You should consider taking multiple steps before and during an in vitro fertilization (IVF) cycle. This will help increase the chances that this infertility treatment is likely to result in a healthy pregnancy.

guide to ivf
Illustration by Alyssa Keifer

You may have several emotions as you prepare for, start, and complete an IVF cycle. After all, IVF can take time, be physically demanding, and cost quite a bit.

Around 2 weeks of regular hormone shots can also heighten your emotions and make your body feel completely out of whack.

The days leading up to your IVF cycle are very important for ensuring your body is healthy, strong, and fully prepared for this fairly intense medical process.

An IVF cycle involves several stages. It’s common to need more than one IVF cycle before you keep your pregnancy.

Here’s a breakdown of the stages:

Preparation

The prep stage begins 2 to 4 weeks before you start your IVF cycle. It includes making small lifestyle changes to ensure that you’re at your healthiest.

Your doctor might recommend medications to help regulate your menstrual cycle, which will make the rest of the IVF stages easier.

Stage 1

Day 1 of your IVF is the first day of your period closest to the scheduled IVF treatment. This stage takes one day.

Stage 2

You’ll begin fertility drugs that stimulate your ovaries so you’ll ovulate. They’ll release more eggs than usual.

This stage can take anywhere from 3 to 12 days.

Stage 3

You’ll receive an injection of the “pregnancy hormone,” or human chorionic gonadotropin (hCG). This hormone helps your ovaries release some eggs.

Exactly 36 hours after the injection, you’ll be at the fertility clinic where your doctor will retrieve the eggs to use in the next stage.

Stage 4

This stage takes one day. Your partner or a donor will have already provided sperm or will do so during egg retrieval.

Your eggs will be fertilized within hours. This is when you’ll begin taking a hormone called progesterone, which helps prepare your uterus for a healthy pregnancy and reduces the chance of a miscarriage.

Stage 5

Less than a week after your eggs were fertilized, a healthy embryo will be put back into your uterus. This is a noninvasive procedure. You may feel mild discomfort or cramping.

Stage 6

You’ll be back in your doctor’s office 9 to 12 days later.

They’ll check on how well your body has taken to the implanted embryo. You’ll also have a blood test to check your pregnancy hormone levels.

Below, we cover the lifestyle changes that’ll best support your body and general health during your IVF cycle and pregnancy.

What to eat

Focus on eating healthy, balanced meals. Don’t make any major or significant changes to your diet during this time, such as going gluten-free if you weren’t already.

Aimee Eyvazzadeh, MD, a fertility doctor, recommends a Mediterranean-style diet. Its plant-based, colorful foundation should provide the nutrition your body needs.

A small study from 2018 shows that a Mediterranean diet may improve the IVF success rate among women who are under 35 years old and who don’t have obesity.

Since diet also affects sperm health, if you’re using a partner’s sperm, encourage them to stick to the Mediterranean diet with you.

Here are easy ways to revamp your nutrition with the Mediterranean diet:

How to work out

Eyvazzadeh recommends continuing your current exercise routine, especially if you already have a consistent fitness regimen, are of a moderate weight, and have a healthy uterus.

If you don’t have a current fitness routine, speak with your doctor for their recommendations. Try to avoid anything too strenuous.

Avoid running long distances

Eyvazzadeh recommends that all people undergoing IVF limit their running to no more than 15 miles per week.

She explains that it can have negative effects on the thickening of the uterus lining and shift blood away from the uterus to other organs and muscles when the reproductive system needs it most.

If you’re an avid runner, replace your long runs with these gentler options:

Chemicals to avoid

Consider tossing, avoiding, or swapping out some household items made with endocrine-disrupting chemicals (EDCs), which may interfere with:

  • hormones
  • reproductive health
  • prenatal development

Examples of common products that contain EDCs include:

Other chemicals and common products to avoid or swap with natural alternatives include:

  • formaldehyde: nail polish
  • parabens, triclosan, and benzophenone: cosmetics, moisturizers, soap
  • brominated flame retardants: furniture, clothing, electronics, yoga mats
  • dioxins: meat, dairy, art clay

You can check product labels for these chemicals.

