The most impactful things you can do to improve IVF success happen in the months before your cycle starts. Eggs take roughly 90 days to mature before they’re retrieved, which means your body weight, diet, sleep, supplements, and your partner’s sperm health all have a meaningful window of influence. Some of these factors carry surprisingly large effects, while several popular add-on tests and technologies show less benefit than clinics sometimes suggest.
Start Preparing Three Months Out
An egg that gets retrieved during your IVF cycle began developing about three months earlier. That 90-day maturation window is your best opportunity to influence egg quality through lifestyle changes and supplements. The IVF cycle itself, from ovarian stimulation through egg retrieval, takes only about two to three weeks. But the groundwork that shapes the quality of those eggs happens well before your first injection.
Body Weight Has a Clear, Measurable Effect
A large study using data from the Society for Assisted Reproductive Technology found that the highest IVF live birth rates occurred in patients with a BMI between 23 and 25. The relationship was nonlinear: as BMI moved in either direction from that range, success rates dropped progressively. Patients with a BMI under 18.5 had an 11% lower probability of live birth compared to the optimal range, while those with a BMI of 40 or above had a 27% lower probability.
Even modest differences mattered. A BMI of 18.5 to 20 carried a 7% reduction, and 20 to 23 showed a 2% reduction. You don’t need to hit a perfect number, but getting closer to the 23 to 25 range in the months before treatment gives you a statistical edge. Extreme dieting right before a cycle isn’t the goal. Gradual, sustainable changes over those three preparatory months are more realistic and less disruptive to your hormonal balance.
The Mediterranean Diet Stands Out
Among dietary patterns studied in IVF patients, the Mediterranean diet has the strongest evidence. Women who closely followed this eating pattern had roughly 25% higher odds of a live birth compared to those who didn’t. A meta-analysis published in Advances in Nutrition found the association was nearly twofold for live birth when pooling data across studies.
In practical terms, this means building meals around vegetables, whole grains, legumes, nuts, olive oil, and fish, while limiting red meat and processed foods. You don’t need to overhaul your diet overnight. Shifting toward this pattern during the three months before your cycle gives your developing eggs the best nutritional environment.
Sleep Quality Affects Egg Retrieval Numbers
A prospective study tracking IVF patients found that poor sleep quality was associated with about 23% fewer eggs retrieved and a similar reduction in mature eggs. But the relationship isn’t as simple as “sleep more.” Women who slept 10 or more hours per night actually had 31% fewer retrieved eggs and 46% fewer good-quality embryos compared to moderate sleepers.
Difficulty falling asleep was particularly damaging. Women who struggled to fall asleep more than three times a week saw a 64% reduction in blastocyst rates, which is the stage embryos need to reach for transfer. Even napping too long carried a penalty: daily naps exceeding one hour were linked to a 74% lower oocyte maturation rate. Short naps appeared fine, but longer ones significantly disrupted outcomes. The takeaway is that consistent, moderate sleep (roughly 7 to 9 hours) with minimal disruption matters more than simply clocking extra hours.
Supplements That Have Clinical Support
CoQ10 is the most studied supplement for egg quality. In a 2018 clinical study, women who took 200 mg three times daily for two months before IVF needed less stimulation medication, produced more eggs, had higher fertilization rates, and achieved better embryo quality. The total daily dose was 600 mg, taken for at least 60 days before the cycle.
A separate study combined CoQ10 (600 mg per day) with DHEA (75 mg per day) and found an increase in the number of developing follicles visible on ultrasound, though pregnancy rates didn’t differ significantly. DHEA on its own is sometimes recommended for women with diminished ovarian reserve, but it should be discussed with your fertility doctor since it’s a hormone precursor and can affect androgen levels.
Melatonin, typically used as a sleep aid, also acts as an antioxidant in the ovarian follicle and is commonly included in fertility supplement protocols. Your clinic may recommend specific combinations based on your diagnosis.
Don’t Overlook Sperm Health
IVF success depends on both egg and sperm quality. Sperm DNA fragmentation, where the genetic material inside sperm is damaged, can reduce fertilization rates, lower embryo quality, and increase miscarriage risk. The most common causes are smoking, heavy alcohol use, obesity, oxidative stress, and advanced paternal age.
