Prepping for IVF: What to Do 3 Months Before Your Cycle to Improve Egg Quality and IVF Outcomes [EP 78]
If IVF is on the calendar, you may feel an enormous amount of pressure to start as quickly as possible. But starting faster doesn't necessarily mean getting to a healthy baby faster. After working with couples for almost a decade, I've seen what can happen when we take the time to investigate the barriers that may have been missed and intentionally prepare both partners before starting IVF.
IVF is an incredible tool, and I'm not anti-IVF. But IVF is a treatment, not a comprehensive fertility workup. In this episode, I'm walking you through what I would investigate before IVF, why I recommend at least three months of preparation before stimulation when medically appropriate, and exactly what I would focus on during those three months—from nutrition and nutrient status to sleep, supplements, metabolic health, sperm quality, and the uterine environment.
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“Sometimes slowing down is what gets you to your baby faster.”
What You’ll Learn:
Why IVF should not replace a comprehensive fertility investigation
What to investigate before starting IVF medications
Why endometriosis should be appropriately evaluated before IVF
Why I recommend at least three months of preparation before stimulation
How nutrition and protein intake can support IVF outcomes
Why egg and sperm quality are influenced by the months before IVF
Which nutrients and supplements may support IVF preparation
Why both partners need to participate in IVF preparation
How sperm DNA fragmentation can influence embryo development and miscarriage risk
Why sleep, metabolic health, and inflammation matter before IVF
How to use the three-month preparation window strategically
Why sometimes slowing down can actually get you to your healthy baby faster
“IVF prep is not just women’s prep. It is couples prep.”
Supplements Mentioned:
CoQ10
Melatonin
NAC (N-acetylcysteine)
Vitamin C
*Supplements are not a quick fix, and more supplements do not necessarily mean better fertility. The goal is to use targeted supplements to support an already strong foundation and individualize them based on what your body actually needs.
Links Mentioned:
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References:
European Society of Human Reproduction and Embryology. ESHRE Guideline: Endometriosis. 2022.
American Society for Reproductive Medicine. Prevention of moderate and severe ovarian hyperstimulation syndrome: a guideline. Fertility and Sterility. 2024.
Russell et al. Retrospective dietary analysis of 120 IVF patients examining macronutrient intake and IVF outcomes. Findings should be interpreted cautiously due to the small observational design and limited publication of the original data.
Chavarro JE, et al. Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstetrics & Gynecology. 2007. Findings from the Nurses' Health Study II.
Clinical evidence of coenzyme Q10 pretreatment for women with diminished ovarian reserve undergoing IVF/ICSI: a systematic review and meta-analysis. 2024. Six randomized controlled trials involving 1,529 women.
Oral melatonin supplementation during in vitro fertilization treatment: a systematic review and meta-analysis of randomized controlled trials. 2021.
Melatonin supplementation and outcomes of assisted reproductive technology: a systematic review and meta-analysis.
Role of N-acetylcysteine treatment in women with advanced age undergoing IVF/ICSI cycles. 2022.
N-acetyl-cysteine as adjuvant therapy in female infertility: a systematic review and meta-analysis.
Griesinger G, et al. Ascorbic acid supplementation during the luteal phase in IVF. Journal of Assisted Reproduction and Genetics. 2002.
Nutritional supplements and IVF: an evidence-based approach. Reproductive BioMedicine Online. 2024.
Fabozzi G, et al. Diet in assisted reproductive technology: what should we recommend? A systematic review from current evidence to tailored nutritional approaches for enhancing reproductive success. Reproductive BioMedicine Online. 2026.
“You are not wasting time. You are using that time.”
Transcript:
If you are preparing for IVF, I want you to hear this before you start medications.
Getting started faster does not necessarily mean getting to a healthy baby faster.
I know that's probably the last thing you want to hear when you've already been trying for years. Once you decide to move forward with IVF, there can be enormous pressure to just go.
Get the testing done. Order the medications. Start with the next cycle.
Every month you wait can feel like another month you're not pregnant.
But after almost a decade of working with couples trying to conceive, I've worked with many couples on the other side of that decision.
I've seen couples go through failed retrievals, multiple failed retrievals, embryos that stopped developing, transfers that didn't stick, and multiple rounds of IVF without a baby.
One of the first things I want to know when those couples come to me is:
What was investigated before IVF?
IVF is an incredible tool.
But IVF doesn't fix why you're struggling to get pregnant.
That distinction matters.
Why Are You Doing IVF
Before we talk about CoQ10, protein, or any of the nutrition strategies, we need to start with a simple question:
Why are you doing IVF?