Tell your fertility doctor about any medications you take as you prepare to start your IVF cycle. Make sure to list everything, even the most ordinary drugs, like:

  • a daily allergy pill
  • acetaminophen or ibuprofen
  • any prescriptions
  • over-the-counter (OTC) supplements

Some medications could potentially:

  • interfere with fertility drugs
  • cause hormonal imbalances
  • make IVF treatment less effective

Medications to flag to your fertility doctor

Some medications react with or affect fertility drugs and should not be taken together. Your doctor should know which ones are safe or unsafe for you to continue.

Certain antianxiety, antidepressant, antiseizure, and thyroid medications may be safe to continue with monitoring or dose adjustment. Others may not be.

Ask your doctor if it’s possible to prescribe alternatives during your IVF cycle and even during pregnancy if you currently take one that should not be taken with fertility drugs.

Start a prenatal vitamin in the 30 days (or even several months) before your IVF cycle begins. Prenatal vitamins can even help boost sperm health.

Many prenatal vitamins increase your folic acid. This vitamin protects against brain and spinal birth defects in developing fetuses.

Eyvazzadeh also recommends fish oil, which can support embryonic development.

If your vitamin D levels are low, start taking vitamin D supplements before your IVF cycle. This may help reduce the risk of developmental problems early on.

Choosing quality supplements

The FDA doesn’t regulate supplements for quality and purity like it does medications. Always review supplements with your doctor and buy from trusted sources before you add them to your daily nutrition.

Check labels for an NSF International certification. This means the supplement has been certified as safe by independent evaluation organizations.

Sleep and fertility are closely connected. Getting the right amount of sleep can help support your IVF cycle.

A 2022 study found that compared to shorter sleep duration, those who slept more had a lower risk of pregnancy and birth complications. The general recommendation is 7 to 9 hours.

Eyvazzadeh notes that melatonin, a hormone that regulates both sleep and reproduction, peaks between 9 p.m. and midnight. This makes 10 p.m. to 11 p.m. the ideal time to fall asleep.

Here are a few ways to make healthy sleep part of your routine:

  • Cool your bedroom to 60 to 67ºF (16 to 19ºC).
  • Take a warm shower or bath just before bed.
  • Diffuse lavender in your bedroom (or in the shower).
  • Avoid caffeine 4 to 6 hours before bedtime.
  • Don’t eat big meals 2 to 3 hours before bedtime.
  • Listen to soft, slow music.
  • Limit screen time for at least 30 minutes before bed. This includes phones, TVs, and computers.
  • Do gentle stretches.

In the 3 to 4 days before a sperm retrieval, those with a penis should avoid ejaculation, manually or vaginally, says Eyvazzadeh.

She notes that it’s best if the “whole pot [is] full” of the very best sperm when it comes time to collect, as opposed to sourcing “what’s left” from a post-ejaculate sample.

That doesn’t mean total abstinence from sex, though, as long as there isn’t ejaculation during the prime sperm development window.

She also recommends keeping penetration shallow and avoiding deep vaginal intercourse, as this can irritate the cervix.

Eyvazzadeh says it’s possible to drink in moderation. But beware that a couple of drinks during the week could have negative effects on the outcome of the IVF cycle.

Also, you may not respond well to alcohol on top of the fertility drugs.

A study from 2022 indicates that regular consumption of alcohol may reduce the chance of pregnancy and live birth after fertility treatment.

Once you’ve completed the embryo transfer, you should abstain from drinking alcohol.

Every person and every cycle are different, so there’s no sure way to know which side effect you’ll experience on any given day of any given cycle.

Here are some ways to manage the side effects of fertility drugs.

Bleeding or spotting

Eyvazzadeh advises people to “expect the worst period of their life after an IVF cycle, because the hormones used not only help the eggs to grow, but also thicken the lining.”

