ICSI?

Absolutely. Sperm quality—particularly DNA fragmentation—affects embryo quality and implantation even with ICSI. Male supplement preparation is just as important.

Q: Is bed rest recommended after embryo transfer?

No—this has been debunked. Bed rest does not improve implantation rates and may even be counterproductive. Light normal activity is appropriate; strenuous exercise and heavy lifting should still be avoided.

Q: What about the "pineapple core" recommendation post-transfer?

There's no clinical evidence that pineapple core (bromelain) improves implantation. It's harmless to try, but shouldn't replace evidence-based preparation.

Q: Can stress cause an IVF cycle to fail?

Extreme stress can affect cortisol and immune function in ways that may impact implantation, but most research suggests psychological stress alone is not a primary cause of IVF failure. Focus on what you can control.

Q: Should I take a prenatal vitamin during IVF preparation?

Yes. A comprehensive prenatal that includes methylfolate, vitamin D, iron, and iodine forms the foundation. Additional targeted supplements (CoQ10, omega-3, inositol) are added on top based on individual need.

Q: Can I do anything to improve endometrial receptivity?

Vitamin D, omega-3 fatty acids, and appropriate progesterone support are all associated with endometrial receptivity. Some clinics also use endometrial scratch, ERA testing (endometrial receptivity analysis), or PGT-A embryo testing to identify and optimise implantation timing.

Building Your IVF Preparation Plan

An effective IVF preparation plan combines clinical management with evidence-based self-care. Start with the non-negotiables: stop smoking, optimise vitamin D, begin methylfolate, and start CoQ10. Add omega-3, inositol, and other nutrients based on your specific situation.

Conceive Plus provides high-quality fertility supplements designed to support IVF preparation, available at conceiveplus.hk/collections/fertility-supplements. Support every element of your IVF journey with the nutrition it deserves.