It sounds obvious, but I can't tell you how many couples I've worked with who were told IVF was the next step without ever really understanding why they weren't getting pregnant in the first place.
IVF is a treatment.
It is not a comprehensive fertility workup.
There are absolutely situations where IVF may be the best option, including severe tubal disease, severe male factor infertility, genetic conditions, and certain situations involving age and ovarian reserve.
I'm not anti-IVF.
I'm very pro using the right tool for the right couple.
But if the explanation is essentially, "You've been trying long enough, and you're not pregnant, so let's do IVF," I want to know what we're missing.
Have you confirmed that you're ovulating well?
Have thyroid function and prolactin been appropriately evaluated?
What do blood sugar and insulin regulation look like?
What about iron and nutrient status?
Have the uterus and fallopian tubes been thoroughly evaluated?
What does the uterine microbiome look like?
Have you thoroughly evaluated the male partner?
And I don't mean simply looking at a semen analysis and saying it's fine.
Depending on your history, we should also be considering sperm DNA fragmentation.
Investigating Endometriosis Before IVF
If you've experienced recurrent pregnancy loss, has that been appropriately investigated?
What do your periods look like?
Do you have signs of endometriosis?
And have those symptoms potentially been dismissed for years?
For some women, infertility may be the only sign of potential endometriosis.
The goal isn't simply to get you through an IVF cycle.
The goal isn't even a positive pregnancy test.
The goal is a healthy baby and a healthy mom at the end of this.
That's why endometriosis needs to be part of the conversation when the symptoms or history suggest it.
Maybe you've been told your painful periods are normal.
Maybe you've always had pain with sex.
Maybe you have bowel symptoms around your period.
Maybe you have unexplained infertility, and nobody has ever talked to you about endometriosis.
Going through IVF does not make those questions irrelevant.
IVF may help bypass some of the fertility challenges associated with endometriosis, but it does not make endometriosis go away.
I am not saying that every woman with unexplained infertility has endometriosis.
But when there are risk factors or symptoms, it should be appropriately evaluated before IVF.
This is an individualized conversation.
There's a huge difference between making an informed decision to move forward with IVF knowing what is part of your fertility picture and moving forward without investigating it at all.
Why Informed Consent Matters
You deserve to know what's happening in your body, especially before moving into a treatment that requires significant medications, procedures, time, money, and emotional energy.
IVF has become so common that I think sometimes we forget it is still a medical procedure.
It is not completely risk-free.
There are medication side effects and procedural risks.
I don't say that to scare you.
I say it because informed consent matters.
If you're going to put your body through IVF, let's make sure we're doing everything reasonably possible to understand your fertility first.
Why I Recommend Three Months of IVF Preparation
Now let's talk about the part I know is hard: waiting.
I want at least three months of preparation before IVF medications begin when medically appropriate.
Not three months before transfer.
Three months before stimulation.
And I want both partners preparing.
This does not mean spending three months trying to achieve some perfect fertility lifestyle.
Please don't do that to yourself.
You don't need 17 supplements or a perfect diet.
You don't need to throw everything away in your kitchen and replace every product in your house.
The point is to use this window strategically and intentionally.
Eggs don't suddenly appear on the day you start stimulation.
Sperm doesn't suddenly appear on the day of retrieval.
These cells have been developing in the environment you've created in the months leading up to IVF.
That environment is influenced by:
Nutrient availability
Oxidative stress
Metabolic health
Inflammation
Sleep
Alcohol
Smoking
Diet
Overall health
What I've Seen After IVF Preparation
I've had couples come to me after failed IVF cycles, spend several months working on barriers that weren't addressed initially, and then never go back to IVF because they became pregnant without it.
I've also had couples who absolutely still needed IVF or chose to stop waiting and move into another IVF cycle.
When they went back to IVF, their outcomes looked completely different.
They had more eggs, better fertilization, more embryos making it to blastocyst, better-quality embryos, positive pregnancy tests, and healthy babies.
That's my clinical experience.
It isn't a promise that three months of preparation will produce these results for everyone.
But the more targeted we can be with you as an individual, the better we can support your outcomes.
After seeing this happen again and again, I cannot look at those three months as wasted time.
I look at them as part of the treatment plan.
Sometimes slowing down is what gets you to your baby faster.
Protein and Nutrition Before IVF
One of the biggest opportunities I see during IVF preparation has nothing to do with an expensive supplement.
It's food.
And specifically, protein.
One study of 120 women undergoing IVF found that women getting more than 25% of their calories from protein had substantially higher blastocyst development compared with women eating less protein.