The good news is that sperm cells regenerate every 72 to 74 days, so lifestyle changes in the partner can have a real impact within two to three months. Quitting smoking, reducing alcohol, reaching a healthier weight, and taking antioxidant supplements all help lower DNA fragmentation. Shortening the period of abstinence before providing a sample (from the commonly recommended 3 to 5 days down to 1 to 2 days) can also reduce fragmentation in the collected specimen. If fragmentation is very high, clinics can use advanced sperm selection techniques to choose the healthiest cells.
Fresh vs. Frozen Embryo Transfer
Whether to transfer a fresh or frozen embryo depends on your clinical situation, but the data isn’t one-size-fits-all. A 2025 randomized controlled trial published in The BMJ found that for women with a low prognosis (fewer eggs, lower expected success), fresh transfer actually outperformed frozen. Live birth rates were 40% with fresh transfer compared to 32% with frozen. Clinical pregnancy rates followed the same pattern: 47% versus 39%.
Frozen transfers are often preferred in cases where ovarian hyperstimulation is a risk, when embryos need genetic testing, or when the uterine lining isn’t optimal at the time of retrieval. For patients with a good response to stimulation and no medical reason to delay, a fresh transfer can be equally or more effective. This is a decision best made with your doctor based on your specific cycle.
Genetic Testing of Embryos: Know the Limits
Preimplantation genetic testing for aneuploidy (PGT-A) screens embryos for chromosomal abnormalities before transfer. It’s widely offered and often presented as a way to boost success, but the evidence is more nuanced than many clinics convey.
The largest randomized trial (the STAR trial) found no significant difference in ongoing pregnancy rates between PGT-A and standard IVF: 50% versus 46% per transfer. A 2021 multicenter trial found that live births actually occurred in 77% of the PGT-A group compared to 82% in the conventional IVF group. A Cochrane review concluded there was insufficient evidence of a difference in cumulative live birth rates with or without PGT-A.
Where PGT-A does show a clearer benefit is in reducing miscarriage rates, particularly for women over 38. National registry data shows miscarriage rates of 14% with PGT-A versus 28% without it for women aged 38 to 40, and 14% versus 38% for women 41 to 42. If you’ve experienced recurrent miscarriage or are over 38, PGT-A may reduce emotional and physical toll by screening out embryos unlikely to result in a healthy pregnancy. For younger patients with a good prognosis, it may not improve your overall chance of taking a baby home.
Skip the ERA Test
The Endometrial Receptivity Analysis (ERA) tests whether your uterine lining is ready for embryo implantation and recommends adjusting transfer timing if it’s not. It gained popularity as an add-on for patients with repeated implantation failure. However, multiple studies, including a double-blind multicenter randomized trial, have found no benefit.
Live birth rates were virtually identical whether patients had ERA-guided transfers or standard timing: 58.5% versus 61.9% in one large trial, and 51.5% versus 56.8% in another. Even in patients who had previously failed transfers, ERA-guided timing did not improve implantation or pregnancy rates. This is one add-on you can confidently skip, saving both cost and an additional procedure cycle.
A Practical Preparation Checklist
Three months before your planned IVF cycle, the highest-impact changes to make are:
- Diet: Shift toward a Mediterranean eating pattern rich in vegetables, whole grains, fish, and olive oil.
- Weight: Aim for a BMI in the 23 to 25 range if possible, through gradual changes rather than crash dieting.
- Sleep: Prioritize 7 to 9 hours of consistent sleep, avoid long naps, and address any difficulty falling asleep.
- Supplements: Discuss CoQ10 (600 mg daily) with your clinic, and consider DHEA if you have diminished ovarian reserve.
- Partner health: Your partner should stop smoking, limit alcohol, and consider antioxidant supplements to protect sperm quality.
- Add-ons: Be skeptical of expensive extras like ERA testing. Ask your clinic what evidence supports any recommended add-on for your specific situation.
IVF success is never guaranteed, and age remains the single strongest predictor of outcomes. But these modifiable factors, taken together, represent the best evidence-based strategy for giving any individual cycle the highest possible chance.