She cautions that this isn’t everyone’s experience, but if it’s yours, try not to worry. Take pain medications as needed and per your doctor’s recommendations.

  • Call your doctor immediately if bleeding or spotting occurs during the cycle.
  • Light bleeding or spotting after an egg retrieval is normal. Heavy bleeding is not.
  • Do not use tampons.

GI and digestive issues

Plenty of OTC options can help treat digestive issues:

Before taking any OTC drugs, talk with your doctor and ask about the best dosage for you.

Bloating

Taking in more fluids can relieve bloating. If water is getting tiresome, hydrate yourself with coconut water or low sugar electrolyte drinks or tablets.

Nausea

If natural remedies aren’t working, try an anti-nausea medication, such as:

But first, talk with your doctor to make sure OTC anti-nausea drugs are safe.

Headache and pain

Some OTC remedies for pain relief include acetaminophen and heating pads. Ibuprofen is not suitable to take during the IVF cycle.

Before taking any OTC drugs, talk with your doctor and ask about the best dosage for you.

Exhaustion and fatigue

  • Try to get 7 to 9 hours of sleep each night.
  • Try taking 30- to 45-minute naps during the day, but not before bed.
  • Take it easy (and say “no” whenever you want to!).

Stress and anxiety

  • Practice a slow, restorative breathing regimen.
  • Practice yoga.
  • Continue your exercise regimen.
  • Stick to any established routines and schedules.
  • Get plenty of sleep.
  • Take warm showers or baths.
  • Speak with a therapist.

Hot flashes

  • Wear light, breathable clothing.
  • Stay in air-conditioned spaces.
  • Add a fan to your bedside or desk, or keep a portable one with you.
  • Stay hydrated with cool water.
  • Avoid smoking, spicy foods, and caffeine.
  • Practice deep-breathing exercises.
  • Do low impact exercises like swimming, walking, or yoga.

Starting to take care of yourself early can be very helpful. Doing so will help you better manage some of the pain points of an IVF cycle.

Here are some tips:

  • Drink plenty of water.
  • Get plenty of sleep and treat yourself to naps.
  • Stock up on your favorite snacks.
  • Socialize with friends.
  • Do yoga or other gentle exercises.
  • Meditate.
  • Take a long, warm bath.
  • Read a book.
  • Journal to track your thoughts and feelings.

If you have a partner, diet, sleep patterns, and self-care are important for them, too, especially if they’re providing a sperm sample.

Here are ways your partner can support your IVF efforts:

  • Drink less alcohol: A 2019 study found that men who drank alcohol daily contributed to the reduced success of the IVF cycle. Not smoking — weed or tobacco — helps, too.
  • Sleep well: Not getting enough sleep (at least 7 to 9 hours per night) can affect testosterone levels and sperm quality.
  • Avoid chemicals: A 2019 study showed that some chemicals and toxins may lower sperm quality.
  • Wear boxers: A 2018 study suggests that wearing boxers may be better for sperm quality than tight options.
  • Eat well and exercise: A moderate weight and balanced nutrition can improve sperm quality.
  • Be supportive: The most important thing your partner can do is be there for you. Turn to them to talk, listen, get help with shots, be proactive about pain medication, manage appointments, and pick up the slack.

Completing an IVF cycle is an important moment in your life. To increase the chances that IVF is successful, it’s important to follow a few steps before, during, and after a cycle.

But rememer: It usually takes more than one cycle before you keep your pregnancy.

It’s important to maintain a balanced diet, a gentle exercise routine, and care for your body in other ways, such as taking prenatal vitamins and getting enough sleep.

Speak with your doctor or a fertility specialist about what you should be doing to take care of yourself during this time.

Brandi Koskie is the founder of Banter Strategy, where she serves as a content strategist and health journalist for dynamic clients. She’s got a wanderlust spirit, believes in the power of kindness, and works and plays in the foothills of Denver with her family.