The reported blastocyst development was around 64% compared with 34%.
Live birth rates were 58.3% compared with 11.3%.
When higher protein intake was combined with carbohydrate intake below 40% of calories, clinical pregnancy rates were reported around 80%.
This was a small observational study.
I don't want you hearing those numbers and deciding that 26% protein is a magic number for IVF.
It might not be right for you.
And it does not mean carbohydrates are bad for fertility.
What I think is useful about this research is that it gets us thinking about whether you're actually eating enough protein.
I see this constantly.
Coffee in the morning.
Maybe some oatmeal.
A salad at lunch with a little chicken and a handful of almonds in the afternoon.
Then dinner is the first time you eat a substantial amount of protein.
If that's you, this is one of the easiest places to start.
Instead of obsessing over percentages, build your meals around protein.
For many women, that might look like roughly 25–35 grams at breakfast, lunch, and dinner, then individualizing your total intake based on body size, activity, metabolic health, and individual needs.
Start with breakfast.
That might look like eggs and another protein source, Greek yogurt or cottage cheese if you tolerate dairy, leftover meat or fish, or a protein smoothie.
It doesn't need to be complicated.
Choosing Nutrient-Dense Carbohydrates
Pair your protein with nutrient-dense carbohydrates.
Think fruits, beans, lentils, potatoes, and squash.
These foods provide fiber and important minerals that support overall fertility.
Carbohydrate quality matters more than declaring carbohydrates good or bad.
Research from the Nurses' Health Study followed more than 17,000 women and found associations between dietary patterns and ovulatory infertility.
This was not an IVF trial, so we cannot take those findings and say that a specific diet will improve IVF live birth rates.
But it adds to something I talk about constantly:
Your fertility responds to your overall environment.
If we're supporting ovulation, we're also supporting egg quality and the environment where those eggs are maturing.
Rather than trying to find the perfect IVF diet, ask yourself:
Am I eating enough?
Am I getting enough protein?
Am I eating omega-3-rich fish?
Am I getting plants and fiber every day?
Are most of my carbohydrates coming from whole-food sources?
Am I eating a lot of added sugar?
Am I going five or six hours without eating and then crashing later?
These are things you can actually work on.
Supplements Before IVF
Supplements can help fill nutritional gaps and support the IVF process.
But supplements are not a quick fix.
They are meant to supplement the foundation you're already building.
Instead of asking, "What are the best IVF supplements?" I want you to ask:
What does my body need?
More supplements do not necessarily equal better fertility.
There are a few supplements with interesting research behind them.
CoQ10 for IVF Preparation
CoQ10 is one of the most talked-about supplements for IVF.
It's involved in mitochondrial energy production, and eggs are incredibly energy-demanding cells.
Research has associated CoQ10 supplementation with more retrieved eggs, more optimal embryos, higher clinical pregnancy rates, and fewer canceled cycles.
CoQ10 may be especially worth discussing with your fertility dietitian if you have diminished ovarian reserve or have had a poor response to IVF in the past.
It's also something that should be started before IVF.
A minimum of three months before IVF is typically recommended to support the follicles that stimulation medications will later mature more rapidly.
Starting ahead of time gives those developing follicles more opportunity to benefit from that mitochondrial support.
Melatonin for IVF
Most people think of melatonin as something that supports sleep.
But melatonin also functions as an antioxidant.
Research in women undergoing IVF has found improvements in mature oocytes, fertilization, embryo quality, and clinical pregnancy.
I don't automatically recommend melatonin to every client.
You need to consider your individual situation.
Lower doses are often better, with three to five milligrams being the range I commonly consider.
We can also overdo it.
Supporting your natural circadian rhythm and sleep is important because that can support your body's own melatonin production.
NAC and Vitamin C
NAC, or N-acetylcysteine, supports glutathione, one of the body's major antioxidant systems.
There is research suggesting it may support egg and embryo quality in certain populations, including women of advanced reproductive age.
NAC can be a helpful option to consider during the preparation period, but it isn't appropriate for everyone.
Vitamin C is another important antioxidant.
More isn't automatically better, but research has found improved IVF outcomes when vitamin C supplementation was started before the IVF cycle.
The important point is that these supplements should support the foundation.
You can take CoQ10, NAC, melatonin, vitamin C, and every other antioxidant you want and still be missing the biggest fertility barriers in your body.
Don't Use Supplements as Band-Aids
If your fasting insulin is high, your ferritin is low, you're not eating enough, you're sleeping six hours a night, or nobody has investigated possible endometriosis despite years of symptoms, those are bigger issues.
Maybe your partner had one basic semen analysis three years ago, and that was the end of the fertility workup.
We need to start there.
Those are going to be the heavier hitters, not the supplements.
Supplements should support your plan, not distract you from the things that actually need to be addressed.
IVF Preparation Is Couples Preparation
Your partner needs to prepare too.
You cannot do IVF preparation on your own.
IVF preparation is couples preparation.
Half of the genetic material in the embryo comes from sperm.
If you have three months or more before IVF, I want both partners using those months strategically.
Look at nutrition, sleep, alcohol intake, tobacco and marijuana use, heat exposure, metabolic health, medications that may impact sperm health, nutrient status, and semen parameters.
Sperm DNA fragmentation should also be considered when appropriate because it can be changed, and conventional semen analysis cannot tell you whether sperm DNA is fragmented.
Sperm with higher DNA fragmentation can contribute to fewer embryos making it to blastocyst and can affect continued embryo development after transfer.
Higher DNA fragmentation is also associated with a higher risk of miscarriage.
I don't want the woman spending three months changing every detail of her life while her partner is simply told to show up on retrieval day.
We can do much better than that.
Sperm also impacts placental development and pregnancy outcomes, as well as the lifelong health of your future child.
What I Would Do Three Months Before IVF
If I were planning IVF and had three months before medications began, this is where I would start.
Number one: Understand why we're doing IVF.
Ask what barriers have been found.
If you're being told there is nowhere else to look, consider finding additional support and making sure the uterine and gut microbiome, mineral status, and previous labs have been appropriately evaluated.
There are significant gaps in the conventional fertility protocol.
Number two: Investigate what has been missed.
If you have symptoms of endometriosis, talk about them.
If you've had recurrent pregnancy losses, make sure you've been appropriately evaluated.
If you've had failed IVF cycles, don't automatically repeat the exact same thing without asking what you learned from the previous cycle.
If you're simply told you have "bad quality eggs," that's not a complete answer.
Egg quality can change.
Sperm quality can change.
The uterine microbiome can change.
We need more investigation to better support your body.
Number three: Evaluate both partners.
Both partners need a comprehensive evaluation and preparation plan.
Number four: Build the food foundation.
Eat enough.
Eat meaningful amounts of high-quality, bioavailable protein at every meal.
Eat omega-3-rich seafood two or three times per week.
Eat plenty of colorful plants and fiber.
Build meals that support stable blood sugar.
Don't skimp on carbohydrates.
Reduce added sugar and heavily processed foods.
And please don't crash diet before IVF.
We want your body feeling nourished and safe so it can produce high-quality eggs that can help create high-quality embryos.
Number five: Look at your actual nutrient status.
Your prenatal is important.
But taking a prenatal does not automatically mean you have adequate nutrient stores.
We can go much deeper and make this much more individualized.
Number six: Prioritize sleep.
Seven hours is better than five.
Eight is better than six.
You don't need a perfect bedtime routine.
Start by giving yourself enough opportunity to sleep.
Number seven: Individualize your supplements.
CoQ10 may make sense.
NAC may make sense.
Melatonin may make sense.
Vitamin C may make sense.
But I want a reason for everything you're taking.
And finally: Give your body time to respond.
You Are Not Wasting Time
If you decide to take three months or more to prepare for IVF, you are not doing nothing.
You are not just waiting.
You're not falling behind.
You're using that time.
You're investigating why you're struggling to conceive.
You're correcting deficiencies.
You're improving metabolic health.
You're eating enough protein.
You're supporting egg and sperm health.
You're addressing the things that may have been overlooked.
And you're giving your body the raw materials it needs before asking it to go through something incredibly demanding.
I've worked with couples who came to me convinced IVF was their only option because that's what they were told.
Some never went back because they conceived while working on their health.
Others did go back, and their next IVF cycle looked completely different.
Both are wins.
I'm not interested in proving that you can get pregnant naturally.
I'm interested in helping you get your healthy baby.
Sometimes IVF is part of the story.
Sometimes it isn't.
But IVF and preconception care should never be treated like opposites.
You can use reproductive technology and support the biology behind your fertility.
If IVF is on the calendar, resist the urge to race to the starting line just because you're desperate to get to the finish line.
When it's medically appropriate, take the time to prepare.
Ask better questions.
Investigate what hasn't been investigated.
Get both partners involved.
Feed your body well.
Correct what needs correcting.
And go into IVF knowing that you've done everything reasonably within your control to give that cycle the strongest starting point possible.
Sometimes taking the time to prepare is exactly what gets you to your healthy baby faster.